Citra-K200 ml

Citra-K is a urinary alkalinizer used to raise urinary and, to a lesser extent, systemic pH. Its accepted uses fall into a few categories of evidence:

Established uses

• Prevention of uric acid and cystine kidney stones — Citra-K maintains an alkaline urinary pH, which reduces the formation of uric acid and cystine calculi, particularly in patients for whom sodium-containing alkalinizers are unsuitable.
• Management of renal tubular acidosis (RTA) — Citra-K corrects the chronic metabolic acidosis and low urinary citrate that occur in distal and proximal RTA.
• Prevention of recurrent calcium stones associated with hypocitraturia — by increasing urinary citrate excretion, Citra-K inhibits calcium oxalate and calcium phosphate crystallization.

Adjunct / combination-therapy use

• Supportive therapy with uricosuric agents (e.g., probenecid) in gout — Citra-K alkalinizes urine to reduce uric acid crystallization while uricosuric drugs promote uric acid excretion.

Common local (adjunctive, symptomatic) use

• In Bangladesh, Citra-K is also commonly prescribed as an adjunct for symptomatic relief of the burning/discomfort associated with uncomplicated urinary tract infection (UTI). It does not treat the underlying infection and must not replace a prescribed antibiotic when one is indicated.

Potassium Citrate + Citric Acid is formulated as an oral solution/syrup combining two citrate-based alkalinizing salts. A typical 5 mL dose provides potassium citrate (commonly in the range of about 1100 mg potassium citrate monohydrate) together with citric acid monohydrate (commonly around 300–350 mg), yielding roughly 2 mEq of potassium ion per mL as citrate/bicarbonate equivalents.

Exact strengths, excipients, and potassium content per mL vary between brands marketed in Bangladesh, so always check the specific product's label or package insert for the precise composition before dosing.

Citra-K is a sugar-free, non-alcoholic oral alkalinizing solution combining potassium citrate and citric acid. It is used chiefly to make the urine less acidic (more alkaline), which helps prevent certain types of kidney stones and corrects the acid-base disturbance seen in some kidney disorders.

Citra-K is available in Bangladesh under several brand names as an oral solution/syrup taken by mouth after dilution with water.

Urinary alkalinizer (potassium and citrate salt combination) – Citra-K belongs to the class of alkalinizing agents/electrolyte supplements used in urology and metabolic acid-base disorders.

After oral administration, the citrate component of Potassium Citrate + Citric Acid is absorbed and oxidized in the body to bicarbonate, acting as a systemic and urinary alkalinizer. At recommended doses this raises urinary pH toward 6.0–7.0 without producing clinically significant systemic alkalosis.

The resulting alkaline urine increases the solubility of uric acid and cystine, reducing their crystallization into stones, and the citrate ion itself binds urinary calcium and inhibits calcium oxalate/phosphate crystal growth and aggregation — the basis for Potassium Citrate + Citric Acid's role in calcium-stone prevention when hypocitraturia is present. The potassium component also supplies potassium bicarbonate equivalents, helping correct the metabolic acidosis of renal tubular acidosis.

Measure the prescribed dose of Citra-K with the dosing device provided and dilute it in water (a full glass for adults, a half glass for young children) before drinking — do not take the concentrated solution undiluted.

Take Citra-K after meals and at bedtime, and remain upright (do not lie down immediately) after dosing to reduce the risk of local gastrointestinal irritation. If a dose is missed, take it as soon as remembered unless it is close to the next scheduled dose; do not double the dose.

The following interactions with Citra-K are clinically significant and well documented:

• Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene) — concurrent use with Citra-K increases the risk of serious hyperkalemia; this combination should generally be avoided.
• ACE inhibitors and angiotensin receptor blockers (ARBs) — these reduce potassium excretion; combined with Citra-K, especially in patients with renal impairment, the hyperkalemia risk rises substantially and serum potassium should be monitored closely.
• Other potassium supplements or potassium-containing salt substitutes — additive risk of hyperkalemia when combined with Citra-K.
• Cardiac glycosides (e.g., digoxin) — hyperkalemia occurring with Citra-K can blunt digoxin's therapeutic effect, while hypokalemia can worsen digoxin toxicity; potassium levels should be kept stable and monitored.
• Aluminum-containing antacids — citrate in Citra-K significantly increases gastrointestinal absorption of aluminum, raising the risk of aluminum toxicity, particularly in patients with renal impairment; concurrent use should be avoided.

At recommended, properly diluted doses Citra-K is generally well tolerated. Reported side effects include:

• Common: nausea, vomiting, diarrhea or loose stools, abdominal discomfort/pain, and an unpleasant/salty taste, particularly if taken undiluted or on an empty stomach.
• Less common: gastrointestinal ulceration or bleeding, most reported with wax-matrix tablet formulations that lodge in the GI tract rather than with properly diluted solution — see Precautions and Warnings.
• Serious (usually with overdose or in at-risk patients): hyperkalemia, presenting as muscle weakness, tingling of the extremities, mental confusion, and cardiac rhythm disturbances — see Overdose.

Pregnancy: There are no well-controlled studies establishing the safety of Citra-K in human pregnancy. As a source of potassium and an alkalinizing agent it is not known to be a major teratogenic risk, but Citra-K should be used in pregnancy only if clearly needed and the potential benefit justifies the potential risk to the fetus, and only under a physician's supervision with periodic monitoring.

Lactation: It is not well established whether the citrate/potassium components of Citra-K pass into breast milk in clinically significant amounts. Because normal dietary potassium and citrate are already present in breast milk, occasional therapeutic use is generally not expected to pose a major risk to a nursing infant, but Citra-K should still be used during breastfeeding only on medical advice, with the infant observed for any unusual symptoms.

Renal function and potassium monitoring: Because Citra-K supplies potassium, serum potassium and renal function should be checked periodically during treatment, especially in patients with any degree of renal impairment, the elderly, or those on interacting drugs (see Interactions). Use with caution, and only under close monitoring, in mild-to-moderate renal impairment; it is contraindicated in severe renal impairment (see Contraindications).

Gastrointestinal irritation/ulceration: Solid (tablet) formulations of Citra-K that do not dissolve or transit the GI tract properly have been associated with mucosal ulceration. To reduce this risk: always dilute liquid doses fully, take Citra-K with food and with an adequate volume of fluid, and remain upright (avoid lying down) for a period after dosing.

Delayed gastrointestinal transit: Use Citra-K with caution in patients with peptic ulcer disease, esophageal compression (e.g., an enlarged left atrium), gastroparesis, or other conditions that delay passage through the GI tract, since prolonged mucosal contact increases irritation risk.

Cardiac disease: Use Citra-K cautiously in patients with cardiac disease, particularly those prone to atrioventricular block, because hyperkalemia can worsen cardiac conduction.

Overdose of Citra-K can cause hyperkalemia and, less commonly, systemic alkalosis. Warning signs include muscle weakness, paresthesia (tingling) of the extremities, listlessness, mental confusion, a sensation of heaviness in the legs, flaccid paralysis, and irregular heartbeat, which can progress to life-threatening cardiac arrhythmia or cardiac arrest if untreated.

Suspected overdose of Citra-K is a medical emergency: stop the medicine and seek immediate medical attention or contact emergency services/a poison control center right away. Do not attempt to manage a suspected overdose at home; treatment (which may include ECG monitoring, measures to lower serum potassium, and correction of acid-base status) must be carried out by medical professionals.

Store at room temperature (below 30°C), away from light and moisture. Keep the container tightly closed. Keep out of reach of children.

Renal impairment: Citra-K requires dose caution and close monitoring in mild-to-moderate renal impairment and is contraindicated in severe renal impairment (see Contraindications) because of the risk of dangerous hyperkalemia.

Hepatic impairment: No specific dose adjustment has been established; use with routine clinical caution.

Elderly: Older adults more often have reduced renal function and may be taking interacting drugs (e.g., ACE inhibitors, potassium-sparing diuretics), so serum potassium should be monitored more closely during Citra-K therapy.

Pediatric and geriatric use: see Pediatric Uses below for weight/age-based dosing considerations.

Duration of treatment with Citra-K depends on the indication: for symptomatic relief of uncomplicated UTI discomfort it is typically used short-term (a few days) alongside any prescribed antibiotic; for prevention of recurrent uric acid, cystine, or hypocitraturic calcium stones, and for renal tubular acidosis, it is often continued long-term under periodic monitoring of urinary pH and serum potassium, as directed by the physician.

Urinary alkalinizer; potassium/citrate electrolyte supplement

Potassium Citrate + Citric Acid is metabolized to bicarbonate, alkalinizing the urine and, to a lesser extent, the blood; the citrate ion also chelates urinary calcium and directly inhibits crystal formation and aggregation, together reducing the formation of uric acid, cystine, and hypocitraturic calcium stones while correcting the acidosis of renal tubular acidosis.

Citra-K is used in children under medical supervision, with doses adjusted by age: for symptomatic UTI-related discomfort, 5 mL three times daily (diluted in half a glass of water) for ages 1–6 years, and the adult dose (10 mL three times daily) from age 6 years upward; for stone prevention or renal tubular acidosis, 5–10 mL four times daily diluted in water. Safety and efficacy of Citra-K in infants under 1 year of age have not been well established, and use in this age group should be individualized and closely supervised by a pediatrician, with attention to serum potassium and renal function.