Potassium Bicarbonate and Potassium Citrate
(poe TASS ee um bye KAR bun ate & poe TASS ee um SIT rate)
- Potassium Bicarbonate and Potassium Citrate (Effervescent)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Tablet Effervescent, Oral:
Effer-K: 10 mEq
Effer-K: 10 mEq [contains fd&c red #40; cherry-vanilla flavor]
Effer-K: 20 mEq
Effer-K: 20 mEq [scored; contains fd&c red #40, fd&c yellow #6 (sunset yellow); orange cream flavor]
Effer-K: 25 mEq [lime flavor]
Effer-K: 25 mEq [contains fd&c red #40, fd&c red #40 aluminum lake, saccharin; cherry berry flavor]
Effer-K: 25 mEq [contains fd&c yellow #10 (quinoline yellow), fd&c yellow #10 aluminum lake, saccharin; lemon citrus flavor]
Effer-K: 25 mEq [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake, saccharin; orange flavor]
Effer-K: 25 mEq [contains saccharin; unflavored flavor]
K-Effervescent: 25 mEq [orange flavor]
K-Prime: 25 mEq [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake, saccharin; orange flavor]
K-Vescent: 25 mEq [orange flavor]
Klor-Con/EF: 25 mEq [DSC] [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake, saccharin]
Klor-Con/EF: 25 mEq [DSC] [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake, saccharin; orange flavor]
Klor-Con/EF: 25 mEq [sugar free; contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake, saccharin]
Klor-Con/EF: 25 mEq [sugar free; contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake, saccharin; orange flavor]
Generic: 25 mEq
Brand Names: U.S.
- Effer - K
- K - Effervescent
- K - Prime
- K - Vescent
- Klor - Con / EF
- Electrolyte Supplement, Oral
Potassium is needed for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function
Well absorbed from upper GI tract
Enters cells via active transport from extracellular fluid
Primarily urine; skin and feces (small amounts); most intestinal potassium reabsorbed
Use: Labeled Indications
Treatment or prevention of hypokalemia, particularly when it is necessary to avoid chloride or the acid/base status requires bicarbonate
Hyperkalemia; concomitant use of potassium-sparing diuretics or potassium supplements
Note: Doses expressed as mEq of potassium.
Normal daily requirement: 40-100 mEq/day or 1-2 mEq/kg/day (off-label dose; Mirtallo, 2004)
Prevention: 10-80 mEq/day in 1-4 divided doses
Treatment: 40-100 mEq/day in 2-4 divided doses. Note: For asymptomatic mild hypokalemia, generally recommended to limit doses to 20-25 mEq/dose to avoid GI discomfort.
Refer to adult dosing.
Dosing: Renal Impairment
No dosage adjustment provided in manufacturer’s labeling. However, patients with chronic renal failure require serum potassium monitoring and appropriate dosage adjustment.
Dosing: Hepatic Impairment
No dosage adjustment provided in manufacturer’s labeling.
Dissolve tablet completely in 3-4 ounces of cold water or juice. May further dilute if GI adverse effects occur.
Store at controlled room temperature 15°C to 30°C (59°F to 86°F)
ACE Inhibitors: Potassium Salts may enhance the hyperkalemic effect of ACE Inhibitors. Monitor therapy
Aliskiren: Potassium Salts may enhance the hyperkalemic effect of Aliskiren. Monitor therapy
Aluminum Hydroxide: Citric Acid Derivatives may increase the absorption of Aluminum Hydroxide. Consider therapy modification
Angiotensin II Receptor Blockers: Potassium Salts may enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Monitor therapy
Eplerenone: May enhance the hyperkalemic effect of Potassium Salts. Management: This combination is contraindicated in patients receiving eplerenone for treatment of hypertension. Consider therapy modification
Heparin: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Heparin (Low Molecular Weight): May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Nicorandil: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Potassium-Sparing Diuretics: Potassium Salts may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Consider therapy modification
Frequency not defined.
Gastrointestinal: Abdominal pain, diarrhea, nausea, vomiting
Endocrine & metabolic: Hyperkalemia and associated manifestations (eg, cardiac arrhythmias, etc)
Concerns related to adverse effects:
• GI effects: May cause GI upset (eg, nausea, vomiting, diarrhea, abdominal pain, discomfort) and lead to GI ulceration, bleeding, perforation and/or obstruction.
• Hyperkalemia: Close monitoring of serum potassium concentrations is needed to avoid hyperkalemia; severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (eg, heart block, ventricular arrhythmias, asystole).
• Acid/base disorders: Use with caution in patients with acid/base alterations; changes in serum potassium concentrations can occur during acid/base correction, monitor closely.
• Cardiovascular disease: Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.
• Metabolic acidosis: Patients with hypokalemia accompanied by metabolic acidosis should be treated with an alkalinizing potassium salt.
• Potassium-altering conditions/disorders: Use with caution in patients with disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (eg, untreated Addison's disease, heat cramps, severe tissue breakdown from trauma or burns).
• Renal impairment: Use with caution in patients with renal impairment; monitor serum potassium concentrations closely. Avoid with severe impairment.
Concurrent drug therapy issues:
• Digitalis: Use with caution in digitalized patients; may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations.
• Potassium-altering therapies: Use with caution in patients receiving concomitant medications or therapies that increase potassium (eg, ACE inhibitors, potassium-sparing diuretics, potassium-containing salt substitutes).
Serum potassium, magnesium (to facilitate potassium repletion), and bicarbonate
Pregnancy Risk Factor
Animal reproduction studies have not been conducted with this combination. See individual agents.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience diarrhea. Have patient report immediately to prescriber signs of high potassium (abnormal heartbeat, confusion, dizziness, passing out, weakness, shortness of breath, numbness or tingling feeling), severe nausea, severe vomiting, abdominal edema, black, tarry, or bloody stools, vomiting blood, or severe abdominal pain (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.