potassium bicarbonate/potassium citrate

Action and Spectrum

Actions and Spectrum 

potassium bicarbonate is an alkalinizing substance that helps in raising the pH of urine and encourages the body to expel extra acid. It functions as a systemic alkalizer, lowering blood acidity by supplying bicarbonate ions (HCO3). 

The main purpose of potassium bicarbonate is to treat metabolic acidosis, a condition marked by high blood acidity. By supplying citrate ions, potassium citrate acts as a urinary alkalinizing agent to raise the pH of urine.

citrate reduces the concentration of calcium in the urine, inhibits crystallisation, and helps avoid kidney stones by binding with calcium in the urine. kidney stones, are frequently prevented and treated using potassium citrate. Patients with uric acid or calcium oxalate benefit most from it. 

Drug Interaction

Adverse Reaction

Frequency not defined  

Vomiting 

Flatulence 

Abdominal pain or discomfort 

Diarrhea 

Hyperkalemia 

Nausea 

Black Box Warning

Black Box Warning 

potassium bicarbonate/potassium citrate does not have any black box warning. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• In people with hyperkalemia, both potassium bicarbonate and potassium citrate should be avoided. The use of these medications may cause potassium levels to rise even more, which could have major negative effects. 
• The use of potassium bicarbonate and potassium citrate may be prohibited in those with end-stage renal disease or severe renal impairment due to the potential danger of further raising potassium levels. 

Caution: 

• Prescriptions for potassium bicarbonate or potassium citrate should be written with caution for individuals with mild to moderate renal impairment.  
• While taking these medications, patients who are dehydrated or have ailments involving fluid and electrolyte imbalances need to be properly watched.  
• The use of potassium bicarbonate or potassium citrate may necessitate caution in patients with Addison’s disease, a disorder marked by adrenal insufficiency, due to the possibility of aggravating electrolyte imbalances. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: C 

Lactation: Excretion into human milk is unknown  

Pregnancy Categories:         

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women. 

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.     

Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology  

A white, crystalline powder known as potassium bicarbonate is made up of potassium and bicarbonate ions. 

By supplying the blood with bicarbonate ions (HCO3), potassium bicarbonate functions as a systemic alkalizer. The body’s buffering system depends on bicarbonate, which also controls the acid-base balance. 

Upon ingestion, potassium bicarbonate splits into potassium ions (K+) and bicarbonate ions in the stomach. The bicarbonate ions can act as a buffer for extra hydrogen ions (H+) in the blood, facilitating the kidneys’ and urine’s ability to remove extra acid. 

By adding citrate ions to the urine, potassium citrate functions as a urinary alkalinizer. Citrate reduces the concentration of calcium in the urine and prevents calcium-based kidney stones from forming by binding with calcium in the urine. 

potassium citrate reduces the production of kidney stones, especially those made of calcium oxalate or uric acid, by raising the pH and citrate levels in urine. 

Pharmacodynamics 

An important electrolyte involved in several physiological functions, including muscle and neuron function, fluid balance, and blood pressure management, potassium is found as potassium bicarbonate. Potassium ions participate in the synthesis of proteins and the metabolism of glucose as co-factors for several enzymes. 

Supplementing with potassium bicarbonate can raise serum potassium levels, which makes it effective for treating or preventing hypokalemia. By raising the pH and citrate levels in the urine, potassium citrate changes the chemistry of the urinary system.

Potassium citrate has an alkalinizing effect because it changes citrate ions into bicarbonate ions, which raises the pH of the urine and lowers the risk of kidney stone development. By raising urinary pH and lowering uric acid saturation in the urine, potassium citrate also helps to inhibit the production of uric acid stones. 

Pharmacokinetics 

Absorption   

The small intestine is where potassium bicarbonate is most effectively absorbed in the digestive system. Passive diffusion is the process used for absorption. 

Additionally, the small intestine is where potassium citrate is most readily absorbed in the digestive system. It goes through passive diffusion to absorb. 

Distribution 

Following absorption, potassium bicarbonate and potassium citrate are both distributed throughout the body. The extracellular fluid, intracellular fluid, and diverse tissues all contain potassium ions. The serum content of potassium and the electrolyte balance are the main factors that control its distribution. 

Metabolism 

The body does not considerably metabolize potassium bicarbonate. It mainly functions as an electrolyte and an acid-base regulator without going through a lot of metabolic changes. 

In the liver, citrate goes through a few metabolic processes before being converted to potassium citrate. Citrate has an alkalinizing impact on the urine because it can be converted to bicarbonate ions. 

Elimination and excretion 

potassium bicarbonate is eliminated by the kidneys. It is primarily removed as potassium ions and bicarbonate ions through the urine. potassium citrate is mostly eliminated by the kidneys, like potassium bicarbonate. Citrate ions help to alkalinize the urine whereas potassium ions are excreted in the urine. 

Adminstartion

Administration 

There are several ways to administer potassium bicarbonate and potassium citrate, including tablets, capsules, powders, and solutions.

Patient Information Leaflet

Patient information leaflet 

Generic Name: potassium bicarbonate/ potassium citrate 

Why do we use potassium bicarbonate/ potassium citrate? 

A condition known as metabolic acidosis is characterised by an abnormal build-up of acid in the body. By supplying bicarbonate ions to raise blood pH, potassium bicarbonate is used to manage and treat metabolic acidosis.  

Kidney stones are frequently prevented and treated with potassium citrate. By alkalinizing the urine, it lowers the concentration of chemicals that can cause stones, such as calcium and uric acid.