Citrate Salts (Potassium Citrate, Sodium Citrate, Citric Acid)
Potassium citrate, Sodium citrate, Citric acid
Also known as: Nutrived · Urocit-K · Citrolith · Polycitra · Oracit · Bicitra · Cytra · Naturalyte · Citrate of potash · Citric acid tripotassium salt monohydrate · Shohl's solution
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Adjunctive therapy to inhibit calcium oxalate crystal formation (hypocitraturia) | 40-75 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Adjunctive therapy to inhibit calcium oxalate crystal formation | Initially 50 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Decrease possibility of calcium oxalate stone formation (Nutrived Potassium Citrate Granules) | 1 scoop mixed or sprinkled on food per 10 lb. body weight per day | PO | q24h | — | 🌎 NA |
| Persistent calcium oxalate crystalluria/uroliths (after diet and hydrochlorothiazide) | 50-75 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Adjunctive therapy of chronic renal failure as a potassium supplement and alkalinizing agent | Initially, 75 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- Adjunctive therapy to inhibit calcium oxalate crystal formation (hypocitraturia): Avoid overzealous urinary alkalinization as calcium phosphate uroliths may form.
- Adjunctive therapy to inhibit calcium oxalate crystal formation: Monitor urine pH; goal is to obtain values of 7-7.5.
- Persistent calcium oxalate crystalluria/uroliths (after diet and hydrochlorothiazide): Give to effect to achieve a urine pH of 6.5-7. If urine pH already above 7-7.5, do not use. Monitor serum potassium monthly.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Adjunctive therapy to inhibit calcium oxalate formation | Initially 50-100 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Decrease possibility of calcium oxalate stone formation (Nutrived Potassium Citrate Granules) | 1 scoop mixed or sprinkled on food per day | PO | q24h | — | 🌎 NA |
| Adjunctive therapy to inhibit calcium oxalate formation | 100-150 mg/kg/day PO | PO | q24h | — | 🌎 NA |
| Adjunctive therapy of chronic renal failure as a potassium supplement and alkalinizing agent | Initially, 75 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Significantly acidemic chronic renal failure | 2.5 mEq (total dose) potassium or 15-30 mg/kg as potassium citrate PO q12h | PO | q12h | — | 🌎 NA |
| Hypokalemic chronic renal failure | 2-4 mEq (total dose) of potassium per day as potassium citrate or potassium gluconate | PO | q24h | — | 🌎 NA |
- Adjunctive therapy to inhibit calcium oxalate formation: Goal is to achieve a urine pH of approximately 7.5.
- Adjunctive therapy to inhibit calcium oxalate formation: It is unclear whether this dose will actually increase urinary citrate in cats.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Citrate salts are primarily utilized in veterinary medicine as urinary alkalinizers and in the management of chronic metabolic acidosis, a condition frequently associated with chronic kidney disease (CKD) or renal tubular acidosis.
Potassium citrate is particularly valuable for the prevention of calcium oxalate uroliths (stones) in dogs and cats. It is often preferred over sodium bicarbonate because it is more palatable and provides potassium supplementation, which is beneficial since many CKD patients are prone to hypokalemia.
Clinical Pearl: While highly effective for calcium oxalate prevention, overzealous alkalinization must be avoided, as a urine pH that is too high can inadvertently promote the formation of calcium phosphate uroliths.
Mechanism of action
Citrate salts are absorbed from the gastrointestinal tract and oxidized in the liver to produce bicarbonate (HCO3-), which acts as a systemic alkalinizing agent, raising blood pH and subsequently urine pH.
In the urinary tract, the mechanism is twofold:
- Alkalinization: The resulting alkaline urine increases the solubility of calcium oxalate.
- Chelation: Excreted citrate directly complexes with calcium in the urine → decreases the concentration of free calcium available to bind with oxalate → inhibits the formation and growth of calcium oxalate crystals.
Safety & warnings
Contraindications
- Heart failure
- Severe renal impairment (with azotemia or oliguria)
- Urinary tract infections (UTI) associated with calcium or struvite stones
- Aluminum toxicity
- Hyperkalemia or conditions predisposing to it (adrenal insufficiency, acute dehydration, uncontrolled diabetes mellitus) - for potassium citrate
- Peptic ulcer disease
- Delayed gastric emptying, esophageal compression, or intestinal obstruction (specifically for tablet formulations)
Adverse effects
- Gastrointestinal distress (nausea, vomiting, diarrhea)
- Hyperkalemia (specifically with potassium citrate)
- Fluid retention (specifically with sodium citrate)
- Metabolic alkalosis (rare)
Precautions
Use with caution (weigh risks vs. benefits) in severe renal tubular acidosis or chronic diarrheal syndromes as they may be ineffective. Sodium citrate products should be used with caution in patients with congestive heart disease due to sodium load. Monitor serum potassium levels closely when using potassium citrate, especially in patients with renal insufficiency.
Drug interactions
Alkalinized urine can decrease excretion, potentially increasing toxicity.
Alkalinized urine can decrease excretion.
May cause systemic alkalosis. Aluminum-containing antacids may cause aluminum toxicity, especially in renal insufficiency. Sodium bicarbonate combinations may cause hypernatremia.
Alkalinized urine can increase the excretion of salicylates, decreasing their efficacy.
Solubility is decreased in an alkaline environment; monitor for signs of crystalluria.
Alkalinized urine can decrease excretion.
Concurrent use is not recommended as methenamine requires an acidic urine for efficacy.
Alkalinized urine can decrease excretion.
Alkalinized urine can decrease excretion.
May lead to increases in serum potassium levels (hyperkalemia) when used with potassium citrate.
May increase serum potassium levels when used with potassium citrate.
May increase serum potassium levels when used with potassium citrate.
May increase serum potassium levels when used with potassium citrate.
May increase serum potassium levels when used with potassium citrate.
May lead to severe hyperkalemia when used with potassium citrate.
Monitoring
- Serum potassium, sodium, bicarbonate, chloride
- Acid/base status
- Urine pH
- Urinalysis (monitor for crystalluria)
- Serum creatinine and CBC (particularly in chronic renal failure)
Pharmacokinetics
Absorption
Absorption is nearly complete after oral administration.
Metabolism
Citrate salts are oxidized in the body to bicarbonate. The citric acid component is converted to carbon dioxide and water.
Elimination
Less than 5% of a dose is excreted unchanged in the urine.
Overdose
Overdosage and acute toxicity generally fall into 4 categories:
- Gastrointestinal distress and ulceration
- Metabolic alkalosis
- Hypernatremia (with sodium citrate)
- Hyperkalemia (with potassium citrate)
Treatment: If an overdose occurs and preventing absorption is reasonable (especially with tablets), employ gut-emptying protocols if not contraindicated. Treat GI effects with intravenous fluids or supportive care. Hyperkalemia, hypernatremia, and metabolic alkalosis should be treated symptomatically. Contact an animal poison control center for specific treatment modalities.
Available products
Formulations
- Granules
- Extended-release oral tablets
- Syrup
- Oral solution
- Crystals for reconstitution
Veterinary
- Potassium Citrate and Fatty Acids Granules: 300 mg potassium citrate (approx. 2.8 mEq K) per 5 g scoop (Nutrived Potassium Citrate Granules for Cats and Dogs)
Human-labeled
- Potassium Citrate Extended-Release Oral Tablets: 5 mEq (540 mg), 10 mEq (1080 mg) & 15 mEq (Urocit-K, generic)
- Potassium Citrate/Sodium Citrate Tablets: 50 mg potassium citrate / 950 mg sodium citrate (Citrolith)
- Potassium Citrate/Sodium Citrate Syrup & Solution: 550 mg K citrate, 500 mg Na citrate, 334 mg citric acid/5 mL (Polycitra, Polycitra-LC)
- Potassium Citrate/Citric Acid Solution: 1100 mg K citrate, 334 mg citric acid/5 mL (Polycitra-K, Cytra-K)
- Potassium Citrate/Citric Acid Crystals for Reconstitution: 3300 mg K citrate, 1002 mg citric acid per packet (Polycitra-K)
- Sodium Citrate/Citric Acid Solutions: 490-500 mg Na citrate, 334-640 mg citric acid/5 mL (Oracit, Bicitra)
- Oral Electrolyte Solution: 20 mEq K, 30 mEq citrate/L (Naturalyte)
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store solutions and potassium citrate tablets in tight containers at room temperature unless otherwise recommended by the manufacturer.
Client information
Important: Do not crush or allow your pet to chew extended-release tablets, as this can cause rapid release of the medication and stomach irritation.
- Administration: Give this medication with or immediately after meals to minimize stomach upset. If using granules or liquid, mix well with food.
- Hydration: Ensure your pet always has access to plenty of fresh drinking water.
- Monitoring: Your veterinarian will likely need to check your pet's urine pH and blood work (especially potassium levels) regularly to ensure the dose is correct and safe.
- Side Effects: Contact your veterinarian if your pet experiences persistent vomiting, diarrhea, weakness, or changes in urination.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.