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potassium citrate (Urocit K)

Indications: - hypokalemia associated with metabolic acidosis - long-term maintenance of alkaline urine - hypertension ? [3] - prevention of osteoporosis ? [3] - inhibition of nephrolithiasis - cystinuria, cystine renal calculi - calcium stones - calcium phosphate renal calculi - calcium oxalate renal calculi [4] - prevents new stone formation & reduces further stone growth in patients with residual oxalate stones [8] - uric acid stones [5] Contraindications: 1) hyperkalemia 2) conditions predisposing to hyperkalemia a) renal failure b) uncontrolled diabetes c) adrenal insufficiency d) concurrent administration of K+ sparing diuretic 3) conditions causing a delay in passage through the GI tract a) delayed gastric emptying b) esophageal compression c) intestinal obstruction or stricture d) concurrent administration of anticholinergic agents 4) peptic ulcer disease 5) active urinary tract infection pregnancy-category :value C safety-in-lactation :value ? Dosage: - 30-100 meq/day - 10 meq TID (1080* mg TID) * using 306.4 mg/mmol & 3 meq/mmol, I get 102.1 mg/meq * as the monohydrate 108.1 mg/meq Tablet: 5, 10, 15 meq Pharmacokinetics: - elimination :route kidney Adverse effects: 1) hyperkalemia 2) metabolic alkalosis 3) gastrointestinal mucosal lesions Mechanism of action: 1) prevents precipitation of calcium in urine - reduces risk of calcium-containing stones 2) makes urine less acidic, thus also reduces risk uric acid stones & cystine stones [5] 3) increases bone mineral density* [3], citrate contributes (KCl does not show same effect) 4) diminishes systolic & diastolic blood pressure* due to K+ [3] * in postmenopausal women

Interactions

monitor with potassium supplements

General

potassium supplement citrate (citric acid) urinary alkalinizer

Database Correlations

PUBCHEM correlations

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Physician's Desk Reference (PDR) 52nd edition, Medical Economics, 1998
  3. Jehle S et al, Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. J Am Soc Nephrol 2006, 17:3213 PMID: 17035614
  4. Deprecated Reference
  5. WebMD: Potassium Citrate for Kidney Stones http://www.webmd.com/kidney-stones/potassium-citrate-for-kidney-stones
  6. Drugs.com: Potassium Citrate http://www.drugs.com/pro/potassium-citrate.html
  7. Pak CY Citrate and renal calculi. Miner Electrolyte Metab. 1987;13(4):257-66. Review. PMID: 3306318
  8. Phillips R, Hanchanale VS, Myatt A et al Citrate salts for preventing and treating calcium containing kidney stones in adults. Cochrane Database Syst Rev. 2015 Oct 6;(10):CD010057. Review. PMID: 26439475

Component-of

bilberry/calcium citrate/potassium citrate/vitamin e bisacodyl/citrate/magnesium carbonate/potassium citrate bisacodyl/citrate/magnesium carbonate/potassium citrate/suppository citrate/potassium citrate (Polycitra K) citrate/potassium citrate (Polycitra K) potassium citrate/sodium fluoride