Potassium Citrate- Citric Acid Crystals

Drug Labeling and Warnings

Drug Details [pdf]

POTASSIUM CITRATE CITRIC ACID CRYSTALS- potassium citrate and citric acid granule, for solution 
Virtus Pharmaceuticals LLC

Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here.

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Potassium Citrate- Citric Acid Crystals

DESCRIPTION

Potassium Citrate - Citric Acid Crystals (potassium citrate and citric acid for oral solution) is a pleasant-tasting oral systemic alkalizer containing potassium citrate and citric acid in a sugar-free base.

Potassium Citrate - Citric Acid Crystals contains in each unit dose packet:

  • * approximate value represented in grams as 1g (1,000mg on individualized packets) units.
  • Potassium Citrate Monohydrate

    3300 mg

    Citric Acid Monohydrate

    1002 mg*

    Each unit dose packet, when reconstituted, provides 30 mEq potassium ion and is equivalent to 30 mEq bicarbonate (HCO3).

    INACTIVE INGREDIENTS

    Blueberry Flavor and Sucralose and other ancillary ingredients as needed to ensure product stability.

    Potassium Citrate Monohydrate  has the chemical name: 1,2,3-Propanetricarboxylic acid, 2-hydroxy-, tripotassium salt, monohydrate. Its chemical structure is as follows:

    potassium chemical structure

    Citric Acid Monohydrate has the chemical name: 1,2,3-Propanetricarboxylic acid, 2-hydroxy-, monohydrate. Its chemical structure is as follows:

    citric acid monohydrate chemical structure

    CLINICAL PHARMACOLOGY

    Potassium citrate is absorbed and metabolized to potassium bicarbonate, thus acting as a systemic alkalizer.  The effects are essentially those of chlorides before absorption and those of bicarbonates subsequently.  Oxidation is virtually complete so that less than 5% of the potassium citrate is excreted in the urine unchanged.

    INDICATIONS AND USAGE

    Potassium Citrate - Citric Acid Crystals is an effective alkalinizing agent useful in those conditions where long-term maintenance of an alkaline urine is desirable, such as in patients with uric acid and cystine calculi of the urinary tract, especially when the administration of sodium salts is undesirable or contraindicated.  In addition, it is a valuable adjuvant when administered with uricosuric agents in gout therapy, since urates tend to crystallize out of an acid urine.  It is also effective in correcting the acidosis of certain renal tubular disorders where the administration of potassium citrate may be preferable.  Potassium Citrate - Citric Acid Crystals is highly concentrated, and when administered after meals and before bedtime, allows one to maintain an alkaline urinary pH around the clock, usually without the necessity of a 2 A.M. dose.  Potassium Citrate - Citric Acid Crystals alkalinizes the urine without producing a systemic alkalosis in recommended dosage.  It is highly palatable, pleasant tasting, and tolerable, even when administered for long periods.  Potassium citrate does not neutralize the gastric juice or disturb digestion.

    CONTRAINDICATIONS

    Severe renal impairment with oliguria or azotemia, untreated Addison's disease, adynamia episodica hereditaria, acute dehydration, heat cramps, anuria, severe myocardial damage, and hyperkalemia from any cause.

    WARNINGS AND PRECAUTIONS

    There have been several reports, published and unpublished, concerning nonspecific small-bowel lesions consisting of stenosis, with or without ulceration, associated with the administration of enteric-coated thiazides with potassium salts.  These lesions may occur with enteric-coated potassium tablets alone or when they are used with nonenteric-coated thiazides, or certain other oral diuretics.  These small-bowel lesions have caused obstruction, hemorrhage, and perforation.  Surgery was frequently required and deaths have occurred.  Based on a large survey of physicians and hospitals, both United States and foreign, the incidence of these lesions is low, and a causal relationship in man has not been definitely established.  Available information tends to implicate enteric-coated potassium salts, although lesions of this type also occur spontaneously.  Therefore, coated potassium-containing formulations should be administered only when indicated, and should be discontinued immediately if abdominal pain, distention, nausea, vomiting, or gastrointestinal bleeding occur.

    Large doses may cause hyperkalemia and alkalosis, especially in the presence of renal disease.  Concurrent administration of potassium-containing medication, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, or cardiac glycosides may lead to toxicity.

    Do not exceed recommended dosage.  Discontinue use if adverse reactions occur.

    Should be used with caution by patients with low urinary output unless under the supervision of a physician.  As with all liquids containing a high concentration of potassium, patients should be directed to dilute adequately with water to minimize the possibility of gastrointestinal injury associated with the oral ingestion of concentrated potassium salt preparations; and preferably, to take each dose after meals to avoid saline laxative effect.

    ADVERSE REACTIONS

    Potassium Citrate - Citric Acid Crystals is generally well tolerated without any unpleasant side effects when given in recommended doses to patients with normal renal function and urinary output.  However, as with any alkalinizing agent, caution must be used in certain patients with abnormal renal mechanisms to avoid development of hyperkalemia or alkalosis.  Potassium intoxication causes listlessness, weakness, mental confusion, tingling of extremities, and other symptoms associated with a high concentration of potassium in the serum.  Periodic determinations of serum electrolytes should be carried out in those patients with renal disease in order to avoid these complications.  Hyperkalemia may exhibit the following electrocardiographic abnormalities:  Disappearance of the P wave, widening and slurring of QRS complex, changes of the S-T segment, tall peaked T waves, etc.

    OVERDOSAGE

    The administration of oral potassium salts to persons with normal excretory mechanisms for potassium rarely causes serious hyperkalemia.  However, if excretory mechanisms are impaired, hyperkalemia can result (see Contraindications and Warnings).  Hyperkalemia, when detected, must be treated immediately because lethal levels can be reached in a few hours.

    Treatment:  Should hyperkalemia occur, treatment measures include the following: (1) Elimination of foods or medications containing potassium. (2) The intravenous administration of 300 to 500 mL/hr of dextrose solution (10 to 25%), containing 10 units of insulin/20 gm dextrose.  (3) The use of exchange resins, hemodialysis, or peritoneal dialysis.  In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the plasma potassium concentration can produce digitalis toxicity.

    DOSAGE AND ADMINISTRATION

    Potassium Citrate - Citric Acid Crystals should be taken mixed in cool water or juice according to directions, followed by additional water or juice, if desired.  Proper dilution may help prevent gastrointestinal injury associated with the oral ingestion of concentrated potassium salt preparations.

    Usual Adult Dose:  Potassium Citrate - Citric Acid Crystals - Contents of 1 packet reconstituted with at least 6 ounces of cool water or juice, after meals and at bedtime, or as directed by physician.

    Usual Pediatric Dose:  Potassium Citrate - Citric Acid Crystals is not recommended for pediatric use.

    Usual Dosage Range:  Contents of 1 packet Potassium Citrate - Citric Acid Crystals, reconstituted as directed and taken four times a day, will usually maintain a urinary pH of 6.5-7.4.  To check urinary pH, HYDRION Paper (pH 6.0-8.0) or NITRAZINE Paper (pH 4.5-7.5) are available and easy to use.

    HOW SUPPLIED

    Potassium Citrate - Citric Acid Crystals - Unit Dose Packets, 100/box (NDC: 76439-261-10).

    STORAGE

    Store at controlled room temperature, 59° - 86° F (15° - 30°C). Protect from excessive heat or freezing.

    Call your doctor for medical advice about side effects.  You may report side effects to FDA at 1-800-FDA-1088 Toll Free.

    Rx ONLY 

    Manufactured for:
    Virtus Pharmaceuticals
    Tampa, FL 33619
    www.virtusRX.com
    MADE IN CANADA

    Virtus
    PHARMACEUTICALS

    Rev. 3/2014

    VIRTUS
    PHARMACEUTICALS       Rx Only

    NDC: 76439-261-10

    Potassium Citrate -
    Citric Acid Crystals

    Oral Solution

    (Potassium Citrate and Citric Acid)

    FRUIT FLAVORED SUGAR FREE

    100 Packets

    Net wt. per packet 4.32 g

     image of carton

    POTASSIUM CITRATE CITRIC ACID CRYSTALS 
    potassium citrate and citric acid granule, for solution
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC: 76439-261
    Route of AdministrationORAL
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    POTASSIUM CITRATE (UNII: EE90ONI6FF) (ANHYDROUS CITRIC ACID - UNII:XF417D3PSL) POTASSIUM CITRATE3.3 g
    CITRIC ACID MONOHYDRATE (UNII: 2968PHW8QP) (ANHYDROUS CITRIC ACID - UNII:XF417D3PSL) ANHYDROUS CITRIC ACID1.002 g
    Inactive Ingredients
    Ingredient NameStrength
    SUCRALOSE (UNII: 96K6UQ3ZD4)  
    Product Characteristics
    Color    Score    
    ShapeSize
    FlavorBLUEBERRYImprint Code
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC: 76439-261-10100 in 1 BOX; Type 0: Not a Combination Product06/13/201404/30/2019
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    Unapproved drug other06/13/201404/30/2019
    Labeler - Virtus Pharmaceuticals LLC (969483143)
    Establishment
    NameAddressID/FEIBusiness Operations
    VIVA PHARMACEUTICAL INC.253288898MANUFACTURE(76439-261)

    Revised: 12/2018