Urinary Alkaliniser
Pregnancy: C
Potassium Citrate
Brand names: Cymex, Potassium Citrate Mixture BPC
Adult dose
Dose: 10 mL three times daily
Route: oral (diluted with water)
Frequency: three times daily
Max: 30 mL/day
Dilute well with water; avoid prolonged use; may mask UTI symptoms — reassess if symptoms persist >2 days
Paediatric dose
Dose: 0.5 mmol/kg
Route: oral
Frequency: three times daily
Max: 15 mL three times daily
Concentration: 1 mmol potassium citrate per mL mmol/ml
Used for urinary alkalinisation in recurrent UTI and uric acid stones; dilute in water
Dose adjustments
Renal
Avoid in renal failure (hyperkalaemia risk)
Hepatic
Use with caution
Paediatric weight-based calculator
Used for urinary alkalinisation in recurrent UTI and uric acid stones; dilute in water
Clinical pearls
- Alkalinises urine to pH >6.5 — relieves dysuria and prevents uric acid crystal formation
- Useful adjunct in uric acid nephrolithiasis (target urine pH 6.5–7.0)
- Does not treat infection — if symptoms persist >2 days, culture and treat
Contraindications
- Renal failure
- Hyperkalaemia
- Urinary tract obstruction
- Metabolic alkalosis
Side effects
- Nausea
- Vomiting
- Hyperkalaemia (if renal impairment)
- Metabolic alkalosis
Interactions
- ACE inhibitors/ARBs (hyperkalaemia)
- Potassium-sparing diuretics (hyperkalaemia)
- Urinary pH-dependent drug interactions
Monitoring
- Serum potassium
- Urine pH
- Renal function
Reference: BNFc; BNF 86. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Hyperkalaemia Management Algorithm · Electrolyte Disorders
- Transtubular Potassium Gradient (TTKG) · Electrolytes
- Potassium Deficit Calculator · Electrolytes
- Hyperkalaemia Severity and ECG Risk · Electrolytes
- IPSS (International Prostate Symptom Score) · Benign Prostatic Hyperplasia
- ICIQ-UI Short Form (Urinary Incontinence) · Incontinence