Potassium citrate Kidney Disease Uses Side Effects Warnings

Potassium citrate Kidney Disease Uses Side Effects Warnings

potassium citrate

Potassium citrate is used to manage kidney conditions that promote kidney stone formation, such as renal tubular acidosis and low citrate excretion in the urine (hypocitraturia).

Renal tubular acidosis occurs when the kidneys cannot efficiently remove acid wastes from the blood, resulting in excessive urine acidity. This can lead to the formation of calcium oxalate stones in the kidneys. Inadequate citrate in the urine is another risk factor for kidney stone formation.

Kidney stones tend to form in an acidic environment. Potassium citrate helps prevent stone formation by increasing urinary citrate and pH levels, making the urine more alkaline. It also reduces calcium ion activity and calcium oxalate saturation. Additionally, potassium citrate inhibits the spontaneous nucleation of calcium oxalate and calcium phosphate, and promotes the ionization of uric acid to the more soluble urate ion.

The FDA-approved uses of potassium citrate include:

  • Renal tubular acidosis with calcium stones
  • Hypocitraturic calcium oxalate nephrolithiasis
  • Uric acid lithiasis with or without calcium stones


  • Do not use if you are hypersensitive to any components in the formulation.
  • Avoid using if you have high blood potassium levels (hyperkalemia) or are predisposed to it. Conditions that can lead to hyperkalemia include:
  • Chronic kidney failure
  • Kidney insufficiency
  • Uncontrolled diabetes mellitus
  • Adrenal insufficiency
  • Extensive tissue breakdown from injury or trauma
  • Acute dehydration
  • Strenuous exercise in unconditioned individuals
  • Avoid using if you have conditions that can cause esophageal compression, delayed gastric emptying, gastrointestinal obstruction or stricture, or are undergoing anticholinergic treatment.

    What are the side effects of potassium citrate?

    Common side effects of potassium citrate include:

    • High blood potassium levels (hyperkalemia)
    • Abdominal discomfort
    • Nausea
    • Vomiting
    • Diarrhea

    Contact your doctor immediately if you experience any of the following symptoms or serious side effects:

    • Serious heart symptoms, such as fast or pounding heartbeats, fluttering in the chest, shortness of breath, or sudden dizziness
    • Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, or feeling unsteady
    • Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out
    • Serious eye symptoms, such as blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights

    This is not a complete list of all side effects. Contact your doctor for medical advice about serious side effects. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

    What are the dosages of potassium citrate?

    Tablet, Extended Release


    Alkalinizing Agent

    Mild to Moderate Hypocitraturia:

    • Urinary citrate > 150 mg/day: Immediate release: 10 mEq 3 times daily; not to exceed 100 mEq/day; Extended release: 15 mEq 2 times daily or 10 mEq 3 times daily; not to exceed 100 mEq/day
    • Urinary citrate < 150 mg/day: Immediate release: 20 mEq 3 times daily or 15 mEq 4 times daily; not to exceed 100 mEq/day; Extended release: 30 mEq 2 times daily or 20 mEq 3 times daily; not to exceed 100 mEq/day
    • Titrate dose to achieve urinary citrate 320-640 mg/day and urinary pH 6.0-7.0 (maximum dose 100 mEq/day)
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    Dosing considerations:

    • Administer dose with meals or within 30 minutes after meals or bedtime snack
    • Use 24-hour urinary citrate and/or urinary pH measurements to determine initial dosage and evaluate effectiveness of any dosage change


    • Safety and efficacy not established


    • Potassium citrate overdose can cause dangerously high blood potassium levels (hyperkalemia). Symptoms may include muscle paralysis, cardiovascular collapse, and cardiac arrest.
    • If overdose occurs, monitor closely for electrolyte imbalance and irregular heart rhythm. Treat overdose by discontinuing potassium-containing and potassium-sparing medications, eliminating foods containing potassium, administering intravenous fluids and appropriate medications, and considering hemodialysis or peritoneal dialysis.

    What drugs interact with potassium citrate?

    Inform your doctor of all medications you are currently taking to check for possible drug interactions. Do not begin, discontinue, or change the dosage of any medication without your doctor’s recommendation.

    • Potassium citrate has no known severe interactions with other drugs.
    • Serious interactions with potassium citrate include: dextroamphetamine transdermal, drospirenone, potassium acid phosphate, potassium chloride, potassium phosphates IV, spironolactone, and triamterene.

    For more information on drug interactions, visit the RxList Drug Interaction Checker. Always inform your doctor, pharmacist, or healthcare provider of all prescription and over-the-counter medications you use.

    Pregnancy and breastfeeding

    • The effects of potassium citrate on reproductive capacity and fetal development are unknown. Use during pregnancy only if clearly needed.
    • The effect of potassium citrate on breast milk potassium ion content is unknown. Use during breastfeeding only if clearly needed.

    What else should I know about potassium citrate?

    • Take potassium citrate tablets exactly as prescribed. Do not crush, chew, or suck on them.
    • You may need regular blood tests and ECGs while taking potassium citrate. Follow up with your doctor.
    • Seek immediate medical help or contact Poison Control in case of overdose.
    • Store safely out of children’s reach.
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    Potassium citrate is used to manage kidney conditions that promote kidney stone formation, such as renal tubular acidosis and low citrate excretion in the urine (hypocitraturia). Common side effects include high blood potassium levels, abdominal discomfort, nausea, vomiting, and diarrhea. Do not use if you have high blood potassium levels or a predisposition for hyperkalemia. Consult your doctor if pregnant or breastfeeding.


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