Urinary Alkalinizer

Availability	Shohl’s Solution	Potassium Citrate Mixt.	Polycitra
mEq	1ml = 1 mEq base	1ml = 3 mEq base	1ml = 2 mEq base
Indication	To correct the acidosis of certain renal tubular disorders To treat metabolic acidosis for long term urine alkalization for prevention Treatment of uric acid and calcium kidney stones and as no particulate neutralizing buffers	For systemic or urine alkalization	For treatment of calcium and uric acid stones
Dose	ADULT: 10 - 20 ml CHILD up to 1 year: 2.5 ml tds 1-5 year: 5 ml tds 6-12 years: 10 ml tds	ADULT: 15-30 ml CHILD up to 1 year: 2.5 ml tds 1 - 5 years: 5 ml 3 times daily 6 - 12 years: 10 ml 3 times daily. To be taken at bedtime	The usual dose of potassium citrate is 30 - 60 mEq/day orally in 3 or 4 doses with meals or within 30 minutes after meals. ADULT: 15 ml tds. CHILD 5-15 ml tds, after meals and at bedtime
	Need to be well diluted with water
Contraindication	Severe renal impairment with Oliguria Azotemia Untreated Addison disease Acute dehydration Heat cramp Anuria Severe myocardial damage Hyperkalemia Sodium-restricted diet	Hyperkalaemia Renal dysfunction Ventricular arrhythmias Addison's Disease.	Severe renal impairment with Oliguria azotemia Untreated Addison’s disease Severe myocardial damage

	Content	Weight (mg)	Molecular weight (g/mol)	Dosage equivalent
Shohl’s solution (1ml)	Sodium Citrate	90	258.07	1ml = 1 mEq base
	Citric Acid Anhydrous Monohydrous	140	192.12 210.14
Shohl’s solution in HKGU (1ml)	Sodium Citrate	200	258.07	1ml = 2 mEq base
	Citric Acid Anhydrous	36.6	192.12
Polycitra (1ml)	Potassium citrate	110	306.395	1ml = 2 mEq base
	Sodium Citrate	100	258.07
	Citric Acid Anhydrous Monohydrous	66.8	192.12 210.14
Potcit	Potassium Citrate	300	306.395	1ml = 3 mEq base
	Citric Acid	50

Shohl’s solution (Phis worksheet)

• Bicitra: Sodium citrate 500 mg and citric acid 334 mg/5 ml (1 mEq sodium and 1 mEq bicarbonate equivalent per ml) (15 ml unit dose, 480 ml).
• Oracit: Sodium citrate 490 mg and citric acid 640 mg/5 ml (1 mEq sodium and 1 mEq bicarbonate equivalent per ml).

References

1. Therapy of Renal Diseases and Related Disorders edited by Wadi N. Suki, Shaul G. Massry

2.https://www.drugs.com/pro/potassium-citrate-sodium-citrate-citric-acid-solution.html

3. PhIS worksheet

4. Lexicomp
5. http://www.rch.org.au/nephrology/protocols/5415_CITRATE_AND_CITRIC_ACID_SOLUTIONS/