Potassium citrate


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Urine alkalinisation; Renal tubular acidosis with calcium stones; Hypocitraturic calcium oxalate nephrolithiasis; Uric acid lithiasis Mild to moderate hypocitraturia (urinary citrate >150 mg/day): As immediate-release tab: Initial: 10 mEq tid. Max: 100 mEq/day. As extended-release tab: Initial: 15 mEq bid or 10 mEq tid. Max: 100 mEq/day. Severe hypocitraturia (urinary citrate <150 mg/day): As immediate-release tab: Initial: 20 mEq tid or 15 mEq 4 times/day. Max: 100 mEq/day. As extended-release tab: Initial: 30 mEq bid or 20 mEq tid. Max: 100 mEq/day.
Dosage Details
Oral
Hypocitraturic calcium oxalate nephrolithiasis, Renal tubular acidosis with calcium stones, Uric acid lithiasis, Urine alkalinisation
Adult: Mild to moderate hypocitraturia (urinary citrate >150 mg daily): As immediate-release tab: Initially, 10 mEq tid. Max: 100 mEq daily. As extended-release tab: Initially, 15 mEq bid or 10 mEq tid. Max: 100 mEq daily. Severe hypocitraturia (urinary citrate <150 mg daily): As immediate-release tab: Initially, 20 mEq tid or 15 mEq 4 times daily. Max: 100 mEq daily. As extended-release tab: Initially, 30 mEq bid or 20 mEq tid. Max: 100 mEq daily.
Renal Impairment
GFR <0.7 mL/kg/min: Contraindicated.
Administration
Should be taken with food. Dilute well w/ water before taking.
Contraindications
Renal insufficiency (GFR <0.7 mL/kg/min); hyperkalaemia or conditions predisposing to hyperkalaemia (e.g. chronic renal failure, uncontrolled DM, acute dehydration, strenuous physical exercise, adrenal insufficiency, extensive tissue breakdown); delayed gastric emptying time, oesophageal compression, intestinal obstruction or stricture, peptic ulcer disease, active UTI.
Special Precautions
Patient w/ conditions which impair K excretion (e.g. severe myocardial damage or heart failure); GI lesions manifested by severe vomiting, abdominal pain or GI bleeding. Pregnancy and lactation.
Adverse Reactions
Abdominal discomfort, vomiting, diarrhoea, loose bowel movements, nausea.
Potentially Fatal: Hyperkalaemia.
MonitoringParameters
Monitor serum electrolytes (K, Cl, Na), bicarbonate, serum creatinine and CBC every 4 mth; urinary citrate and/or urinary pH at initiation or dose change and every 4 mth; periodically ECG.
Overdosage
Symptoms: Hyperkalaemia manifested by increased serum K concentration and ECG changes; late manifestations include muscle paralysis and CV collapse from cardiac arrest. Management: Eliminate medications containing K, agents w/ K sparing properties (e.g. K-sparing diuretics, ACE inhibitors, NSAIDs) and food w/ high K content (e.g. almonds, beans, milk, salmon). May give IV Ca gluconate if the patient is at no risk or low risk of developing digitalis toxicity. Administer IV dextrose 10% containing 10-20 U of crystalline insulin per 1,000 mL at a rate of 300-500 mL/hr. Acidosis may be corrected w/ IV Na bicarbonate. May perform haemodialysis or peritoneal dialysis.
Drug Interactions
Risk of severe hyperkalaemia w/ K-sparing diuretics. Increased incidence of GI irritation w/ drugs that slow GI transit time (e.g. anticholinergics).
Action
Description: Potassium citrate is metabolised to bicarbonate, producing an alkaline load which in turn increases urinary pH and raises urinary citrate by augmenting citrate clearance w/o altering ultrafilterable serum citrate.
Pharmacokinetics:
Metabolism: Metabolised hepatically to bicarbonate.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store at or below 30°C.
ATC Classification
A12BA02 - potassium citrate ; Belongs to the class of potassium-containing preparations. Used as dietary supplements.
Disclaimer: This information is independently developed by MIMS based on Potassium citrate from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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