Dosing & Uses
Dosage Forms & Strengths
Doses expressed as mEq of potassium
tablet for oral solution
- 8 mEq
- 10 mEq
- 15 mEq
- 20 mEq
- 25 mEq
Daily Requirements
40-100 mEq/day or 1-2 mEq/kg/day
Hypokalemia
Prevention: 10-80 mEq/day PO qDay or divided qid
Treatment: 40–100 mEq/day dissolved in at least 4 ounces (per tablet) cold water PO divided bid/qid
Divide doses so that single doses are not > 25 mEq to avoid GI adverse effects
Renal Impairment
Use in patients with chronic renal disease or any condition impairing potassium excretion requires careful monitoring
Hepatic Impairment
No dosage adjustments listed by the manufacturer
Dose Considerations
If hypokalemia is result of diuretic therapy, consider lowering diuretic dose
Proper dilution lessens the possibility of gastrointestinal irritation
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (7)
- dextroamphetamine transdermal
potassium citrate 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.
- drospirenone
drospirenone and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.
- potassium acid phosphate
potassium acid phosphate and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.
- potassium chloride
potassium chloride and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.
- potassium phosphates, IV
potassium bicarbonate and potassium phosphates, IV both increase serum potassium. Avoid or Use Alternate Drug.
potassium citrate and potassium phosphates, IV both increase serum potassium. Avoid or Use Alternate Drug. - spironolactone
spironolactone and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.
- triamterene
triamterene and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.
Monitor Closely (104)
- acebutolol
acebutolol and potassium citrate both increase serum potassium. Use Caution/Monitor.
- amantadine
potassium citrate will increase the level or effect of amantadine by Other (see comment). Modify Therapy/Monitor Closely. Urine pH changes towards alkalinic conditions may lead to an accumulation of amantadine with a possible increase in adverse reactions. Monitor for adverse reactions of amantadine.
- amiloride
amiloride and potassium citrate both increase serum potassium. Use Caution/Monitor.
- arformoterol
potassium citrate increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- aspirin
aspirin and potassium citrate both increase serum potassium. Use Caution/Monitor.
- aspirin rectal
aspirin rectal and potassium citrate both increase serum potassium. Use Caution/Monitor.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate and potassium citrate both increase serum potassium. Use Caution/Monitor.
- atenolol
atenolol and potassium citrate both increase serum potassium. Use Caution/Monitor.
- benazepril
benazepril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
potassium citrate and benazepril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors - betaxolol
betaxolol and potassium citrate both increase serum potassium. Use Caution/Monitor.
- bisacodyl
bisacodyl decreases levels of potassium citrate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- bisoprolol
bisoprolol and potassium citrate both increase serum potassium. Use Caution/Monitor.
- bumetanide
potassium citrate increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- canagliflozin
potassium citrate and canagliflozin both increase serum potassium. Use Caution/Monitor.
- candesartan
candesartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- captopril
captopril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- carvedilol
carvedilol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- celecoxib
celecoxib and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- chloroquine
potassium bicarbonate will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr
- chlorothiazide
potassium citrate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- chlorthalidone
potassium citrate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- choline magnesium trisalicylate
choline magnesium trisalicylate and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- cyclopenthiazide
potassium citrate increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- cyclosporine
cyclosporine and potassium citrate both increase serum potassium. Use Caution/Monitor.
- deferiprone
potassium bicarbonate decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.
- diclofenac
diclofenac and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- diflunisal
diflunisal and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- disopyramide
potassium citrate increases effects of disopyramide by pharmacodynamic synergism. Use Caution/Monitor. Additive cardiovascular depression.
- dobutamine
potassium citrate increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- enalapril
enalapril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- ephedrine
potassium citrate increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- epinephrine
potassium citrate increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- epinephrine racemic
potassium citrate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- eplerenone
potassium citrate and eplerenone both increase serum potassium. Modify Therapy/Monitor Closely.
- eprosartan
eprosartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- esmolol
esmolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- ethacrynic acid
potassium citrate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- etodolac
etodolac and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- fenoprofen
fenoprofen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- finerenone
potassium citrate 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.
potassium bicarbonate 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. - flurbiprofen
flurbiprofen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- formoterol
potassium citrate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- fosinopril
fosinopril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- furosemide
potassium citrate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- gentamicin
potassium citrate increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- hydrochlorothiazide
potassium citrate increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- ibuprofen
ibuprofen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- ibuprofen IV
ibuprofen IV and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- indapamide
potassium citrate increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- indomethacin
indomethacin and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- irbesartan
irbesartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- isoproterenol
potassium citrate increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- ketoprofen
ketoprofen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- ketorolac
ketorolac and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- labetalol
labetalol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- levalbuterol
potassium citrate increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- lisinopril
lisinopril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- losartan
losartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- meclofenamate
meclofenamate and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- mefenamic acid
mefenamic acid and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- meloxicam
meloxicam and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- metaproterenol
potassium citrate increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- methyclothiazide
potassium citrate increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. .
- metolazone
potassium citrate increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- metoprolol
metoprolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- moexipril
moexipril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- nabumetone
nabumetone and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- nadolol
nadolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- naproxen
naproxen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- nebivolol
nebivolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- noni juice
potassium citrate and noni juice both increase serum potassium. Use Caution/Monitor.
- norepinephrine
potassium citrate increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- olmesartan
olmesartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- oxaprozin
oxaprozin and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- penbutolol
penbutolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- perindopril
perindopril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- pindolol
pindolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- pirbuterol
potassium citrate increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- piroxicam
piroxicam and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate/citric acid
potassium citrate and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.
- potassium iodide
potassium iodide and potassium citrate both increase serum potassium. Use Caution/Monitor.
- propranolol
propranolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- quinapril
quinapril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- ramipril
ramipril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- sacubitril/valsartan
sacubitril/valsartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- salicylates (non-asa)
salicylates (non-asa) and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- salmeterol
potassium citrate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- salsalate
salsalate and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- sotalol
sotalol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- sparsentan
sparsentan and potassium citrate both increase serotonin levels. Use Caution/Monitor. Monitor serum potassium frequently.
- succinylcholine
potassium citrate and succinylcholine both increase serum potassium. Modify Therapy/Monitor Closely.
- sulfasalazine
sulfasalazine and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- sulindac
sulindac and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- tacrolimus
tacrolimus and potassium citrate both increase serum potassium. Use Caution/Monitor.
- telmisartan
telmisartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- terbutaline
potassium citrate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- timolol
timolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- tolmetin
tolmetin and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- tolvaptan
potassium citrate and tolvaptan both increase serum potassium. Modify Therapy/Monitor Closely.
- torsemide
potassium citrate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- trandolapril
trandolapril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.
- trimethoprim
trimethoprim and potassium citrate both increase serum potassium. Use Caution/Monitor. Trimethoprim decreases urinary potassium excretion. May cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia.
- valsartan
valsartan and potassium citrate both increase serum potassium. Use Caution/Monitor.
- voclosporin
voclosporin and potassium citrate both increase serum potassium. Use Caution/Monitor.
Minor (26)
- acarbose
potassium citrate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- amphotericin B deoxycholate
amphotericin B deoxycholate decreases levels of potassium citrate by increasing renal clearance. Minor/Significance Unknown.
- cadexomer iodine
cadexomer iodine increases levels of potassium citrate by decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.
- chlorpropamide
potassium citrate increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- glimepiride
potassium citrate increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- glipizide
potassium citrate increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- glyburide
potassium citrate increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin aspart
potassium citrate increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin detemir
potassium citrate increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin glargine
potassium citrate increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin glulisine
potassium citrate increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin lispro
potassium citrate increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin NPH
potassium citrate increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- insulin regular human
potassium citrate increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- iodinated glycerol
iodinated glycerol increases levels of potassium citrate by decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.
- iodine
iodine increases levels of potassium citrate by decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.
- metformin
potassium citrate increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- miglitol
potassium citrate increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- nateglinide
potassium citrate increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- pioglitazone
potassium citrate increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- repaglinide
potassium citrate increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- rosiglitazone
potassium citrate increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- saxagliptin
potassium citrate increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- sitagliptin
potassium citrate increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- tolazamide
potassium citrate increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- tolbutamide
potassium citrate increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
Adverse Effects
Frequency Not Defined
Hyperkalemia
Nausea
Vomiting
Flatulence
Abdominal pain or discomfort
Diarrhea
Warnings
Contraindications
Patients with hyperkalemia
Hypersensitivity to any component of product
Patients on triamterene and amiloride
Concomitant use with potassium sparring diuretics or potassium supplements
Cautions
Hyperkalemia may complicate chronic renal failure, systemic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal insufficiency or administration of potassium-sparing diuretics
Use caution in patients with acid/base alterations
Use caution in patients with cardiovascular disease
Use alkalinizing potassium salts in patients with hypokalemia that have metabolic acidosis concomitantly
Digitalized patients may be more susceptible to potentially life-threatening cardiac effects
Solid oral dosage forms of potassium chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract, particularly if drug maintains contact with gastrointestinalmucosa for prolonged periods; consider use of liquid potassium in patients with dysphagia, swallowing disorders, or severe gastrointestinal motility disorders
If severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occurs, discontinue therapy and consider possibility of ulceration, obstruction or perforation
Drug should not be taken on an empty stomach because of its potential for gastric irritation
Drug interaction overview
- Use with triamterene or amiloride can produce severe hyperkalemia; concomitant use contraindicated
- Drugs that inhibit renin-angiotensin-aldosterone system (RAAS) including angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), spironolactone,eplerenone, or aliskiren produce potassium retention by inhibiting aldosterone production; closely monitor potassium in patients on concomitant RAAS inhibitors
- NSAIDS may produce potassium retention by reducing renal synthesis of prostaglandin E and imparing renin-angiotensin system; closely monitor potassium in patients on concomitant NSAIDs
Pregnancy & Lactation
Pregnancy
There are no human data related to use of during pregnancy, and animal reproduction studies have not been conducted; potassium supplementation that does not lead to hyperkalemia is not expected to cause fetal harm
Lactation
Normal potassium ion content of human milk is about 13 mEq per liter; since oral potassium becomes part of the body potassium pool, so long as body potassium is not excessive, the contribution of potassium chloride supplementation should have little or no effect on level in human 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.Pharmacology
Mechanism of Action
Potassium depletion occurs when rate of loss through renal excretion and/or GI tract exceeds intake
Supplementation with potassium-containing products may alleviate depletion
Potassium plays essential role in the conduction of nerve impulses in the heart, brain, and skeletal muscle; plays a role in contraction of cardiac, skeletal, and smooth muscles
Pharmacokinetics
Absorption: Well absorbed in upper GI tract
Distribution: Cells (via active transport from extracellular fluid)
Excretion: Urine (primarily), skin, and feces
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Formulary
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