Dosing & Uses
Dosage Forms & Strengths
tablet, extended release
- 5mEq
- 10mEq
- 15mEq
Alkalinizing Agent
Urinary citrate <150 mg/day: 60 mEq/day PO (20 mEq with each meal) OR
Urinary citrate >150 mg/day: 30 mEq/day PO (10 mEq with each meal)
Maintenance
- Titrate dose to achieve urinary citrate 320-640 mg/day & urinary pH 6.0-7.0 (maximum dose 100 mEq/day)
Other Indications & Uses
Alkalinzing agent for maintaining long-term alkaline urine, alkalinizing agent for correcting acidosis of certain renal tubular disorders
Management of renal tubular acidosis w/ calcium stones, hypocitraturic calcium oxalate nephrolithiasis, uric acid lithiasis
Safety & efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Common: abdominal discomfort, vomiting, diarrhea, loose bowel movements or nausea
Serious: Hyperkalemia (potential for cardiac arrest), GI ulceration, GI irritation
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 Rx, peptic ulcer dz, active UTI
Concomitant K+-sparing agents (e.g., triamterene, spironolactone, amiloride)
Cautions
Large doses may cause hyperkalemia and alkalosis, esp in renal impairment
Pregnancy & Lactation
Pregnancy Category: A
Lactation: safe
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
Onset: 1 hr
Duration: 12 hr
Metabolite: bicarbonate (active)
Excretion: urine
Mechanism of Action
Alkalinizes urine; citrate binds with urinary calcium
Images
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.
