Side Effects of Urocit-K (potassium citrate)

Urocit-K (potassium citrate) is a urinary alkalinizing medication used to treat

• renal tubular acidosis with calcium stones,
• hypocitraturic calcium oxalate nephrolithiasis (kidney stones), and
• uric acid lithiasis with or without calcium stones.

Urocit-K makes urine less acidic. Urocit-K works by crystallizing stone-forming salts such as

• calcium oxalate,
• calcium phosphate, and
• uric acid within the urinary bladder by increasing the urinary pH and urine citrate levels. 

Common side effects of Urocit-K include

• abdominal discomfort,
• nausea,
• vomiting,
• diarrhea, and
• increased potassium levels.

Serious side effects of Urocit-K include

• bleeding or perforation of the stomach or small intestine from ulcers,
• narrowing (stricture) of the small intestine from healed ulcers, and
• rarely, cardiac arrest.

Drug interactions of Urocit-K include potassium-sparring diuretics, which can increase potassium levels in body and potentially lead to cardiac arrest.

• Drugs that slow transit of food through the intestine such as atropine, loperamide, liraglutide, and similar drugs may delay passage of potassium tablets through the digestive system and result in increased irritation, ulceration or narrowing of the small intestine.
• Angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and certain diuretics increase potassium levels, causing high potassium levels in the blood when combined with potassium supplements.
• Salt substitutes (for example, Mrs. Dash) often contain potassium.
• Patients using salt substitutes while taking potassium supplements may develop high levels of potassium in the blood.

There are no adequate studies done on Urocit-K to determine safe and effective use in pregnant women. Normally, potassium ions are present in breast milk.

It is unknown if administering Urocit-K can further increase potassium levels. Urocit-K citrate should only be given if needed while breastfeeding.

Side effects of potassium citrate are:

• abdominal discomfort,
• nausea,
• vomiting,
• diarrhea,
• increased potassium levels, and
• rarely cardiac arrest.

Potassium supplements can cause bleeding or perforation of the stomach or small intestine from ulcers, and narrowing (stricture) of the small intestine from healed ulcers.

Postmarketing Experience

Some patients may develop minor gastrointestinal complaints during Urocit-K therapy, such as

• abdominal discomfort,
• 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 their feces.

Potential Effects Of Potassium Citrate On Other Drugs

Potassium-Sparing Diuretics

Concomitant administration of Urocit-K and a potassium-sparing diuretic (such as triamterene, spironolactone or amiloride) should be avoided since the simultaneous administration of these agents can produce severe hyperkalemia.

Potential Effects Of Other Drugs On Potassium Citrate

Drugs That Slow Gastrointestinal Transit Time

These agents (such as anticholinergics) can be expected to increase the gastrointestinal irritation produced by potassium salts.