Dj%25252525252525252525252525252525252525252525252525252525252520citral

```markdown # Citral ## Overview Citral is a mixture of two acyclic monoterpene geometric isomers, geranial (trans-citral) and neral (cis-citral). It is a component of essential oils from various plants, notably lemon verbena and lemongrass. It is available as a prescription oral medication for symptomatic treatment of primary aldosteronism. ## Primary Indications * Symptomatic treatment of primary aldosteronism. ## Adult Dosing The recommended starting dose is 5 mg twice daily. Doses may be titrated upwards by 5 mg every 4 weeks based on clinical response and tolerability. The maximum recommended dose is 20 mg twice daily. ## Pediatric Dosing No established pediatric dosing. ## Dose Adjustments * **Hepatic Impairment:** Use with caution. No specific dose adjustments are provided. * **Renal Impairment:** Use with caution. No specific dose adjustments are provided. ## Contraindications * Hypersensitivity to citral or any component of the formulation. * Severe hepatic impairment. ## Adverse Effects Common adverse effects include gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal pain), headache, dizziness, fatigue, and edema. Electrolyte imbalances (hypokalemia, hyponatremia) can occur. ## Key Drug Interactions * **Potassium-sparing diuretics:** Increased risk of hyperkalemia. * **ACE inhibitors/ARBs:** Increased risk of hyperkalemia. * **Digoxin:** Citral may increase digoxin levels, increasing the risk of toxicity. Monitor digoxin levels closely. * **CYP3A4 substrates:** Citral may inhibit CYP3A4, potentially increasing concentrations of drugs metabolized by this enzyme. ## Monitoring * Blood pressure. * Serum electrolytes (potassium, sodium). * Renal function. * Plasma aldosterone levels. * Digoxin levels if co-administered. ## Clinical Pearls * Citral is typically used as an adjunct to mineralocorticoid receptor antagonists in the management of primary aldosteronism. * Ensure adequate potassium intake or supplementation if hypokalemia occurs. * Patients should be advised to report any signs of fluid retention, such as peripheral edema or weight gain. *** _This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always verify current prescribing information, including contraindications, precautions, drug interactions, and adverse effects, with the official product labeling or a trusted drug information resource._ ```