potassium citrate (Urocit-K)

Potassium citrate is a urinary alkalinizing medication. It makes urine less acidic. Potassium citrate works by crystallizing stone-forming salts such as calcium oxalate, calcium phosphate, and uric acid within the urinary bladder by increasing the urinary pH and urine citrate levels. Urocit-k was approved in August 1985.

Urocit-K

GENERIC AVAILABLE: Yes

Yes

Side effects of potassium citrate are:

• abdominal discomfort,
• nausea,
• vomiting,
• diarrhea,
• increased potassium levels, and
• rarely cardiac arrest.

Potassium supplements can cause bleeding or perforation of the stomach or small intestine from ulcers, and narrowing (stricture) of the small intestine from healed ulcers.

Dosing of potassium citrate is based on urinary citrate levels.

Mild to moderate hypocitraturia (Urinary citrate greater than 150 mg/day):

• Take 10 mEq potassium citrate orally three times a day
• Severe hypocitraturia (Urinary citrate less than 150 mg/day):
• Take 30 mEq potassium citrate orally 2 times a day or 20 mEq 3 times a day; with meals or within 30 minutes after meals.
• Maintenance:
• To achieve urinary citrate 320 to 640 mg/day and urinary pH 6.0-7.0: Titrate dose to maximum of 100 mEq/day

Potassium citrate should be used with caution with potassium-sparring diuretics, which can increase potassium levels in body and potentially lead to cardiac arrest.

Drugs that slow transit of food through the intestine may delay passage of potassium tablets through the digestive system and result in increased irritation, ulceration or narrowing of the small intestine. Examples of such drugs include atropine, loperamide (Imodium), liraglutide (Saxzenda, Victoza) and similar drugs.

Angiotensin converting enzyme (ACE) inhibitors (for example, enalapril [Vasotec]), angiotensin receptor blockers (ARB) drugs (for example, valsartan [Diovan]) and certain diuretics (for example, spironolactone [Aldactone] and triamterene [Dyrenium]) increase potassium levels, causing high potassium levels in the blood when combined with potassium supplements. Potassium blood levels should be measured regularly in these patients.

Salt substitutes (for example, Mrs. Dash) often contain potassium. Therefore, patients using salt substitutes while taking potassium supplements may develop high levels of potassium in the blood.

There are no adequate studies done on potassium citrate to determine safe and effective use in pregnant women.

Normally, potassium ions are present in breast milk. It is not known whether administering potassium citrate can further increase potassium levels. Therefore, potassium citrate should only be given if needed.

What preparations of potassium citrate-oral tablet are available?

Potassium citrate is available in extended-release tablets. They are available in 5 mEq (540 mg), 10 mEq (1080 mg), and 15 mEq (1620 mg) strengths. The packets for oral solution were discontinued in the U.S.

How should I keep potassium citrate-oral tablet stored?

Store potassium citrate tablets at room temperature in a tightly closed container.