potassium citrate/citric acid (Rx)

Brand and Other Names:Cytra-K

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

potassium citrate/citric acid

oral solution

  • (1100mg/334mg)/5mL
  • Contains 2 mEq/mL potassium ion equivalent to 2 mEq/mL bicarbonate (HCO3)

Urinary Alkalinization

Indicated for long-term maintenance of an alkaline urine (eg, patients with uric acid and cystine calculi of the urinary tract), especially when the administration of sodium salts is undesirable or contraindicated

Usual dose: 15-30 mL PO diluted with 1 glass of water QID (after meals and at bedtime)

Administration

Dilute oral solution in water according to directions, followed by additional water, if desired

Proper dilution may help prevent gastrointestinal injury associated with the oral ingestion of concentrated potassium salt preparations

Palatability enhanced if chilled

Dosage Forms & Strengths

potassium citrate/citric acid

oral solution

  • (1100mg/334mg)/5mL
  • Contains 2 mEq/mL potassium ion equivalent to 2 mEq/mL bicarbonate (HCO3)

Urinary Alkalinization

Indicated for long-term maintenance of an alkaline urine (eg, patients with uric acid and cystine calculi of the urinary tract), especially when the administration of sodium salts is undesirable or contraindicated

Usual dose: 5-15 mL PO diluted with one-half glass of water QID (after meals and at bedtime)

Administration

Dilute oral solution in water according to directions, followed by additional water, if desired

Proper dilution may help prevent gastrointestinal injury associated with the oral ingestion of concentrated potassium salt preparations

Palatability enhanced if chilled

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Interactions

Interaction Checker

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              Serious - Use Alternative (1)

              • dextroamphetamine transdermal

                potassium citrate/citric acid will increase the level or effect of dextroamphetamine transdermal by Other (see comment). Avoid or Use Alternate Drug. Urinary alkalinizing agents can increase blood levels and potentiate the action of amphetamine.

              Monitor Closely (38)

              • aliskiren

                aliskiren and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • amiloride

                amiloride and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • azilsartan

                azilsartan and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • benazepril

                benazepril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor. Risk of hyperkalemia.

              • canagliflozin

                canagliflozin and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • candesartan

                candesartan and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • captopril

                captopril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor. Risk of hyperkalemia. Monitor potassium.

              • cyclosporine

                cyclosporine and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • drospirenone

                drospirenone and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • enalapril

                enalapril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • eplerenone

                eplerenone and potassium citrate/citric acid both increase serum potassium. Modify Therapy/Monitor Closely.

              • eprosartan

                eprosartan and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • finerenone

                potassium citrate/citric acid and finerenone both increase serum potassium. Modify Therapy/Monitor Closely. Finerenone dose adjustment based on current serum potassium concentration. Monitor serum potassium and adjust finerenone dose as described in the prescribing information as necessary.

              • fosinopril

                fosinopril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • heparin

                heparin and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • irbesartan

                irbesartan and potassium citrate/citric acid both increase serum potassium. Modify Therapy/Monitor Closely.

              • lisinopril

                lisinopril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • losartan

                losartan and potassium citrate/citric acid both increase serum potassium. Modify Therapy/Monitor Closely.

              • moexipril

                moexipril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • olmesartan

                olmesartan and potassium citrate/citric acid both increase serum potassium. Modify Therapy/Monitor Closely.

              • pentamidine

                pentamidine and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • perindopril

                perindopril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • potassium acid phosphate

                potassium acid phosphate and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • potassium chloride

                potassium chloride and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • potassium citrate

                potassium citrate and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • potassium phosphates, IV

                potassium phosphates, IV and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • quinapril

                quinapril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • ramipril

                ramipril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • sacubitril/valsartan

                sacubitril/valsartan and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • spironolactone

                spironolactone and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • succinylcholine

                succinylcholine and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • tacrolimus

                tacrolimus and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • telmisartan

                telmisartan and potassium citrate/citric acid both increase serum potassium. Modify Therapy/Monitor Closely.

              • trandolapril

                trandolapril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • triamterene

                triamterene and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • trimethoprim

                trimethoprim and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • valsartan

                valsartan and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              • voclosporin

                voclosporin and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Hyperkalemia

                Alkalosis

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                Warnings

                Contraindications

                Severe renal impairment with oliguria or azotemia

                Untreated Addison's disease

                Adynamia episodica hereditaria

                Acute dehydration

                Heat cramps

                Anuria

                Severe myocardial damage

                Hyperkalemia from any cause

                Hypersensitivity to any ingredient

                Cautions

                Small bowel lesions (eg, stenosis with or without ulceration) reported with potassium salts (mostly from enteric-coated products)

                Large doses may cause hyperkalemia and alkalosis, especially in presence of renal disease

                Caution with low urinary output

                Direct patients to dilute solution with water before ingestion to minimize GI injury associated with concentrated potassium preparations

                Take after meals to avoid saline laxative effect

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: Unknown whether distributed in breast milk

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Potassium citrate is absorbed and metabolized to potassium bicarbonate and this acts as a systemic alkalizer

                Elimination

                Excretion: Oxidation of potassium citrate is virtually complete so <5% is excreted in the urine unchanged

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Cytra-K oral
                -
                1,100-334 mg/5 mL solution
                potassium citrate-citric acid oral
                -
                1,100-334 mg/5 mL solution
                potassium citrate-citric acid oral
                -
                1,100-334 mg/5 mL solution

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                potassium citrate-citric acid oral

                POTASSIUM CITRATE/CITRIC ACID - ORAL

                (poe-TAS-ee-um SI-trate/SIT-rik AS-id)

                COMMON BRAND NAME(S): Polycitra-K

                USES: This medication is used to make the urine less acidic. This effect helps the kidneys get rid of uric acid, thereby helping to prevent gout and kidney stones. This medication can also prevent and treat certain metabolic problems (acidosis) caused by kidney disease.Citric acid and citrate salts (which contain potassium and sodium) belong to a class of drugs known as urinary alkalinizers. If you have a condition that requires you to limit your intake of potassium and sodium, your doctor may direct you to take a product that is lower in potassium and sodium.

                HOW TO USE: Take this medication by mouth as directed by your doctor, usually 4 times a day after meals and at bedtime. To help prevent diarrhea, take each dose after a meal. To prevent stomach upset/injury, mix your prescribed dose of medication in cold water or juice as directed. Drink the entire mixture slowly. If you still have stomach upset, mixing your dose in a larger amount of liquid may help unless your doctor directs you otherwise. Ask your doctor or pharmacist for further instructions.The liquid form of this medication must be mixed with at least 4 - 8 ounces (120 - 240 milliliters) of water before taking. Shake the bottle well before each dose and carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you are using the powdered/crystal form of this medication, mix the contents of the packet in at least 3/4 cup (6 ounces or 180 milliliters) of cool water or juice before taking.Refrigerating the mixture before drinking may improve the taste. Drink more water or juice after taking this medication unless otherwise directed by your doctor.Dosage is based on your medical condition and response to treatment.Take this medication exactly as prescribed. Do not increase your dose or take this more often without your doctor's approval. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.While taking this medication, you may need to test the pH (acidity) of your urine using special paper. The pH will help determine the proper dose. Consult your doctor or pharmacist for more information.

                SIDE EFFECTS: Nausea, vomiting, diarrhea, and stomach pain may occur. Mixing the medication with water or juice, taking it after meals, and drinking more fluids will help prevent these side effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: severe stomach/abdominal pain, tingling/numbness of the hands/feet, weakness, fast/slow/irregular heartbeat, mental/mood changes (such as confusion, restlessness), muscle spasms, seizures, bloody/black/tarry stools, vomit that looks like coffee grounds.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: underactive adrenal gland (Addison's disease), heart disease (such as recent heart attack, irregular heartbeat, heart failure), kidney disease, potassium-restricted diet, high potassium levels, dehydration, low calcium levels, stomach/gut problems (such as peptic ulcers, irritable bowel).Liquid forms of this product may contain sugar. Caution is advised if you have diabetes. Ask your doctor or pharmacist about using this product safely.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: antacids that contain aluminum, aspirin and other salicylates (such as salsalate), certain blood pressure medications (including ACE inhibitors such as lisinopril, angiotensin blockers such as losartan), drospirenone, eplerenone, certain heart medications (such as quinidine, digoxin), lithium, potassium supplements, certain "water pills" (potassium-sparing diuretics such as amiloride, spironolactone, triamterene).If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow heartbeat, muscle spasms, seizures.

                NOTES: Do not share this medication with others.Lab and/or medical tests (such as potassium levels) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store at room temperature away from heat, light, and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

                Information last revised November 2022. Copyright(c) 2023 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.