檸檬酸鹽（檸檬酸鉀、檸檬酸鈉、檸檬酸）
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
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
檸檬酸鹽在獸醫學中主要用作尿液鹼化劑，並用於治療與慢性腎病（CKD）或腎小管酸中毒相關的慢性代謝性酸中毒。
檸檬酸鉀特別適用於預防犬貓的草酸鈣結石。由於它適口性較佳且能補充鉀離子（許多慢性腎病患畜容易出現低血鉀），因此通常比碳酸氫鈉更受青睞。
臨床要點：雖然對預防草酸鈣結石非常有效，但必須避免過度鹼化尿液，因為過高的尿液 pH 值可能會意外促進磷酸鈣結石的形成。
作用機制
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.
安全性與警告
禁忌症
- 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)
不良反應
- 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.
藥物相互作用
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.
監測
- Serum potassium, sodium, bicarbonate, chloride
- Acid/base status
- Urine pH
- Urinalysis (monitor for crystalluria)
- Serum creatinine and CBC (particularly in chronic renal failure)
藥物動力學
吸收
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.
排除
Less than 5% of a dose is excreted unchanged in the urine.
過量
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.
可用產品
劑型
- Granules
- Extended-release oral tablets
- Syrup
- Oral solution
- Crystals for reconstitution
獸醫用
- 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)
人用標示
- 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)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store solutions and potassium citrate tablets in tight containers at room temperature unless otherwise recommended by the manufacturer.
飼主須知
重要提示：請勿讓您的寵物咀嚼或咬碎緩釋錠，這會導致藥物釋放過快並刺激胃部。
- 給藥方式：請與食物一起或飯後立即餵食，以減少腸胃不適。如果使用顆粒或液體劑型，請與食物充分混合。
- 水分補充：請確保寵物隨時有充足的新鮮飲水。
- 監測：您的獸醫師可能需要定期檢查寵物的尿液 pH 值和血液（特別是鉀離子濃度），以確保劑量正確且安全。
- 副作用：如果您的寵物出現持續嘔吐、腹瀉、虛弱或排尿習慣改變，請立即聯繫您的獸醫師。
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