(poe TASS ee um SIT rate)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet Extended Release, Oral:
Urocit-K 5: 5 mEq (540 mg)
Urocit-K 10: 10 mEq (1080 mg)
Urocit-K 15: 15 mEq (1620 mg)
Generic: 5 mEq (540 mg), 10 mEq (1080 mg), 15 mEq (1620 mg)
Brand Names: U.S.
- Urocit-K 10
- Urocit-K 15
- Urocit-K 5
- Alkalinizing Agent, Oral
Hepatic to bicarbonate
Use: Labeled Indications
Kidney stones: For the management of renal tubular acidosis with calcium stones, hypocitraturic calcium oxalate nephrolithiasis of any etiology, and uric acid lithiasis with or without calcium stones.
Severe renal insufficiency; patients with hyperkalemia or with conditions predisposing to hyperkalemia (eg, acute dehydration, adrenal insufficiency, uncontrolled diabetes mellitus, tissue breakdown, concurrent use of potassium-sparing agents); patients with delayed gastric emptying, esophageal compression, intestinal obstruction or stricture, or those taking anticholinergic medication; patients with active urinary tract infection
Alkalinizer, bicarbonate precursor: Oral:
Mild-to-moderate hypocitraturia (>150 mg urinary citrate):
Immediate release: 10 mEq 3 times daily; maximum dose: 100 mEq/day
Extended release: 15 mEq 2 times daily or 10 mEq 3 times daily; maximum dose: 100 mEq/day
Severe hypocitraturia (<150 mg/day urinary citrate):
Immediate release: 20 mEq 3 times daily or 15 mEq 4 times daily; maximum dose: 100 mEq/day
Extended release: 30 mEq 2 times daily or 20 mEq 3 times daily; maximum dose: 100 mEq/day
Refer to adult dosing.
Dosing: Renal Impairment
Use is contraindicated in patients with renal insufficiency (GFR <0.7 mL/kg/minute) or chronic renal failure.
Dosing: Hepatic Impairment
No dosage adjustment provided in manufacturer’s labeling.
Administer with meals or bedtime snack (or within 30 minutes after). Swallow tablets whole with a full glass of water.
Ensure adequate fluid intake; limit salt intake. Take with meals or snack.
Store in a cool, dry place.
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. Monitor therapy
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.
Endocrine & metabolic: Hyperkalemia
Gastrointestinal: Abdominal distress, diarrhea, nausea, vomiting
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. Oral liquid preparations (not solid) should be used in patients with esophageal compression or delayed gastric emptying.
• 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.
• Hepatic impairment: Citrate is converted to bicarbonate in the liver; this conversion may be blocked in patients in hepatic failure.
• 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. Contraindicated with severe impairment.
• Severely ill: Citrate is converted to bicarbonate in the liver; this conversion may be blocked in patients who are severely ill or in shock.
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, ACEI, potassium-sparing diuretics, potassium containing salt substitutes).
Serum electrolytes (potassium, chloride, sodium), bicarbonate, serum creatinine, and CBC every 4 months (more frequently with cardiac/renal disease or acidosis); urinary citrate and/or urinary pH at initiation or dose change and every 4 months; ECG (periodically)
Pregnancy Risk Factor
Animal reproduction studies have not been conducted.
• 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 or tablet shell in stool. Have patient report immediately to prescriber signs of high potassium (abnormal heartbeat, confusion, dizziness, passing out, weakness, shortness of breath, numbness or tingling feeling), abdominal edema, severe nausea, severe vomiting, severe abdominal pain, black, tarry, or bloody stools, or vomiting blood (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.
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- Drug class: urinary pH modifiers
Other brands: Urocit-K