Potassium Citrate Dosages for Adults: Your GoodRx Guide

If you’ve ever had kidney stones, you may have been prescribed medication to help treat them — or prevent them from happening again. Potassium citrate (Urocit-K) is one medication that does just that.

To get the most out of this medication, you’ll want to follow your prescriber’s instructions for how to take it. Using the right potassium citrate dosage is important to effectively treat your kidney stones and minimize possible side effects.

Potassium citrate, however, isn’t approved for use in children. Though it may be used off-label in some cases, we’ll only discuss its use in adults in this article.

What’s the typical potassium citrate dosage for adults?

Potassium citrate comes as an extended-release (ER) tablet. It’s available as 5 milliequivalents (mEq), 10 mEq, and 15 mEq tablets. It’s FDA approved to treat kidney stones made of calcium and uric acid, and to prevent calcium stones from recurring. It’s also used to treat stones made of cystine, though this is an off-label use.

Your potassium citrate dosage depends on the amount of citrate in your urine. This is measured using a 24-hour urinary citrate test. The pH of your urine may also be measured. Urine pH is a measure of how acidic or basic your urine is.

Citrate is an acid that’s naturally produced in your body. It’s also found in a variety of fruits and vegetables. In the urine, citrate helps block the formation of kidney stones in many ways. If you have low citrate in your urine (hypocitraturia), you’re more likely to have kidney stones.

The two goals of potassium citrate treatment are to:

• Increase citrate in the urine to greater than 320 mg per day and as close to what’s considered the normal value of 640 mg per day

• Increase the pH of your urine to a target of 6 to 7

Mild to moderate hypocitraturia

If you have more than 150 mg per day of citrate in your urine, the typical potassium citrate dose is 15 mEq twice daily or 10 mEq three times per day.

Severe hypocitraturia

If you have less than 150 mg per day of citrate in your urine, you’re considered to have severe hypocitraturia. In this case, the typical potassium citrate dose is either 30 mEq twice daily or 20 mEq three times daily.

How will you be monitored if you take potassium citrate?

You’ll complete a 24-hour urinary citrate test before you start potassium citrate. They’ll also check the pH of your urine. These tests may be repeated after dosage changes and regularly throughout treatment. Other tests that your prescriber may order for you include:

• An electrolyte panel to check sodium, potassium, and chloride levels 

• A creatinine test to check your creatinine levels in the blood, which is a measure of kidney function

• A complete blood count (CBC) to check the levels of various blood cells

• An electrocardiogram (ECG) which looks at your heart’s electrical patterns

If any tests show abnormalities, your prescriber may adjust your potassium citrate dosage or recommend you stop taking it altogether. For example, one side effect of potassium citrate, high potassium levels (hyperkalemia), can be severe in rare cases. If your electrolyte panel shows high potassium levels, ask your prescriber whether you need to make any changes.

How frequently you need these tests depends on your current health status. For example, if you have kidney or heart problems, your prescriber may check these more often.

How do you take potassium citrate?

There are a few tips to follow if you’re taking potassium citrate. These include:

• Limiting your salt intake: It’s best to limit salt (sodium) while taking potassium citrate. This is because when the body loses sodium in the urine, it also loses calcium, which can form stones. Limiting sodium to 2,000 mg per day is a good goal. This may take some extra effort, since just one teaspoon of salt has about 2,3000 mg of sodium.

• Drinking lots of fluids: This increases how much you pee, reducing the risk of kidney stones. Drinking 2 liters of water per day is a good goal.

• Taking potassium citrate with food: Taking potassium citrate with meals, or within 30 minutes after meals or a snack, can help alleviate side effects like nausea.

Should certain people avoid potassium citrate?

Some people may need to avoid potassium citrate. If you have existing hyperkalemia, kidney failure, or diabetes that isn’t controlled, potassium citrate should be avoided. Another time to avoid potassium citrate is when you have an active urinary tract infection (UTI).

Additionally, certain medications aren’t safe to combine with potassium citrate. For example, it’s best to avoid over-the-counter (OTC) supplements containing potassium because this increases your risk of hyperkalemia. To figure out whether any of your medications might interact with potassium citrate, give your prescriber and pharmacist a list of medications you take. Make sure to include any OTC products you use.

What happens if you miss a dose of potassium citrate?

If you miss a dose of potassium citrate, take it as soon as you remember. However, if it’s close to your next dose, just skip the missed dose and resume your usual dosing schedule.

Try to avoid missing too many doses of potassium citrate. This may increase your chances of developing kidney stones. If you need help remembering to take your medication, consider using a reminder app if you have a smartphone. You can also ask your pharmacist for other strategies to help.

What should you do if you take too much potassium citrate?

The major risk of taking too much potassium citrate is hyperkalemia. Severe hyperkalemia can lead to heart rhythm problems (arrhythmias) or cause your heart to stop (cardiac arrest). But this is rare, and usually only happens if your potassium is extremely high. 

Part of the reason taking too much potassium citrate can be dangerous is because hyperkalemia doesn’t always cause symptoms. So if you think you’ve taken too much potassium citrate, call your prescriber or Poison Control at 1-800-222-1222 right away. Even if you’re not sure how much you’ve taken, make sure you get someone on the phone who can guide you through next steps. 

If you’re experiencing severe symptoms of hyperkalemia, such as heart palpitations, shortness of breath, or chest pain, seek emergency care or dial 911.

How to save on potassium citrate

Potassium citrate is available as both a brand-name and generic medication. GoodRx can help you save over 80% off the average retail price of the generic version. Generic potassium citrate's price at certain pharmacies may be as low as $23.74 per month with a free GoodRx discount.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Soojin Jun, PharmD

Soojin has 10 years of experience in various pharmacy settings, from inpatient to outpatient settings, and population health in value-based healthcare models. She completed training in various areas of healthcare to ensure patient safety, from activism, geriatric pharmacy, medication safety, healthcare quality, patient safety, death and dying, and trauma-informed care.

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