Dosing & Uses
Dosage Forms & Strengths
tablet, extended release
- 5mEq
- 10mEq
- 15mEq
Alkalinizing Agent
Mild to Moderate Hypocitraturia
- Urinary citrate >150 mg/day
- Immediate release: 10 mEq 3 times daily; not to exceed 100 mEq/day
- Extended release: 15 mEq 2 times daily or 10 mEq 3 times dialy; not to exceed 100 mEq/day
Severe Hypocitraturia
- Urinary citrate <150 mg/day
- Immediate release: 20 mEq 3 times daily or 15 mEq 4 times daily; not to exceed 100 mEq/day
- Extended release: 30 mEq 2 times daily or 20 mEq 3 times daily; not to exceed 100 mEq/day
Maintenance
- Titrate dose to achieve urinary citrate 320-640 mg/day & urinary pH 6.0-7.0 (maximum dose 100 mEq/day)
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Warnings
Contraindications
Hypersensitivity, hyperkalemia, Addison's disease, anuria, uncontrolled DM, acute dehydration, adrenal insufficiency, renal insufficiency (GFR <0.7ml/kg/min)
Delayed gastric emptying, esophageal compression, GI obstruction, concomitant anticholinergic therapy, peptic ulcer disease, active UTI
Concomitant K+-sparing agents (e.g., triamterene, spironolactone, amiloride)
Cautions
Large doses may cause hyperkalemia and alkalosis, especially in renal impairment
Abdominal discomfort, vomiting, diarrhea, loose bowel movements or nausea may occur
Hyperkalemia (monitor; potential for cardiac arrest), GI ulceration, GI irritation may occur
Use with caution in patients with acid/base alteration (monitor)
Use caution in patients receiving therapy that increases potassium levels (ACE inhibitors, potassium based salt substitutes, sparing diuretics)
Use with caution in patients with cardiovascular disease (higher risk of life-threatening cardiac effects associated with hyper/hypokelemia
Use caution in patients with disorders that may contribute to altered serum potassium and hyperkalemia including untreated Addison's disease, heat cramps or severe tissue breakdown from trauma or burns)
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Excreted in breast milk; not recommended
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
Alkalinizes urine; citrate binds with urinary calcium
Pharmacokinetics
Onset: 1 hr
Duration: 12 hr
Metabolism: Hepatic
Metabolite: Bicarbonate (active)
Excretion: Urine
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Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
