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potassium citrate/citric acid (Cytra-K)

 

Classes: Urinary Alkalinizing Agents

Dosing and uses of Cytra-K (potassium citrate/citric acid)

 

Adult dosage forms and strengths

potassium citrate/citric acid

oral solution

  • (1100mg/334mg)/5mL
  • Each 2 mL contains 2 mEq potassium ion and is equivalent to 2 mEq bicarbonate (HCO3)

 

Urinary Alkalinization

Indicated for long-term maintenance of an alkaline urine (eg, patients with uric acid and cystine calculi of the urinary tract), especially when the administration of sodium salts is undesirable or contraindicated

Usual dose: 15-30 mL PO diluted with 1 glass of water QID (after meals and at bedtime)

 

Administration

Dilute oral solution in water according to directions, followed by additional water, if desired

Proper dilution may help prevent gastrointestinal injury associated with the oral ingestion of concentrated potassium salt preparations

Palatability enhanced if chilled

 

Pediatric dosage forms and strengths

potassium citrate/citric acid

oral solution

  • (1100mg/334mg)/5mL
  • Each 2 mL contains 2 mEq potassium ion and is equivalent to 2 mEq bicarbonate (HCO3)

 

Urinary Alkalinization

Indicated for long-term maintenance of an alkaline urine (eg, patients with uric acid and cystine calculi of the urinary tract), especially when the administration of sodium salts is undesirable or contraindicated

Usual dose: 5-15 mL PO diluted with one-half glass of water QID (after meals and at bedtime)

 

Administration

Dilute oral solution in water according to directions, followed by additional water, if desired

Proper dilution may help prevent gastrointestinal injury associated with the oral ingestion of concentrated potassium salt preparations

Palatability enhanced if chilled

 

Cytra-K (potassium citrate/citric acid) adverse (side) effects

Frequency not defined

Hyperkalemia

Alkalosis

 

Warnings

Contraindications

Severe renal impairment with oliguria or azotemia

Untreated Addison's disease

Adynamia episodica hereditaria

Acute dehydration

Heat cramps

Anuria

Severe myocardial damage

Hyperkalemia from any cause

Hypersensitivity to any ingredient

 

Cautions

Small bowel lesions (eg, stenosis with or without ulceration) reported with potassium salts (mostly from enteric-coated products)

Large doses may cause hyperkalemia and alkalosis, especially in presence of renal disease

Caution with low urinary output

Direct patients to dilute solution with water before ingestion to minimize GI injury associated with concentrated potassium preparations

Take after meals to avoid saline laxative effect

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Unknown whether distributed in breast milk

 

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 of Cytra-K (potassium citrate/citric acid)

Mechanism of action

Potassium citrate is absorbed and metabolized to potassium bicarbonate and this acts as a systemic alkalizer

 

Elimination

Excretion: Oxidation of potassium citrate is virtually complete so <5% is excreted in the urine unchanged