Noston Special Precautions

Hyperkalemia: Potassium citrate administration can produce hyperkalemia and cardiac arrest in patients with impaired mechanisms for potassium excretion. Potentially fatal hyperkalemia may develop rapidly and may be asymptomatic. Use of potassium citrate should therefore be avoided in patients with chronic renal failure, or any other condition which impairs potassium excretion such as severe myocardial damage or heart failure.
Gastrointestinal Lesions: In the event of severe vomiting, abdominal pain or gastrointestinal bleeding, potassium citrate treatment should be discontinued immediately and the possibility of bowel perforation or obstruction investigated. Patient should also be instructed to inform physician at once if tarry stools or other evidence of gastrointestinal bleeding is noticed.
General: Regular serum potassium monitoring is recommended. Acid-base balance, other serum electrolyte levels, and electrocardiogram (ECG) should periodically be determined. Careful attention should likewise be given to the patient's clinical status, particularly in the presence of cardiac disease, renal disease or acidosis.
Discontinue potassium citrate treatment in the occurrence of hyperkalemia, a significant rise in serum creatinine, or a significant fall in blood hematocrit or hemoglobin.
Use in Children: Safety and efficacy in children have not been established.