クエン酸塩（クエン酸カリウム、クエン酸ナトリウム、クエン酸）
Citrate Salts (Potassium Citrate, Sodium Citrate, Citric Acid)
Potassium citrate, Sodium citrate, Citric acid
別名: Nutrived · Urocit-K · Citrolith · Polycitra · Oracit · Bicitra · Cytra · Naturalyte · Citrate of potash · Citric acid tripotassium salt monohydrate · Shohl's solution
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
クエン酸塩は獣医学において主に尿アルカリ化剤として使用され、慢性腎臓病（CKD）や尿細管性アシドーシスに伴う慢性代謝性アシドーシスの管理に役立ちます。
特にクエン酸カリウムは、犬や猫のシュウ酸カルシウム結石の形成を予防するために推奨されます。嗜好性が高く、CKD患者に多い低カリウム血症のカリウム補給にもなるため、炭酸水素ナトリウムよりも好まれることがよくあります。
臨床のポイント: シュウ酸カルシウム結石の予防には非常に効果的ですが、尿のpHが高くなりすぎるとリン酸カルシウム結石の形成を促進する恐れがあるため、過度なアルカリ化は避ける必要があります。
作用機序
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.
安全性・警告
禁忌
- 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)
有害事象
- Gastrointestinal distress (nausea, vomiting, diarrhea)
- Hyperkalemia (specifically with potassium citrate)
- Fluid retention (specifically with sodium citrate)
- Metabolic alkalosis (rare)
注意事項
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.
医薬品相互作用
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.
監視
- Serum potassium, sodium, bicarbonate, chloride
- Acid/base status
- Urine pH
- Urinalysis (monitor for crystalluria)
- Serum creatinine and CBC (particularly in chronic renal failure)
薬物動態
吸収
Absorption is nearly complete after oral administration.
代謝
Citrate salts are oxidized in the body to bicarbonate. The citric acid component is converted to carbon dioxide and water.
消失
Less than 5% of a dose is excreted unchanged in the urine.
過剰投与
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.
製品
製剤
- Granules
- Extended-release oral tablets
- Syrup
- Oral solution
- Crystals for reconstitution
動物用医薬品
- 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)
ヒト用医薬品
- 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)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store solutions and potassium citrate tablets in tight containers at room temperature unless otherwise recommended by the manufacturer.
飼主向け情報
重要：徐放錠を砕いたり、ペットに噛ませたりしないでください。薬が急激に放出され、胃を刺激する原因になります。
- 投与方法：胃腸の不調を和らげるため、食事と一緒に、または食後すぐに与えてください。顆粒や液体の場合は、食事によく混ぜてください。
- 水分補給：常に新鮮な水が飲めるようにしてください。
- モニタリング：用量が適切で安全であることを確認するため、獣医師による定期的な尿pHや血液検査（特にカリウム値）が必要になる場合があります。
- 副作用：持続的な嘔吐、下痢、脱力感、または排尿の変化が見られた場合は、獣医師にご連絡ください。
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