Potassium Citrate / Sodium Citrate / Citric Acid

Trade Names:
Polycitra
- Syrup 550 mg potassium citrate, 500 mg sodium citrate, 334 mg citric acid/5 mL (1 mEq K, 1 mEq Na/mL; equiv. to 2 mEq bicarbonate)

Trade Names:
Polycitra-LC
- Solution 550 mg potassium citrate, 500 mg sodium citrate, 334 mg citric acid/5 mL (1 mEq K, 1 mEq Na/mL; equiv. to 2 mEq bicarbonate)

Pharmacology

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Potassium citrate and sodium citrate are metabolized to potassium bicarbonate and sodium bicarbonate, thus acting as systemic alkalizers.

Indications and Usage

Treatment of chronic metabolic acidosis, particularly when caused by renal tubular acidosis; conditions when long-term maintenance of an alkaline urine is desirable, in treatment of patients with uric acid and cystine calculi of the urinary tract and in conjunction with uricosurics in gout therapy to prevent uric acid nephropathy.

Contraindications

Severe renal function impairment with oliguria; azotemia; untreated Addison disease; severe myocardial damage; certain situations when patients are on a sodium- or potassium-restricted diet.

Dosage and Administration

PO 3 to 6 tsp (15 to 30 mL), diluted with water, 4 times daily after meals and at bedtime, or as directed by health care provider.

PO 1 to 3 tsp (5 to 15 mL), diluted with water 4 times daily after meals and at bedtime, or as directed by health care provider.

Storage/Stability

Store syrup at controlled room temperature (59° to 86°F). Keep tightly capped and protect from freezing or excessive heat.

Drug Interactions

Concurrent use may lead to toxicity.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Metabolic

Alkalosis; hyperkalemia leading to listlessness, weakness, mental confusion, tingling of extremities, and other symptoms associated with high serum potassium concentrations (eg, ECG abnormalities).

Precautions

Pregnancy

Undetermined.

Lactation

Undetermined.

Special Risk Patients

Sodium salts should be used with caution in patients with cardiac failure, hypertension, impaired renal function, peripheral and pulmonary edema, and toxemia of pregnancy.

Low urinary output or reduced glomerular filtration rate

Because hyperkalemia or alkalosis can occur, use with caution.

GI effects

Dilute with water to minimize GI injury associated with oral ingestion of concentrated potassium salts.

Overdosage

Symptoms

Diarrhea, nausea, vomiting, hypernoia (excessive mental activity), convulsions, hyperkalemia, alkalosis.

Patient Information

• Advise patient to take as prescribed and to not change the dose or stop taking unless advised by health care provider.
• Advise patient to dilute each dose with 1 to 3 oz of cold water and take after meals if possible to prevent laxative effect. Additional water may follow the dose if desired.
• Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
• Advise patient to inform health care provider if any of the following occur: edema, decreased urine production, persistent diarrhea, any other bothersome side effects.

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