Potassium bicarbonate and citric acid (oral route)


    Brand Name

    US Brand Name

    Effer-K


    Description

    Potassium bicarbonate and citric acid is used to treat and prevent hypokalemia (low potassium in the blood).

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Tablet, Effervescent

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of potassium bicarbonate and citric acid combination in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    No information is available on the relationship of age to the effects of potassium bicarbonate and citric acid combination in geriatric patients.

    Breastfeeding

    Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Aclidinium
    • Amantadine
    • Amiloride
    • Amitriptyline
    • Amoxapine
    • Anisotropine
    • Atropine
    • Belladonna
    • Benztropine
    • Biperiden
    • Bornaprine
    • Brompheniramine
    • Butylscopolamine
    • Canrenoate
    • Canrenone
    • Carbinoxamine
    • Carisoprodol
    • Chlorpheniramine
    • Chlorpromazine
    • Cimetropium
    • Clemastine
    • Clidinium
    • Clomipramine
    • Clozapine
    • Cyclobenzaprine
    • Cyclopentolate
    • Cyproheptadine
    • Darifenacin
    • Desipramine
    • Dicyclomine
    • Dimenhydrinate
    • Diphenhydramine
    • Doxepin
    • Emepronium
    • Eplerenone
    • Fesoterodine
    • Flavoxate
    • Fluphenazine
    • Glycopyrrolate
    • Glycopyrronium Tosylate

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Aceclofenac
    • Acemetacin
    • Alacepril
    • Aliskiren
    • Amiloride
    • Amtolmetin Guacil
    • Aspirin
    • Azilsartan
    • Azilsartan Medoxomil
    • Benazepril
    • Bromfenac
    • Bufexamac
    • Candesartan
    • Canrenoate
    • Captopril
    • Celecoxib
    • Choline Salicylate
    • Cilazapril
    • Clonixin
    • Delapril
    • Dexibuprofen
    • Dexketoprofen
    • Diclofenac
    • Diflunisal
    • Dipyrone
    • Droxicam
    • Enalapril
    • Enalaprilat
    • Eprosartan
    • Etodolac
    • Etofenamate
    • Etoricoxib
    • Felbinac
    • Fenoprofen
    • Fepradinol
    • Feprazone
    • Floctafenine
    • Flufenamic Acid
    • Flurbiprofen
    • Fosinopril

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Licorice

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Diabetes, uncontrolled or
    • Electrolyte imbalance (eg, metabolic acidosis) or
    • Kidney disease (eg, chronic renal failure) or
    • Stomach or bowel problems (eg, blockage, ulcer)—Use with caution. May increase risk for serious side effects.
    • Heart disease (eg, heart block) or
    • Nerve or muscle problems (eg, familial periodic paralysis, myotonia congenita)—Use with caution. May make these conditions worse.
    • Hyperkalemia (high potassium in the blood)—Should not be used in patients with this condition.

    Proper Use

    Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

    Take this medicine with food or right away after a meal. You may sip the medicine slowly for 5 to 10 minutes.

    To use Effer-K® 10 mEq tablets:

    • Flavored (Cherry Vanilla): Dissolve the tablet completely in 2 to 3 ounces (58 to 85 ml) of cold or ice water.
    • Unflavored: Dissolve the tablet completely in 2 to 3 ounces (58 to 85 ml) of cold juice.

    To use Effer-K® 20 mEq tablets:

    • Flavored (Orange Cream): Dissolve the tablet completely in 3 to 4 ounces (85 to 115 ml) of cold or ice water.
    • Unflavored: Dissolve the tablet completely in 3 to 4 ounces (85 to 115 ml) of cold juice.

    To use Effer-K® 25 mEq tablets:

    • Flavored (Orange, Lemon Citrus, or Cherry Berry): Dissolve the tablet completely in 4 ounces of cold or ice water.
    • Unflavored: Dissolve the tablet completely in 12 to 16 ounces of cold juice.

    Tell your doctor if you are on a low-salt diet or if you are also using salt substitutes.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For oral dosage form (effervescent tablet):
      • For treatment and prevention of hypokalemia:
        • Adults—One tablet 1 to 4 times a day.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Storage

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep the tablet in the foil pouch until you are ready to use it.


    Precautions

    It is important that your doctor check your progress at regular visits to see if the medicine is working properly and to decide if you should continue to take it. Blood, urine, and other laboratory tests may be needed to check for unwanted effects.

    This medicine may cause hyperkalemia. Check with your doctor right away if you have confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, stomach pain, trouble breathing, or weakness or heaviness of the legs.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    More common

    • Confusion
    • diarrhea
    • irregular heartbeat
    • nausea or vomiting
    • nervousness
    • numbness or tingling in the hands, feet, or lips
    • stomach pain
    • trouble breathing
    • weakness or heaviness of the legs

    Incidence not known

    • Bloody or black, tarry stools
    • constipation
    • vomiting of blood or material that looks like coffee grounds

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Most common

    • Stomach discomfort

    Rare

    • Skin rash

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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






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