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UROCIT-K is a brand name for Potassium Citrate, supplied as a tablet (extended-release). The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: AND CLINICAL USE UROCIT®-K (Potassium Citrate Extended-Release Tablets, USP) is indicated for the management or renal tubular acidosis (RTA) with calcium stones, hypocitraturic calcium oxalate nephrolithiasis of any etiology, and uric acid lithiasis with or without calcium stones. CONTRAINDICATIONS UROCIT®-K…
Verbatim from this product's HC label. Tap a section to expand.
Some patients may develop minor gastrointestinal complaints during UROCIT®-K (Potassium Citrate, Extended-Release Tablets, USP) therapy, such as abdominal discomfort, flatulence, vomiting, diarrhea, loose bowel movements or nausea.
These symptoms are due to the irritation of the gastrointestinal tract, and may be alleviated by taking the dose with meals or snacks, or by reducing the dosage. Patients may find intact matrices in feces. One of the most severe adverse effects from oral potassium salts is hyperkalemia (see WARNINGS).
There have also been warnings of esophageal and gastrointestinal obstruction, bleeding ulcerations or perforation from wax-matrix potassium preparations. (See CONTRAINDICATIONS and WARNINGS sections). SYMPTOMS AND TREATMENT OF OVERDOSAGE Overdosage from therapeutic doses of solid oral potassium salts in persons with normal excretory mechanisms rarely occurs; however, if excretory mechanisms are impaired, potentially fatal hyperkalemia may occur.
Acute (accidental or intentional) overdoses of solid oral potassium salts have resulted in severe and/or fatal hyperkalemia. Symptoms Overdosage with potassium is characterized chiefly by cardiovascular, neuromuscular and gastrointestinal disturbances.
Cardiovascular:
ECG changes, hypotension, and shock, bundle-branch block, ventricular arrhythmias, ventricular fibrillation leading possibly to cardiac arrest. Neuromuscular: paresthesia, arreflexia, convulsions, flaccid paralysis of striated muscle leading possibly to respiratory paralysis.
Gastrointestinal:
Nausea, vomiting, diarrhea and abdominal cramps. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum potassium concentration and characteristic electrocardiographic changes which include increased amplitude and peaking of the T-wave, and flattening or absence of P-wave.
As hyperkalemia worsens prolongation of P-R interval, and widening of QRS complex with S-T segment depression, and arrhythmias may develop. 7 Widening of the QRS complex is one of the most ominous signs and indicates the need for aggressive treatment.
Treatment The plasma concentration and electrocardiogram must be monitored in every case of potassium overdosage, as well as serum electrolytes, BUN, glucose and arterial blood gases. Electrocardiographic signs of hyperkalemia (tall peaked T-waves, P-R prolongation, disappearance of P-waves, QRS widening, heart block) are indications for immediate treatment.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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In severe hyperkalemia (plasma potassium exceeds 8 mEq/L or ECG abnormalities include absence of P-wave, presence of widened QRS complex or ventricular arrhythmia): • Administer intravenously 300 to 500 mL/hr of 10% dextrose solution containing 10- 20 units of insulin per 1,000 mL.
• Correct acidosis, if present, with intravenous sodium bicarbonate (44 to 132 mEq per liter of glucose solution). v. over 1 to 5 minutes under continuous ECG monitoring. Administer cation exchange resin by high retention enema. 30 to 50 g sodium polystyrene sulfonate suspended in 100 mL warm aqueous sorbitol solution should be kept in the sigmoid colon for several hours, if possible.
The colon is then irrigated with a non-sodium containing solution to remove the resin. Repeated enemas can be administered, or the resin given repeatedly by month to maintain a physiologic potassium concentration. Hemodialysis or peritoneal dialysis may be of use, particularly in patients with renal failure.
5 and 8 mEq/L or ECG peaking of T-wave): • Administer intravenously 300 to 500 mL/hr of 10% dextrose solution containing 10-20 units of insulin per 1000 mL. • Correct acidosis, if present, with intravenous sodium bicarbonate (44 to 132 mEq/L of glucose solution).
• Correct hyponatremia and hypovolemia, if present. Once the patient's cardiac state has been stabilized, in the case of a recent acute ingestion of UROCIT®-K, consideration should be given to the evacuation of the stomach. When overdosage is the result of chronic therapeutic ingestion, UROCIT®-K should be discontinued immediately as well as potassium containing foods and medications and also potassium-sparing diuretics.
8 In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the serum potassium concentration can produce digitalis toxicity. DOSAGE AND ADMINISTRATION Treatment with UROCIT®-K (Potassium Citrate Extended-Release Tablets, USP) should be added to a regimen that limits salt intake (avoidance of foods with high salt content and of added salt at the table) and encourages high fluid intake (urine volume should be at least two liters per day).
0. In patients with severe hypocitraturia (urinary citrate of less than 150 mg/day), therapy should be initiated at a dosage of 60 mEq/day (20 mEq three times/day or 15 mEq four times/day) with meals or within 30 minutes after meals or bedtime snack.
In patients with mild-moderate hypocitraturia (>150 mg/day), UROCIT®-K should be initiated at a dosage of 30 mEq/day (10 mEq three times/day) with meals. Twenty-four hour urinary citrate and/or urinary pH measurements should be used to determine the adequacy of the initial dosage and to evaluate the effectiveness of any dosage change.
In addition, urinary citrate and/or p H should be measured every four months. Doses of UROCIT®-K greater than 100 mEq/day have not been studied and should be avoided. Serum electrolytes (sodium, potassium, chloride and carbon dioxide), serum creatinine, and complete blood count should be monitored every four months.
Treatment should be discontinued if […]