Potassium bicarbonate and citric acid (Oral)

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.

It is important for your doctor to check your progress during regular visits to see if the medicine is working properly and to determine if you should keep taking it. You may need blood, urine, and other lab tests to look for unwanted effects.

This medicine may cause hyperkalemia. Contact your doctor immediately if you experience confusion, an irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in your hands, feet, or lips, stomach pain, trouble breathing, or weakness or heaviness in your legs.

Do not take any other medicines unless you have talked about them with your doctor. This includes both prescription and nonprescription (over-the-counter [OTC]) medicines, as well as herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks against the benefits. Here are important points to think about for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

There have not been appropriate studies on how age affects the use of potassium bicarbonate and citric acid combination in children. Safety and effectiveness have not been established.

Geriatric

There is no information available on how age affects the use of potassium bicarbonate and citric acid combination in older patients.

Breast Feeding

Studies indicate that this medication may change milk production or its composition. If your doctor does not prescribe an alternative, you should watch the infant for side effects and ensure they are getting enough milk.

Interactions with Medicines

Some medicines should never be used together, while others can be used together even if an interaction might happen. In these cases, your doctor may change the dose or take other precautions. It is especially important for your healthcare professional to know if you are taking any of the medicines listed below when taking this medicine. The following interactions are significant and are not 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
• Homatropine
• Hydroxyzine
• Hyoscyamine
• Imipramine
• Ipratropium
• Isopropamide
• Loxapine
• Mebeverine
• Meclizine
• Mepenzolate
• Methantheline
• Methixene
• Methscopolamine
• Nortriptyline
• Olanzapine
• Orphenadrine
• Oxitropium Bromide
• Oxybutynin
• Paroxetine
• Perphenazine
• Pimozide
• Pinaverium
• Pipenzolate Bromide
• Pirenzepine
• Prochlorperazine
• Procyclidine
• Promethazine
• Propantheline
• Propiverine
• Protriptyline
• Quetiapine
• Revefenacin
• Scopolamine
• Solifenacin
• Spironolactone
• Stramonium
• Terodiline
• Thioridazine
• Thiothixene
• Tiotropium
• Tizanidine
• Tolterodine
• Triamterene
• Trifluoperazine
• Trihexyphenidyl
• Trimethobenzamide
• Trimipramine
• Tropicamide
• Trospium
• Umeclidinium
• Valethamate

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

• 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
• Ibuprofen
• Imidapril
• Indomethacin
• Irbesartan
• Ketoprofen
• Ketorolac
• Lisinopril
• Lornoxicam
• Losartan
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Moexipril
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Olmesartan
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Pentopril
• Perindopril
• Phenylbutazone
• Piketoprofen
• Piroxicam
• Pranoprofen
• Proglumetacin
• Propyphenazone
• Proquazone
• Quinapril
• Ramipril
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sparsentan
• Spirapril
• Spironolactone
• Sulindac
• Telmisartan
• Temocapril
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Trandolapril
• Triamterene
• Valdecoxib
• Valsartan
• Zofenopril

Using this medicine with any of the following medicines may increase the risk of certain side effects, but taking both may be the best option for you. If both are prescribed together, your doctor may adjust the dose or how often you take one or both.

• Licorice

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around mealtime or with certain foods because interactions might happen. Using alcohol or tobacco with certain medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect how this medicine works. Make sure to inform your doctor if you have any other medical problems, especially:

• Uncontrolled diabetes
• Electrolyte imbalance (e.g., metabolic acidosis) or
• Kidney disease (e.g., chronic renal failure) or
• Stomach or bowel issues (e.g., blockage, ulcer)—Use with caution. May increase risk of serious side effects.

• Heart disease (e.g., heart block) or
• Nerve or muscle problems (e.g., familial periodic paralysis, myotonia congenita)—Use with caution. May worsen these conditions.

• Hyperkalemia (high potassium in the blood)—Should not be used in patients with this condition.

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.

In the U.S.

• Effer-K

Available Dosage Forms:

• Tablet, Effervescent

Therapeutic Class: Potassium Supplement

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.