Indications of Citralka Syrup
Citralka syrup is primarily indicated for urinary alkalinization in conditions where long-term maintenance of alkaline urine is desirable, such as in patients with uric acid and cystine calculi of the urinary tract. 1
Primary Indications
- Urinary tract calculi management, particularly uric acid and cystine stones, especially when sodium salts are undesirable or contraindicated 1
- Adjuvant therapy with uricosuric agents in gout treatment, as urates tend to crystallize in acidic urine 1
- Correction of acidosis in certain renal tubular disorders where potassium citrate administration is preferred 1
Mechanism of Action
- Citralka (potassium citrate and citric acid) functions as an alkalinizing agent that increases urinary pH without producing systemic alkalosis when used at recommended dosages 1
- The formulation is designed to be administered after meals and before bedtime to maintain alkaline urinary pH throughout the day 1
- Unlike some antacids, potassium citrate does not neutralize gastric juice or disturb digestion 1
Administration Considerations
- Highly concentrated formulation allows for maintenance of alkaline urinary pH around the clock, usually without requiring middle-of-the-night dosing 1
- The syrup is described as highly palatable and tolerable, even for long-term administration 1
- Should be used with caution in patients with significant renal impairment, as hypermagnesemia may occur in those with creatinine clearance <20 mg/dL 2
Clinical Relevance
- Urinary alkalinization helps prevent crystallization of certain types of kidney stones 1
- In gout therapy, maintaining alkaline urine enhances the effectiveness of uricosuric agents by preventing urate crystal formation 1
- For renal tubular disorders with acidosis, Citralka provides a potassium-based alkalinizing option 1
Important Precautions
- Not indicated for treatment of chronic idiopathic constipation, despite other citrate formulations sometimes being used for this purpose 2
- Unlike magnesium-based products, Citralka's mechanism does not rely on creating an osmotic gradient in the GI tract 2
- Should be distinguished from other citrate-containing products that may have different indications and mechanisms of action 2
The FDA-approved indications clearly establish Citralka syrup as a urinary alkalinizing agent rather than a treatment for gastrointestinal conditions like constipation or gastroesophageal reflux disease 1.