K-Ston Tablets (1 Bottle = 30 Tablets)

Requires Prescription (YES/NO)

Yes

Generics

Potassium Citrate

Used For

Kidney Disease

How it works

When given orally, the metabolism of absorbed citrate produces an alkaline load. The induced alkaline load in turn increases urinary pH and raises urinary citrate by augmenting citrate clearance without measurably altering ultra-filterable serum citrate. In addition to raising urinary pH and citrate, increases urinary potassium by approximately the amount contained in the medication. It causes a transient reduction in urinary calcium. The changes induced by potassium citrate produce urine that is less conducive to the crystallization of stone-forming salts (calcium oxalate, calcium phosphate and uric acid). Increased citrate in the urine, by complexing with calcium, decreases calcium ion activity and thus the saturation of calcium oxalate. Citrate also inhibits the spontaneous nucleation of calcium oxalate and calcium phosphate (brushite). The increase in urinary pH also decreases calcium ion activity by increasing calcium complexation to dissociated anions. The rise in urinary pH also increases the ionization of uric acid to the more soluble urate ion. Therapy does not alter the urinary saturation of calcium phosphate, since the effect of increased citrate complexation of calcium is opposed by the rise in pH-dependent dissociation of phosphate. Calcium phosphate stones are more stable in alkaline urine.In the setting of normal renal function, the rise in urinary citrate following a single dose begins by the first hour and lasts for 12 hours. With multiple doses the rise in citrate excretion reaches its peak by the third day and averts the normally wide circadian fluctuation in urinary citrate, thus maintaining urinary citrate at a higher, more constant level throughout the day. When the treatment is withdrawn, urinary citrate begins to decline toward the pre-treatment level on the first day. The rise in citrate excretion is directly dependent on the dosage. In patients with severe renal tubular acidosis or chronic diarrheal syndrome where urinary citrate may be very low (<100 mg/day), It may be relatively ineffective in raising urinary citrate. A higher dose may therefore be required to produce a satisfactory citraturic response. In patients with renal tubular acidosis in whom urinary pH may be high, it produces a relatively small rise in urinary pH.

Dosage

Potassium Citrate

Side Effects

Abdominal discomfort, vomiting, diarrhea, loose bowel movements or nausea .

Drug Interactions

Potassium-sparing diuretic (such as triamterene, spironolactone or amiloride) , drugs that slow gastrointestinal transit time such as anticholinergic .

Indication

Indicated for management of : Renal tubular acidosis (RTA) with calcium stones ; Hypocitraturic calcium oxalate nephrolithiasis of any etiology ; Uric acid lithiasis with or without calcium stones .

When not to Use

* In patients with hyperkalemia (or who have conditions pre-disposing them to hyperkalemia), as a further rise in serum potassium concentration may produce cardiac arrest. Such conditions include: chronic renal failure, -uncontrolled diabetes -mellitus, acute dehydration, strenuous physical - exercise in unconditioned individuals, adrenal insufficiency, extensive - tissue breakdown or the administration of a potassium-sparing agent - (such as triamterene, spironolactone or amiloride) . * In patients in whom there is cause for arrest or delay in tablet passage through the gastrointestinal tract, such as those suffering from delayed - gastric emptying, -esophageal compression, intestinal obstruction or - stricture, or those taking anticholinergic medication. * In patients with peptic ulcer disease because of its ulcerogenic potential. * In patients with active urinary tract infection (with either urea-splitting or - other organisms, in association with either calcium or struvite stones). - The ability of potassium citrate to increase urinary citrate may be attenuated by - bacterial enzymatic degradation of citrate. Moreover, the rise in urinary - pH resulting from potassium citrate therapy might promote further bacterial growth. * In patients with renal insufficiency (glomerular filtration rate of less - than 0.7 ml/kg/min), because of the danger of soft tissue calcification and increased risk for the development of hyperkalemia.

Precaution

The use of potassium citrate in patients with chronic renal failure, or any other condition which impairs potassium excretion such as severe myocardial damage or heart failure, should be avoided. Closely monitor for signs of hyperkalemia with periodic blood tests and ECGs .

Warning 1

In patients with impaired mechanisms for excreting potassium, administration can produce hyperkalemia and cardiac arrest. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic.

Warning 2

Upper gastrointestinal mucosal lesions and bleeding should be anticipated. If there is severe vomiting, abdominal pain or gastrointestinal bleeding, it should be discontinued immediately and the possibility of bowel perforation or obstruction investigated.

Warning 3

Safety and effectiveness in children have not been established.

Pregnancy category

Always consult your physician before using any medicine.

Storage (YES/NO)

Store this medicine at room temperature, away from direct light and heat.