potassium bicarbonate/potassium citrate (Rx)

Brand and Other Names:Klor-Con/EF, K-Lyte, more...K-Lyte DS, K-Prime, Effer-K
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

Doses expressed as mEq of potassium

tablet for oral solution

  • 10 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

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Interactions

Interaction Checker

and potassium bicarbonate/potassium citrate

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              Serious - Use Alternative (6)

              • 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 (103)

              • 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.

              • 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.

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              Adverse Effects

              Frequency Not Defined

              Hyperkalemia

              Nausea

              Vomiting

              Flatulence

              Abdominal pain or discomfort

              Diarrhea

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              Warnings

              Contraindications

              Patients with hyperkalemia

              Hypersensitivity to any component of product

              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

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: Unknown whether distributed in breast milk, caution advised

              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 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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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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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.