serum potassium frequently.spironolactoneSerious - Use Alternative (1)spironolactone and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.succinylcholineMonitor Closely (1)potassium citrate and succinylcholine both increase serum potassium. Modify Therapy/Monitor Closely.sulfasalazineMonitor Closely (1)sulfasalazine and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.sulindacMonitor Closely (1)sulindac and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.tacrolimusMonitor Closely (1)tacrolimus and potassium citrate both increase serum potassium. Use Caution/Monitor.telmisartanMonitor Closely (1)telmisartan and potassium citrate both increase serum potassium. Use Caution/Monitor.terbutalineMonitor Closely (1)potassium citrate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.timololMonitor Closely (1)timolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.tolazamideMinor (1)potassium citrate increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.tolbutamideMinor (1)potassium citrate increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.tolmetinMonitor Closely (1)tolmetin and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.tolvaptanMonitor Closely (1)potassium citrate and tolvaptan both increase serum potassium. Modify Therapy/Monitor Closely.torsemideMonitor Closely (1)potassium citrate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.trandolaprilMonitor Closely (1)trandolapril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.triamtereneSerious - Use Alternative (1)triamterene and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.trimethoprimMonitor Closely (1)trimethoprim and potassium citrate both increase serum potassium. Use Caution/Monitor. Trimethoprim decreases urinary potassium excretion. May cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia.valsartanMonitor Closely (1)valsartan and potassium citrate both increase serum potassium. Use Caution/Monitor.voclosporinMonitor Closely (1)voclosporin and potassium citrate both increase serum potassium. Use Caution/Monitor. Contraindications Hypersensitivity, hyperkalemia, Addison's disease, anuria, uncontrolled DM, acute dehydration, adrenal insufficiency, renal insufficiency (GFR <0.7ml/kg/min) Delayed gastric emptying, esophageal compression, GI obstruction or stricture, concomitant anticholinergic therapy, peptic ulcer disease, active UTI Concomitant K+-sparing agents (e.g., triamterene, spironolactone, amiloride) In patients with active urinary tract infection (with either urea-splitting or other organisms, in association with either calcium or struvite stones) Cautions The ability of the drug to increase urinary citrate may be attenuated by bacterial enzymatic degradation of citrate; moreover, the rise in urinary pH resulting from therapy might promote further bacterial growth Use with caution in patients with acid/base alteration (monitor) Not for use when experiencing urinary tract infections; the ability of drug to increase urinary citrate may be attenuated by bacterial enzymatic degradation of citrate. Moreover, the rise in urinary pH resulting from therapy might promote further bacterial growth Use with caution in patients with cardiovascular disease (higher risk of life-threatening cardiac effects associated with hyper/hypokelemia Gastrointestinal lesions Abdominal discomfort, vomiting, diarrhea, loose bowel movements or nausea may occur Solid dosage forms of potassium chlorides have produced stenotic and/or ulcerative lesions of the small bowel and deaths; these lesions are caused by a high local concentration of potassium ions in the region of the dissolving tablets, which injured the bowel Perhaps because wax-matrix preparations are not enteric-coated and release some of their potassium content in the stomach, there have been reports of upper gastrointestinal bleeding associated with these products If there is severe vomiting, abdominal pain, or gastrointestinal bleeding, drug should be discontinued immediately and the possibility of bowel perforation or obstruction investigated Hyperkalemia Large doses may cause hyperkalemia and alkalosis, especially in renal impairment Use caution in patients receiving therapy that increases potassium levels (ACE inhibitors, potassium-based salt substitutes, sparing diuretics) Use caution in patients with disorders that may contribute to altered serum potassium and hyperkalemia including untreated Addison's disease, heat cramps, or severe tissue breakdown from trauma or burns) In patients with impaired mechanisms for excreting potassium, administration of drug can produce hyperkalemia and cardiac arrest; potentially fatal hyperkalemia can develop rapidly and be asymptomatic Avoid use in patients with chronic renal failure or any other condition which impairs potassium excretion such as severe myocardial damage or heart failure; closely monitor for signs of hyperkalemia with periodic blood tests and ECGs Drug interaction overview Drugs that inhibit renin-angiotensin-aldosterone system (RAAS) including angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), spironolactone, eplerenone, or aliskiren produce potassium retention by inhibiting aldosterone production; closely monitor potassium in patients receiving concomitant RAAS therapy NSAIDs may produce potassium retention by reducing renal synthesis of prostagladin E and impairing renin-angiotensin system; closely monitor potassium in patients on concomitant NSAIDs Pregnancy Category: C Lactation: Excreted in breast milk; not recommendedPregnancy 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. Mechanism of Action Alkalinizes urine; citrate binds with urinary calcium Pharmacokinetics Onset: 1 hr Duration: 12 hr Metabolism: Hepatic Metabolite: Bicarbonate (active) Excretion: Urine BRAND FORM. UNIT PRICE PILL IMAGE Urocit-K 5 oral- 5 mEq (540 mg) tabletpotassium citrate oral- 5 mEq (540 mg) tabletpotassium citrate oral- 10 mEq (1,080 mg) tabletpotassium citrate oral- 10 mEq (1,080 mg) tabletpotassium citrate oral- 10 mEq (1,080 mg) tabletpotassium citrate oral- 5 mEq (540 mg) tabletpotassium citrate oral- 15 mEq tabletpotassium citrate oral- 15 mEq tabletpotassium citrate oral- 10 mEq (1,080 mg) tabletpotassium citrate oral- 15 mEq tabletpotassium citrate oral- 10 mEq (1,080 mg) tabletpotassium citrate oral- 5 mEq (540 mg) tabletpotassium citrate oral- 15 mEq tabletpotassium citrate oral- 5 mEq (540 mg) tabletpotassium citrate oral- 15 mEq tabletpotassium citrate oral- 10 mEq (1,080 mg) tabletpotassium citrate oral- 15 mEq tabletpotassium citrate oral- 5 mEq (540 mg) tabletpotassium citrate oral- 15 mEq tabletUrocit-K 10 oral- 10 mEq (1,080 mg) tabletUrocit-K 15 oral- 15 mEq tabletCopyright © 2010 First DataBank, Inc.Print Patient Educationpotassium citrate oral POTASSIUM CITRATE TABLET - ORAL (poh-TASS-ee-um SYE-trate) COMMON BRAND NAME(S): Urocit-K USES: This medication is used to make the urine less acidic. This effect helps the kidneys get rid of uric acid, thereby helping to prevent gout and kidney stones. This medication can also prevent and treat certain metabolic problems (acidosis) caused by kidney disease.Citric acid and citrate salts (which contain potassium and sodium) belong to a class of drugs known as urinary alkalinizers. If you have a condition that requires you to limit your intake of potassium and sodium, your doctor may direct you to take a product that is lower in potassium and sodium. HOW TO USE: Take this medication by mouth as directed by your doctor. Follow your doctor's directions carefully. This medication should be taken with meals or a bedtime snack.Swallow this medication with a full glass of water or other liquid (8 ounces or 240 milliliters) unless your doctor directs you otherwise. Swallow the tablets whole. Do not crush or chew the tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Do not lie down for at least 10 minutes after taking this medication. Do not take this medication on an empty stomach.Your doctor may direct you to eat a low-salt (low-sodium) diet and drink lots of fluids. Follow your doctor's directions closely. Do not use salt substitutes that contain potassium.Dosage is based on your medical condition and response to treatment.Take this medication exactly as prescribed. Do not increase your dose or take this more often without your doctor's approval. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.While taking this medication, you may need to test the pH (acidity) of your urine using special paper. The pH will help determine the proper dose. Consult your doctor or pharmacist for more information. SIDE EFFECTS: Nausea, vomiting, diarrhea, and stomach pain may occur. Taking it after meals will help prevent these side effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.An empty tablet shell may appear in your stool. This is harmless because your body has already absorbed the medication.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This drug may cause serious stomach or intestinal problems (such as bleeding, blockage, puncture). Tell your doctor right away if any of these serious side effects occur: abdominal swelling, black/bloody stools, constipation, dizziness, fast heartbeat, severe stomach/abdominal pain, difficult/painful swallowing, severe vomiting, vomit that looks like coffee grounds.This medication may cause high potassium levels in the blood (hyperkalemia). Tell your doctor right away if any of these serious side effects occur: muscle cramps/weakness, severe dizziness, slow/irregular heartbeat, mental/mood changes (such as confusion, restlessness), tingling of the hands/feet, unusually cold skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain adrenal gland problem (Addison's disease), bladder infection, diabetes, low calcium levels, severe diarrhea, heart problems (such as irregular heartbeat, heart attack), kidney problems, potassium-restricted diet, high potassium levels, stomach/intestinal problems (such as blockage, constipation, ulcers), dehydration.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: antacids that contain aluminum, aspirin and other salicylates (such as salsalate), certain blood pressure medications (including ACE inhibitors such as lisinopril, angiotensin blockers such as losartan), drospirenone, drugs that slow the movement of food/drugs through the esophagus/stomach (including anticholinergics such as belladonna/scopolamine/benztropine, antispasmodics such as glycopyrrolate/oxybutynin, strong opioid pain medicines such as morphine), eplerenone, certain heart medications (such as quinidine, digoxin), lithium, potassium supplements (including salt substitutes), pramlintide, certain "water pills" (potassium-sparing diuretics such as amiloride, spironolactone, triamterene).If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow heartbeat, heart attack, inability to move. NOTES: Do not share this medication with others.Lab and/or medical tests (such as complete blood count, potassium/sodium/chloride levels, kidney function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details. MISSED DOSE: If