Urocit-K (potassium citrate) Overdosage

About Urocit^®-K

Treatment of overdosage

The administration of potassium salts to persons without predisposing conditions for hyperkalemia rarely causes serious hyperkalemia at recommended dosages. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum potassium concentration and characteristic electrocardiographic changes (peaking of T-wave, loss of P-wave, depression of S-T segment and prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest.

Treatment measures for hyperkalemia include the following:

Patients should be closely monitored for arrhythmias and electrolyte changes.
Elimination of medications containing potassium and of agents with potassium sparing properties such as potassium-sparing diuretics, ARBs, ACE inhibitors, NSAIDs, certain nutritional supplements and many others.
Elimination of foods containing high levels of potassium such as almonds, apricots, bananas, beans (lima, pinto, white), cantaloupe, carrot juice (canned), figs, grapefruit juice, halibut, milk, oat bran, potato (with skin), salmon, spinach, tuna and many others.
Intravenous calcium gluconate if the patient is at no risk or low risk of developing digitalis toxicity.
Intravenous administration of 300-500 mL/hr of 10% dextrose solution containing 10-20 units of crystalline insulin per 1,000 mL.
Correction of acidosis, if present, with intravenous sodium bicarbonate.
Hemodialysis or peritoneal dialysis.
Exchange resins may be used. However, this measure alone is not sufficient for the acute treatment of hyperkalemia.

Lowering potassium levels too rapidly in patients taking digitalis can produce digitalis toxicity.

Important Safety Information

Contraindications

Patients with hyperkalemia, peptic ulcer disease, active urinary tract infection, and renal insufficiency
Conditions predisposing patients to hyperkalemia, including chronic renal failure, uncontrolled diabetes mellitus, acute dehydration, strenuous physical exercise in unconditioned individuals, adrenal insufficiency, and extensive tissue breakdown

Warnings and Precautions

Hyperkalemia: In patients with impaired mechanisms for excreting potassium, Urocit-K administration can produce hyperkalemia and cardiac arrest. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic. The use of Urocit-K 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
Gastrointestinal lesions: If there is severe vomiting, abdominal pain or gastrointestinal bleeding, Urocit-K should be discontinued immediately and the possibility of bowel perforation or obstruction investigated

Patient Counseling Information

Administration of Drug

Patients should be told to take Urocit-K 15 mEq without crushing, chewing, or sucking the tablet
Patients should be told to take Urocit-K 15 mEq only as directed, especially if the patient is also taking both diuretics and digitalis preparations
Patients should be told to check with the doctor if they experience difficulty swallowing the tablet or it seems to stick in the throat
Patients should be told to check with the doctor at once if they notice tarry stools or other signs of gastrointestinal bleeding
Patients should be advised that regular blood tests and electrocardiograms will be performed to ensure safety

Patient Monitoring Information

Hyperkalemia

Patients with impaired mechanisms for excreting potassium should be closely monitored for signs of hyperkalemia with periodic blood tests and ECGs

This material is intended to provide basic information. Patients should discuss all medical advice, diagnosis, and treatment with their healthcare provider.

Please see full Prescribing Information