Indication

Urinary tract infections, Prevent kidney stone, Prevent gout, Acidosis

Adult Dose

Alkalinizing Agent\r\nUrinary citrate <150 mg/day: 60 mEq/day PO (20 mEq with each meal) OR\r\nUrinary citrate >150 mg/day: 30 mEq/day PO (10 mEq with each meal)\r\n\r\nMaintenance\r\nTitrate dose to achieve urinary citrate 320-640 mg/day & urinary pH 6.0-7.0 (maximum dose 100 mEq/day)

Child Dose

Safety & efficacy not established

Contraindication

Hypersensitivity, hyperkalemia, Addison's disease, anuria, uncontrolled DM, acute dehydration, adrenal insufficiency, renal insufficiency (GFR <0.7ml/kg/min)\r\nDelayed gastric emptying, esophageal compression, GI obstruction, concomitant anticholinergic Rx, peptic ulcer dz, active UTI\r\nConcomitant K+-sparing agents (e.g., triamterene, spironolactone, amiloride)

Mode of Action

Alkalinizes urine; citrate binds with urinary calcium.

Precaution

This medication should not be used ifpatient have (Addison's disease), current bladder infection, uncontrolled diabetes, severe heart disease (e.g., recent heart attack, heart damage), certain stomach/intestinal problems (diabetic gastroparesis, conditions decreasing gut movement, peptic ulcer, blockage), severe kidney disease (e.g., inability to make urine), potassium-restricted diet, high potassium levels, severe loss of body water (dehydration).\r\n\r\nBefore using this medication, tell your doctor or pharmacist your medical history, especially of: low calcium levels, severe diarrhea, heart problems (e.g., irregular heartbeat, heart failure), kidney disease, stomach/gut problems (e.g., irritable bowel), severe tissue damage (e.g., severe burns).\r\n\r\nBefore having surgery, tell your doctor or dentist that you are taking this medication.

Side Effect

Nausea, vomiting, diarrhea, and stomach pain may occur. Taking it after meals will help prevent these side effects.\r\nAn empty tablet shell may appear in your stool. This is harmless because your body has already absorbed the medication.\r\nThis drug may cause serious stomach or intestinal problems (e.g., bleeding, blockage, puncture). \r\nThis medication may cause high potassium levels in the blood (hyperkalemia). \r\nA very serious allergic reaction to this drug is rare.

Interaction

K-sparing diuretics, anticholinergics & other drugs which delay GI transit time.