potassium citrate (Rx)

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 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.

Mechanism of Action

Alkalinizes urine; citrate binds with urinary calcium

Pharmacokinetics

Onset: 1 hr

Duration: 12 hr

Metabolism: Hepatic

Metabolite: Bicarbonate (active)

Excretion: Urine