Citric Acid / Lactic Acid / Potassium Bitartrate
Citric acid, lactic acid, and potassium bitartrate is a hormone-free combination gel used as on-demand contraception to prevent pregnancy.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 2 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Citric Acid / Lactic Acid / Potassium Bitartrate: Patient Information Guide
A plain-language walkthrough of Citric Acid / Lactic Acid / Potassium Bitartrate — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
What Citric Acid / Lactic Acid / Potassium Bitartrate is used for
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This ingredient combination is found in vaginal gels used for hormone-free, on-demand contraception.
- Phexxi (vaginal gel): FDA-approved to prevent pregnancy in people of reproductive potential, used as needed before vaginal intercourse.
- Phexx (vaginal gel): FDA-approved to prevent pregnancy in people of reproductive potential, used as needed before vaginal intercourse.
- Neither Phexxi nor Phexx is effective if applied after intercourse has occurred.
- These products are not indicated for use before the onset of the first menstrual period.
How Citric Acid / Lactic Acid / Potassium Bitartrate works
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Semen is naturally alkaline, which can raise vaginal pH and make conditions more hospitable for sperm. Lactic acid, citric acid, and potassium bitartrate work together to buffer vaginal pH — keeping it in the normal, slightly acidic range (3.5–4.5) even when semen is present. In clinical studies, this acidic environment significantly reduced sperm motility (movement), making it harder for sperm to reach and fertilize an egg.
How Citric Acid / Lactic Acid / Potassium Bitartrate is taken (dosage)
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Phexxi and Phexx each come as a pre-filled vaginal applicator used right before sex — no daily pill or hormone schedule required. Insert one applicator vaginally up to one hour before each act of vaginal intercourse. If more than one act occurs within that hour, an additional dose is needed for each additional act. Both products can be used at any point in the menstrual cycle.
- Must be used before intercourse — not after.
- Can be restarted after childbirth, abortion, or miscarriage when vaginal intercourse is safe to resume.
- May be combined with condoms, diaphragms, or hormonal contraceptives; do not use with vaginal rings.
Citric Acid / Lactic Acid / Potassium Bitartrate side effects in detail
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Most side effects are local — affecting the vaginal area — and the majority are mild.
- Vaginal burning sensation (most common)
- Vaginal itching (pruritus)
- Vaginal discomfort or pain
- Vaginal discharge
- Yeast infection (vulvovaginal mycotic infection)
- Urinary tract infection (UTI)
- Bacterial vaginosis
- Painful urination (dysuria)
- Genital discomfort reported by some male partners
Serious reactions to watch for: signs of a kidney infection (fever, back or flank pain, nausea) or an allergic reaction. Contact your doctor right away if these occur.
Citric Acid / Lactic Acid / Potassium Bitartrate warnings and precautions
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- Urinary tract and kidney infections: A small percentage of people in clinical trials developed bladder infections (cystitis) or kidney infections (pyelonephritis) — one case required hospitalization. Anyone with a history of recurrent UTIs or urinary tract abnormalities should not use Phexxi or Phexx.
- Hypersensitivity (allergic reaction): At least one case of suspected drug hypersensitivity was reported. Avoid use if you have known sensitivity to any ingredient.
- Not effective after intercourse: Using the gel after sex will not prevent pregnancy.
Citric Acid / Lactic Acid / Potassium Bitartrate interactions: what it interacts with
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Phexxi and Phexx have a few important compatibility considerations with other products used vaginally or for contraception.
- Vaginal rings: Avoid using Phexxi or Phexx alongside vaginal rings — the combination is not recommended.
- Condoms and diaphragms: Safe to use together with latex, polyurethane, and polyisoprene condoms, as well as vaginal diaphragms.
- Hormonal contraceptives: Can be used alongside hormonal birth control methods.
- Vaginal infection treatments: Miconazole, metronidazole, and tioconazole do not significantly affect how Phexxi or Phexx work — they can be used together safely.
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
Before taking Citric Acid / Lactic Acid / Potassium Bitartrate
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- Recurrent UTIs or urinary tract abnormalities: Do not use Phexxi or Phexx if you have a history of frequent urinary tract infections or structural urinary tract problems.
- Pregnancy: Discontinue use if you become pregnant — there is no role for this product during pregnancy.
- Breastfeeding: No data exist on whether the ingredients pass into breast milk; discuss with your healthcare provider.
- Before first period (pre-menarche): This product is not indicated for use before menarche.
- Allergies: Do not use if you have had a hypersensitivity reaction to lactic acid, citric acid, or potassium bitartrate.
Pharmacokinetics: how your body processes Citric Acid / Lactic Acid / Potassium Bitartrate
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Formal pharmacokinetic studies in humans have not been performed for Phexxi or Phexx. The amounts of lactic acid, citric acid, and potassium bitartrate absorbed into the bloodstream after vaginal application are not expected to raise any safety concerns. Lab studies showed that commonly used vaginal treatments — including miconazole, metronidazole, and tioconazole — do not meaningfully alter the pH or buffering ability of the gel.
How to store Citric Acid / Lactic Acid / Potassium Bitartrate
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Store in the original foil pack at room temperature 20°C to 25°C (68°F to 77°F); excursion permitted between 15°C to 30°C (59°F to 86°F) .
📄 Written from Citric Acid / Lactic Acid / Potassium Bitartrate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Citric Acid / Lactic Acid / Potassium Bitartrate: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Citric Acid / Lactic Acid / Potassium Bitartrate — the kind of thing our pharmacy team would talk through with you at the counter.
How exactly do I use Phexxi or Phexx — do I take it like a pill?
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Does it protect against STIs (sexually transmitted infections)?
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Can I use Phexxi or Phexx with my other birth control or vaginal medications?
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What side effects should I expect, and when should I call my doctor?
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I get UTIs a lot. Is this product safe for me?
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Can I use this while breastfeeding or if I'm pregnant?
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Is Citric Acid / Lactic Acid / Potassium Bitartrate available over the counter?
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When was Citric Acid / Lactic Acid / Potassium Bitartrate first available?
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💬 Answers drafted from Citric Acid / Lactic Acid / Potassium Bitartrate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 More about Citric Acid / Lactic Acid / Potassium Bitartrate on HelloPharmacist
💊 Citric Acid / Lactic Acid / Potassium Bitartrate forms and strengths (how it comes)
Citric Acid / Lactic Acid / Potassium Bitartrate is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Vaginal cream or gel
How this form is used
- Phexxi is used to prevent pregnancy in people of reproductive potential as an on-demand contraceptive method.
- Phexx is used to prevent pregnancy in people of reproductive potential as an on-demand contraceptive method.
- Phexxi and Phexx are not effective when applied after intercourse — they must be used beforehand.
- Phexxi: Insert one pre-filled applicator vaginally immediately before or up to one hour before each act of vaginal intercourse; use an additional dose if more than one act occurs within that hour.
- Phexx: Insert one pre-filled applicator vaginally immediately before or up to one hour before each act of vaginal intercourse; use an additional dose if more than one act occurs within that hour.
- Phexxi and Phexx can be used at any point in the menstrual cycle and can be resumed as soon as it is safe to have vaginal intercourse after childbirth, abortion, or miscarriage.
- Avoid using Phexxi or Phexx with vaginal rings; both products can be used alongside condoms, diaphragms, and hormonal contraceptives.
📊 Citric Acid / Lactic Acid / Potassium Bitartrate on the U.S. market: products, makers and brands
How Citric Acid / Lactic Acid / Potassium Bitartrate appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
📈 How widely Citric Acid / Lactic Acid / Potassium Bitartrate is used (Medicaid data)
A general measure of how commonly Citric Acid / Lactic Acid / Potassium Bitartrate is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Citric Acid / Lactic Acid / Potassium Bitartrate is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Citric Acid / Lactic Acid / Potassium Bitartrate prescribed? Of the 1,599 medications we measure, Citric Acid / Lactic Acid / Potassium Bitartrate ranks #821 by Medicaid prescriptions — more than 49% of them.
Utilization by Citric Acid / Lactic Acid / Potassium Bitartrate product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel
Summed across the 2 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2385348
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Citric Acid / Lactic Acid / Potassium Bitartrate, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 5 listed Citric Acid / Lactic Acid / Potassium Bitartrate NDCs with Medicaid activity.
🔍 Compare Citric Acid / Lactic Acid / Potassium Bitartrate products
A representative set of FDA-listed product records for Citric Acid / Lactic Acid / Potassium Bitartrate — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Vaginal cream or gel | ||||
| LACTIC ACID, L- 90 mg/5 g; CITRIC ACID MONOHYDRATE 50 mg/5 g; POTASSIUM BITARTRATE 20 mg/5 g | Vaginal | Evofem, Inc. × 2 listings | NDA | View NDC → |
| 50; 90; 20 mg/5 g; mg/5 g; mg/5 g | Vaginal | Evofem, Inc. | NDA | View NDC → |
Showing 3 of 3 products — FDA National Drug Code Directory. See every product, package size and price: browse all 3 Citric Acid / Lactic Acid / Potassium Bitartrate NDCs →
📈 Citric Acid / Lactic Acid / Potassium Bitartrate side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Citric Acid / Lactic Acid / Potassium Bitartrate — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Citric Acid / Lactic Acid / Potassium Bitartrate in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ Citric Acid / Lactic Acid / Potassium Bitartrate FDA approval history
How Citric Acid / Lactic Acid / Potassium Bitartrate went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Citric Acid / Lactic Acid / Potassium Bitartrate recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.
RxCUI 2385347 1 dose form · 1 strength
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Dose form (SCDF) Vaginal Gel RxCUI 2385346In current FDA listingsClinical drug / strength (SCD) citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MGRxCUI 2385348
Look up RxCUI 2385347 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Citric Acid / Lactic Acid / Potassium Bitartrate supply and shortage status
Whether Citric Acid / Lactic Acid / Potassium Bitartrate is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Citric Acid / Lactic Acid / Potassium Bitartrate brand names
🏭 Who makes Citric Acid / Lactic Acid / Potassium Bitartrate: manufacturers and labelers
Citric Acid / Lactic Acid / Potassium Bitartrate drug class (RxNorm)
Citric Acid / Lactic Acid / Potassium Bitartrate belongs to the Organic acids class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Sources for this Citric Acid / Lactic Acid / Potassium Bitartrate page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 2 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Evofem, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.