WHAT IS POTASSIUM CITRATE
We have reached the point in the evolution of this site where the main stone risk factors are introduced and detailed, and the importance of citrate established. I have written about the price of potassium citrate because many patients and physicians have told me that it has risen steeply in recent months, and I would like to be of help.
A LOUD DISCLAIMER
In this post I will mention beverages and medications by name. Let me be clear: I have no financial relationships with the companies that produce or sell the products I write about here. Likewise neither I nor my colleagues at University of Chicago receive any support, financial or otherwise from these companies.
WHAT DOES CITRATE DO FOR PATIENTS?
It Can Reduce Formation of Uric Acid Stones
Some patients produce too acidic a urine which raises risk of uric acid stones, and they need supplemental alkali to make their urine less acidic. The use of potassium citrate to make urine less acidic will prevent uric acid stones in most patients who form them.
It Can Reduce Calcium Stone Formation in Patients with Low Urine Citrate
Some patients form calcium stones because they produce urine that is low in citrate, a valuable inhibitor of crystal formation. Most of the naturally occurring inhibitors in urine are complex molecules about which we can presently do nothing. But citrate is a small and easily measured molecule which we can prescribe and which will increase the urine citrate in at least some patients. Potassium citrate lowers urine calcium excretion. In so doing it reverses a key kidney stone risk factor. In trials potassium citrate reduced stone formation.
Potassium Citrate is Preferable to Sodium Citrate
I have a long list of sodium’s undesirable effects. It can raise blood pressure in large numbers of people, especially with age. It raises the amount of calcium lost in the urine, and that increase of calcium can raise supersaturation and promote calcium kidney stones. High sodium intake can reduce bone mineral retention. But, it may be that the sodium in sodium bicarbonate causes less of these problems than the sodium in sodium chloride – table salt. So I offer sodium bicarbonate as an alternative – with reservations.
Because sodium produces problems of its own, we tend to use potassium citrate as the preferred medication, and generations of stone patients have taken it. In several trials it has reduced new stone formation when given to patients whose urine is citrate deficient.
IS THERE A COST ISSUE?
I am not at all sure why the pricing of potassium citrate has become a topic I often hear about from patients, doctors, and just about everybody in the kidney stone world. Certainly the price must have increased, but I cannot find data on the web to prove the point. I also believe Medicare and perhaps other insurers have altered the status of this drug in their payment schedules. Perhaps some of you know more about the problem than I do and are willing to share what you know by way of a comment.
I did find on inspection of the Medicare lists of drug prices by insurance plan that some plans appear to include potassium citrate pills in their formularies at a preferred level and charge as little as $10 for what appears to be 90 pills. Others do not do this and publish higher prices, often as percentages of the retail cash price. Once again, I hope those of you with experiences in purchasing the drug will share what you know.
CAREFUL SHOPPING LOWERS PRICES
Listening to agitated, and worrisome stories about inflated prices for potassium citrate, I decided to try to be helpful. A Google search for prices of potassium citrate yielded a few promising shopping sites, and on study of the prices I found some much better than others. Note that in the following sections I present a lot of prices and arithmetic. Sometimes, when the message is very clear the results are rounded for simplicity. I give the basis for every calculation if you want absolute exact answers to the nearest penny. Likewise, because we are comparing prices, I have chosen 4 pills daily as my cost basis. The actual range can be from 2 to 6 pills or even more daily, so you will have to adjust costs to your own prescription.
SAM’S CLUB
GoodRx gives what I believe is the clearest list of prices. On their site, Sam’s Club was least expensive at $145 for 180 pills or $0.805 per pill. A typical 4 pills per day treatment option would therefore come to $290/quarter, which is still very pricey. The site gives a long list of other stores whose prices are even higher. Everyday health offers an approximate price for Cytra-K and Polycitra K of $50 – $99, but I could not be sure if this was for a month and likewise how much medication was in a dose.
CANADA
So far as I can tell, importing from Canada will not save you much money. I found Urocit K at $1.10 per tablet, which is higher than Sam’s Club. Another generic, K-Citra 10 was $0.79, which is about the same as Sam’s Club. Another less desirable canadian price was $0.52 per pill if you buy 90 pills, but it was for the 5 mEq size, 1/2 of the usual and therefore the corresponding price for 10 mEq would be $1.04/pill. Given that some costs must accrue for mailing, and there are issues with importing, I cannot see an advantage right now.
WHAT TO DO
Shop Well
Certainly web shopping is a good thing because in my modest and amateurish shopping efforts I found a tremendous range of prices. I am sure that many of you who read this post are far more skilled than I am at shopping for best prices. It is time for you to step forward and share your knowledge with all of us by posting a comment. Everyone will benefit and appreciate your contributions.
But even if you shop better than I did, retail pricing for this medication seems too high for most to afford. At even 4 pills a day, and at the best price I found ($290.00/quarter) we are over $1000.00 yearly for this one product. It seems to me that if your plan does not subsidize this medication, cost could be a serious issue.
Use Beverages
A useful publication reports the alkali content of commercial beverages. The ‘lemonade formula’ referred to on the graph is given as 1/2 cup ReaLemon© mixed with 7-1/2 cups of 
water and sweetened to taste with sugar or artificial sweetener. Diet 7-up was the winner with 10 mEq of citrate in a liter. A single Urocit K tablet contains 10 mEq of potassium citrate, as a comparison, so you would need 4 liters of the beverage daily to match 4 pills.
You Can Do Better
My colleague Dr. John Asplin has measured an additional group of products: Minute Maid Lemonade contains 10.3 mEq/liter of alkali, like Diet 7-up. Gatorade contains only 8.3 mEq/liter. But Crystal Light Lemonade contains 21.7 mEq of alkali, so it is the winner. Each liter substitutes for 2 potassium citrate pills, $1.60 a day, or $144 every 3 months.
We know About Classic Crystal Light
Crystal Light beverages include teas and other drinks. Our measurements refer to the classic or standard lemonade beverage. In what follows all of my remarks at bounded by that limitation. For example, I do not know if liters of the Crystal Light tea might contain excessive amounts of oxalate.
The Prices of Crystal Light
I did not research the price of Crystal Light Lemonade extensively, but Crystal Light Lemonade Pitcher Packs – 3-Pack – are $27.95 at Amazon. Each 3 pack provides 96 quarts of beverage. Each quart is about one liter (0.946 liters to be exact). The cost is therefore $27.95/96 or about $0.29 per 20 mEq (2 pills). This comes to $0.58 daily or $52 every three months. The Amazon site points out that prices might be lower at other stores. Please comment on the best prices you have found so everyone can benefit.
It is Not Just How Much Citrate is in the Beverage
You may have read, on a label or in a scientific paper, that some of the beverages I have listed contain quite a lot of citrate, yet we show them as inferior as an alkali. The reason has to do with the form of the citrate. If the drink is made up in a very acidic manner, much of the citrate is citric acid and will not produce alkali in the body when metabolized. It is only when the molecule is citrate itself, not the citric acid, that it can benefit you as an alkali. The graph and the additions by Dr. Asplin present the true alkali content.
Be Wary of Sugar
The beverages are mainly diet so they do not add to your caloric burden. If you sweeten them, or lace them with fruit juice, or add fruit juice or other flavorings to baking soda – see below, you will be adding calories to your diet and that may not be ideal.
But apart from weight gain, sugar has undesirable effects specific to kidney stone formers: It raises urine calcium losses. Even worse, as the article points out, urine flow rate falls as urine calcium increases, so supersaturation rises for two reasons.
What About Sodium Bicarbonate
It Has a Lot of Alkali for the Money
Baking Soda
According to Google, a teaspoon contains 4,500 mg of baking soda (sodium bicarbonate). Given the molecular weight of 84 mg/mEq (each molecule is one mEq of alkali) the teaspoon contains 53 mEq of sodium alkali. In principle, therefore, one can get alkali for nearly nothing by way of price. According to Dr. Asplin, who has – unbelievably – determined such matters, a teaspoon can contain up to 6,100 mg of baking soda depending on packing and whether the teaspoon is level or heaping.
To get 20 mEq of alkali from baking soda would require about 1/3 teaspoon. Given the variability of what a teaspoon holds, and the sheer problems of fractions of a teaspoon for every dose, I strongly recommend we abandon the remarkable cost savings from baking soda and use sodium bicarbonate tablets, which are very inexpensive and measure out the dose for you.
Sodium Bicarbonate Tablets
You can buy sodium bicarbonate tablets OTC and they are cheap. Concord, via Amazon, sells one hundred 650 mg tablets for $14.95 ($0.14 each). Rugby sells 1000 tablets of the same size for $25.77 ($0.026 each). Because each tablet contains only 7.7 mEq of alkali, it takes about 3 to match 2 K citrate pills (I realize 7.7 times 3 is 23.1 mEq but it approximates 20 mEq and the difference is not important). But that is only $0.075 for the three. So the price can come way down with this form of alkali.
It has a lot of Sodium, Too
But, alas, the 1/3 teaspoon, or the three 650 mg pills, deliver 20 mEq of sodium for each 20 mEq of alkali. The extra 20 mEq of sodium is 460 mg, about 20% of a full day’s sodium intake. For the 40 mEq (4 potassium citrate pills) we have used as a benchmark thus far, it is 40% of a full day’s sodium intake.
Whereas I am unconcerned to recommend beverages as replacements for potassium citrate pills, I have considerable reservation about sodium loads for reasons I have already mentioned and repeat here for emphasis. Excess sodium intake can raise blood pressure in those who are sensitive to salt. Although we have not as yet discussed urine calcium losses as a risk factor for stones, sodium loads will raise urine calcium, and are therefore not beneficial in that respect. If you are taking a diuretic to reduce urine calcium for stone prevention, sodium loads will reduce the efficacy of the treatment and promote losses of potassium. People with heart disease may develop worsening heart failure. Always ask your physician before using sodium bicarbonate as an alkali.
Even so, sodium bicarbonate is not sodium chloride – table salt. For physicians I have reviewed a few papers on the subject. If I sound ambivalent, I am. We may need a few more trials on this subject. In the mean time, all of my reservations hold sway. Use sodium bicarbonate sparingly.
How To Put It All Together
Compromise is the best policy, and I offer a general scheme which patients and physicians can use, if they wish, with their personal alterations. Be sure and check that your combinations provide the dosages your physician wants you to have.
Make a List of Equivalent Dosages
Each potassium citrate pill is 10 mEq; 2 are 20 mEq of alkali. Each liter of Crystal Light is just over 20 mEq of alkali. Each OTC 10 grain (650 mg) sodium bicarbonate tablet is 7.7 mEq of alkali so 3 make 23 mEq.
Make A Day’s Menu
Consider dividing the day’s alkali into 3 parts: Beverages; sodium bicarbonate; potassium citrate pills.
To Replace 2 Potassium Citrate Pills
If we only need 2 10 mEq potassium citrate pills (20 mEq), substitute 1 liter of Crystal Light (20 mEq). It is part of the day’s fluids, but also like a medication, so spread its use out over the day and, if possible, night.
To Replace 4 Potassium Citrate Pills
If we need 4 pills (40 mEq) consider 1 liter of Crystal Light and three sodium bicarbonate pills (20 mEq). The beverage and individual pills can be spread out through the day.
To Replace 6 Potassium Citrate Pills
If we need 6 pills (60 mEq), consider 2 liters of Crystal light (40 mEq) and three sodium bicarbonate pills (20 mEq) likewise spread out through the day. Reserve the potassium citrate pills for when you tire of the beverage or if the extra sodium is raising blood pressure or urine calcium.
Use Many Beverage Types But Keep the Dose of Alkali The Same
Crystal Light is convenient because of how much citrate it contains. But the chart shows many alternatives which can be used instead in larger volumes. Just remember to multiply so the total amount of alkali remains about the same. For example, you need 2 liters of Diet 7-Up to equal one liter of Crystal Light.
Be Inventive: Not All Days Need Be The Same
Mixing and matching is perfectly acceptable. Each day need not look like the one before so long as the correct amount of total alkali is used. The only drawback of a mix and match approach is confusion, so make lists and keep track. As a general rule, try to make the sodium component smaller than the beverage component. Keep the expensive potassium citrate pills as a convenience and source of variety. Obviously if sodium is contraindicated medically, and beverages are too tiresome as a source for all the alkali that is needed, potassium citrate pills can be used to replace sodium bicarbonate pills.
Not All Patients Need Potassium Citrate Or Any Other Alkali
This post is for those who have been told by their physicians to use alkali. Nothing I have written here should induce anyone to begin alkali unless their physician has prescribed or recommended it. Stone formation is complicated. Sometimes alkali can worsen stones, or even become a danger. Potassium can itself be dangerous if kidney function is below normal. Sodium loads are a problem for people with high blood pressure, heart disease, and other illnesses. Do not use sodium or potassium alkali or even high volumes of Crystal Light unless the physician who is treating your stones recommends you do so.
Stay Hopeful
Whatever caused the price rise, the changes in how insurers pay for this medication, or both, may be transitory. Millions of people have kidney stones in the US. Prices for 90 days of a standard treatment are so high that few can afford them without serious budgetary concerns. When so many people are affected, hopefully market or even political forces will countervail. In the meantime, between a few potassium citrate pills, a few liters of Crystal Light, and maybe some sodium bicarbonate, physicians can piece together an adequate regime of alkali for those patients who need it. Not every stone former does need alkali, of course.
ANOTHER AND FINAL DISCLAIMER
I have brought Crystal Light to your attention as an inexpensive substitute for some of the medicinal alkali your physicians may have prescribed. As in my initial ‘Loud Disclaimer’ I say here that I receive no financial or other benefits of any kind from the makers of this beverage, have not, in fact, ever tasted it, and do not currently plan to do so. My evidence for the value of Crystal Light comes from the work of Dr. John Asplin, and comparisons to the published work of Dr. Eisner and his colleagues.
I take potassium citrate prescription and at around 118.00 a month but now must get 90 day supply and the pharmacy and my plan want 537.00 for 3 months worth I would say that’s high! Now switching to TheraLith xr any advice as to this medicine vs potassium citrate?
Hi Diane, I looked and looked but could not find out what is really in this much hyped supplement. It contains magnesium and potassium citrate but the amounts are hidden – at least I failed. So it is just another of many ways to get potassium citrate. The rest of it is nonsense. You could do me a favor – read the label and write back how much magnesium and potassium citrate are in a pill. That will tell you – and me – how much replaces the wildly overpriced potassium citrate pills. If I sound annoyed, I am; reputable companies publish what is in their products – this bunch does not do it very clearly. So, it is just another citrate, and we need to know how much you get in a pill. Thanks for asking, Fred
My urologist put me on Potassium Citrate 3 years ago after 6 kidney stones and sepsis. My prescription is a generic for Urocil K SR 10 meq tablet. It requires you to take more a day but it is cost effective through Medicare. I have one stone left and it has not changed in 3 years. 180 tablets run $3.00 and sometimes $6.00. I have been taking 4 a day for 2 years now and started with 6 a day in the beginning.
Hi Paulette, Thanks for the comment. How many pills do you need to take in order to match the 10 mEq tablets? Regards, Fred Coe
My urologist put me on Potassium Citrate 3 years ago after 6 kidney stones and sepsis. My prescription is a generic for Urocil K SR 10 meq tablet. It requires you to take more a day but it is cost effective through Medicare. I have one stone left and it has not changed in 3 years. 180 tablets run $3.00 and sometimes $6.00. I have been taking 4 a day for 2 years now and started with 6 a day in the beginning.
Hi Paulette, Thanks for the comment. How many pills do you need to take in order to match the 10 mEq tablets? Regards, Fred Coe
Hi Paulette, Thanks for the comment. How many pills do you need to take in order to match the 10 mEq tablets? Regards, Fred Coe
Found this to be so interesting. I was on UrocitK 15 meq for years. I had kidneys stones and bladder infections. The bladder infections were so bad and frequent. I became allergic to so many antibiotics because of taking so often and so long. Two to three rounds to clear it up. Took Citro so much that the last time was rushed to hospital because of reaction. Retired and plan B has been a nightmare. Couldn’t afford it and urologist put me on EfferK 10 meq. Well, I have had 5 bladder infections since being on it. Decided to bite the bullit and pay for the UrocitK. A 90 day supply at WalMart was over $800.00. I take 4 a day. I only got a months suppply and using a coupon from Goodrx, I got it for $88.00. Symbacort is about $150.00 a month. Which I am paying $50.00. This drug crap has to stop! My boyfriend had heart trouble and was on tons of prescriptions and only paying $16.00 for plan D and never paying hardly anything for his medication. That has only been about 4 years ago! I don’t understand what happened. Sorry for the novel, but had to get off my chest.
Hi Jerri, The Effer K 10 mEq tablets more or less conform the the potassium citrate tablets although not exactly. As for the price inflation, I think it scandalous and profiteering. Government cannot stop this until it somehow gets enough will to step in and protect patients. As for me, a simple professor, all I can do is write about the facts. Best, Fred Coe
Found this to be so interesting. I was on UrocitK 15 meq for years. I had kidneys stones and bladder infections. The bladder infections were so bad and frequent. I became allergic to so many antibiotics because of taking so often and so long. Two to three rounds to clear it up. Took Citro so much that the last time was rushed to hospital because of reaction. Retired and plan B has been a nightmare. Couldn’t afford it and urologist put me on EfferK 10 meq. Well, I have had 5 bladder infections since being on it. Decided to bite the bullit and pay for the UrocitK. A 90 day supply at WalMart was over $800.00. I take 4 a day. I only got a months suppply and using a coupon from Goodrx, I got it for $88.00. Symbacort is about $150.00 a month. Which I am paying $50.00. This drug crap has to stop! My boyfriend had heart trouble and was on tons of prescriptions and only paying $16.00 for plan D and never paying hardly anything for his medication. That has only been about 4 years ago! I don’t understand what happened. Sorry for the novel, but had to get off my chest.
Hi Jerri, The Effer K 10 mEq tablets more or less conform the the potassium citrate tablets although not exactly. As for the price inflation, I think it scandalous and profiteering. Government cannot stop this until it somehow gets enough will to step in and protect patients. As for me, a simple professor, all I can do is write about the facts. Best, Fred Coe
Hi could someone please advise me as to how I can check whether i have Calcium Oxalate stones or Uric Acid stones? I have had a number of incidences of severe pain over the last 3.5 years. The first time i thought i was going to faint and passed blood in my urine and the pain stopped immediately. The second time 6 months ago i had severe pain and cold sweat etc on a few different days. A CT scan showed a 4mm stone in my ureta. I didnt want to have surgery so i drank lot of water took Apple Cider Vinegar drank heaps of Watermelon juice and improved my diet hugely and the symptoms disappeared. An ultrasound showed no hydronephrosis and i chose not to do another CT scan as the symptoms had gone however a couple of days ago i have been in agony again with sever pain in my lower back in waves for the last 2 days. This is 6 months down the track. Can someone please help and let me know how i can find out what kind of kidney stones i have? Any other advice would be helpful. Thank you very much.
Hi Al, if the stones can be seen on CT the hounsfield number will help; low values indicate uric acid. You physician can do this. Of course, a stone itself should be analysed. Regards, Fred Coe
Hi could someone please advise me as to how I can check whether i have Calcium Oxalate stones or Uric Acid stones? I have had a number of incidences of severe pain over the last 3.5 years. The first time i thought i was going to faint and passed blood in my urine and the pain stopped immediately. The second time 6 months ago i had severe pain and cold sweat etc on a few different days. A CT scan showed a 4mm stone in my ureta. I didnt want to have surgery so i drank lot of water took Apple Cider Vinegar drank heaps of Watermelon juice and improved my diet hugely and the symptoms disappeared. An ultrasound showed no hydronephrosis and i chose not to do another CT scan as the symptoms had gone however a couple of days ago i have been in agony again with sever pain in my lower back in waves for the last 2 days. This is 6 months down the track. Can someone please help and let me know how i can find out what kind of kidney stones i have? Any other advice would be helpful. Thank you very much.
Hi Al, if the stones can be seen on CT the hounsfield number will help; low values indicate uric acid. You physician can do this. Of course, a stone itself should be analysed. Regards, Fred Coe
I’ve recently found that Wyler’s Light lemonade mix seems to have the same ingredients as Crystal Light, but for a much lower price. On Amazon, one can purchase Wyler’s in bulk that produces 96 drinks for $8.89 as apposed to $27.95 for the same amount of Crystal Light. I don’t, however, know if the mEq is the same in both drinks. I purchased small 10 dose boxes of each at Walmart, and I must say the Crystal Light has a little better flavor than the Wyler’s, but the Wyler’s was $1.00 and the Crystal Light was $2.40. Not knowing how to calculate mEq is somewhat troubling as related to the Wyler’s. Thanks.
I’ve recently found that Wyler’s Light lemonade mix seems to have the same ingredients as Crystal Light, but for a much lower price. On Amazon, one can purchase Wyler’s in bulk that produces 96 drinks for $8.89 as apposed to $27.95 for the same amount of Crystal Light. I don’t, however, know if the mEq is the same in both drinks. I purchased small 10 dose boxes of each at Walmart, and I must say the Crystal Light has a little better flavor than the Wyler’s, but the Wyler’s was $1.00 and the Crystal Light was $2.40. Not knowing how to calculate mEq is somewhat troubling as related to the Wyler’s. Thanks.
Hi Ray, You cannot tell about the citrate. My colleague measured it in Crystal Light but not in Wylers. So if you do use it, get a repeat 24 hour urine and be sure your citrate really went up. Regards, Fred Coe
My son, who suffered from kidney stones for several months, was found to have undetectable levels of citrate in his urine. He was prescribed 6 potassium citrate pills/day. When I tried to pick up his 30 day prescription from Walgreens in Columbia Missouri it was mistakenly coded as not covered by our insurance (Express Scripts). I asked how much the cost would be absent insurance I was told over $900! That’s over $5/pill. I called ES and they straightened the coding problem. Our final cost 20% copay) after insurance was about $40 (about $1.10/pill). Still quite high but manageable.
Hi Jan, All of us are disturbed by the predatory pricing of this simple commonplace material, but you seem to have found a decent alternative. The many comments give lots of others. Be sure your physician is clear with you about why the citrate is so low. Undetectable is unusual. Does he have a reason?? Regards, Fred Coe
My son, who suffered from kidney stones for several months, was found to have undetectable levels of citrate in his urine. He was prescribed 6 potassium citrate pills/day. When I tried to pick up his 30 day prescription from Walgreens in Columbia Missouri it was mistakenly coded as not covered by our insurance (Express Scripts). I asked how much the cost would be absent insurance I was told over $900! That’s over $5/pill. I called ES and they straightened the coding problem. Our final cost 20% copay) after insurance was about $40 (about $1.10/pill). Still quite high but manageable.
Hi Jan, All of us are disturbed by the predatory pricing of this simple commonplace material, but you seem to have found a decent alternative. The many comments give lots of others. Be sure your physician is clear with you about why the citrate is so low. Undetectable is unusual. Does he have a reason?? Regards, Fred Coe
Dr Coe, I had a 24hr urinalysis that detected low levels of urinary citrate ( less than 150 ). I’ve had kidney stones +15 years, Subsequently, my urologist advised supplementing with Potassium Citrate. I did just that and take 6 pills per day which equate to 600mg. Questions
1) What dosing is advisable and how to ascertain that?
2)My urine PH increased from 6 to 8 within a month. Normal?
pjm
Hi PJM, The dosing should be enough to raise your urine citrate without increasing supersaturation with calcium phosphate from high pH. This is something your physician has to supervise. But this drug has special uses. Take a look and see if you fit in. Regards, Fred Coe
Dr Coe, I had a 24hr urinalysis that detected low levels of urinary citrate ( less than 150 ). I’ve had kidney stones +15 years, Subsequently, my urologist advised supplementing with Potassium Citrate. I did just that and take 6 pills per day which equate to 600mg. Questions
1) What dosing is advisable and how to ascertain that?
2)My urine PH increased from 6 to 8 within a month. Normal?
pjm
Hi PJM, The dosing should be enough to raise your urine citrate without increasing supersaturation with calcium phosphate from high pH. This is something your physician has to supervise. But this drug has special uses. Take a look and see if you fit in. Regards, Fred Coe
Dr. Coe, what do you think of using (under medical supervision, of course) the potassium citrate powder that is now available in bulk on Amazon? One brand offers a 5-lb. container for $54.99. It is described as TriPotassium Citrate Monohydrate – USP Food Grade Fine Granular. The seller says it is manufactured in Germany, and repackaged and distributed by a company in Texas. A couple of other brands are also offered for slightly higher prices. One is manufactured in Switzerland by a reputable company, the other in China, and both are distributed by US companies. All three brands are represented as over-the-counter health supplements made up of pure potassium citrate which can be weighed out and dissolved in water. This sounds to me like the answer to the predatory pricing of the drug companies. What do you think? Am I missing something?
Hi Pat, food grade potassium citrate can be used. I would avoid China products; they have a bad record of tainted materials. But doses for stones are about one gram, so you need a proper scale. And, your physician needs to be in the loop and approve. Regards, Fred Coe
Check, check, and check. Thank you so much!
Here is just some info on cost of a 90 day supply of Potassium Citrate ER 15MEQ. I take 2 pills daily = 180pills total. I pay $406. I have insurance coverage but need to met my deductible before they cover anything. So I pay $406 every three months. I get mine from Walgreens. I’ve priced CVS, Osco and Walmart and they are all within pennies of each other. So this is $4.51 a day or 2.25 per pill. Pricing seems insane to me.
Hi Laura, It is gouging. Take a look at the older comments that have a number of tips and workarounds. You will find a cheaper way among them. Best, Fred Coe
Here is just some info on cost of a 90 day supply of Potassium Citrate ER 15MEQ. I take 2 pills daily = 180pills total. I pay $406. I have insurance coverage but need to met my deductible before they cover anything. So I pay $406 every three months. I get mine from Walgreens. I’ve priced CVS, Osco and Walmart and they are all within pennies of each other. So this is $4.51 a day or 2.25 per pill. Pricing seems insane to me.
Hi Laura, It is gouging. Take a look at the older comments that have a number of tips and workarounds. You will find a cheaper way among them. Best, Fred Coe
Hi Dr. Coe,
I just discovered your site, but if this question has been addressed, I couldn’t find it. My husband takes 20MEQ of potassium citrate a day. A friend recently pointed out that potassium citrate tablets are available over the counter. He would have to take about 10 a day, but it would be a huge savings. My concern is that there is no real control over OTC supplements and they could actually be at a much lower strength than advertised. I couldn’t find any with government certification. Thanks! Sally Wenger
Hi Sally, It has been a long term issue on the site. Take a look at older comments – they include Canadian sources, bulk food grade K citrate and DIY measurement. The small OTC pills are what you say. But your physician can tell about the dosing because urine potassium increases and urine ammonia falls in relation to urine sulfate quite predictably with K citrate. Your physician can make this assessment from 24 hour urines done before and during treatment. I presume these have been done. Regards, Fred Coe
My urologist just recommended ksp tabs from ksptabs.com. They combine citrate, B6 and magnesium in an effervescent tablet. They can be pricey. Are they worth the cost in an attempt to stop my ongoing problem with kidney stones or is there something else better? I have an autoimmune disease with calcinosis. I have many subcutaneous calcium lumps.
Thanks for your input.
Hi Sue Loy, You need to know why you need potassium citrate. Take a look at this article for orientation. If you do need it, why not just take it without the extra frills and cost? I sense confusion, and wrote the article to help with it. Regards, Fred Coe
My urologist just recommended ksp tabs from ksptabs.com. They combine citrate, B6 and magnesium in an effervescent tablet. They can be pricey. Are they worth the cost in an attempt to stop my ongoing problem with kidney stones or is there something else better? I have an autoimmune disease with calcinosis. I have many subcutaneous calcium lumps.
Thanks for your input.
Hi Sue Loy, You need to know why you need potassium citrate. Take a look at this article for orientation. If you do need it, why not just take it without the extra frills and cost? I sense confusion, and wrote the article to help with it. Regards, Fred Coe
Hello
I produce kidney stones, likely due to having had a colectomy and subsequent j pouch. My most recent stone was 9mm and laser lithotripsy was used to remove it from the ureter about 3 weeks ago. I had just started using potassium citrate about 3 weeks prior to that most recent attack and don’t know if that caused it to move on down the ureter or if it may have eventually dissolved on its own as did a 4mm stone which was present in my other kidney as a CT scan showed, only 1 month before that during a previous attack. Now, I am stone free (I hope) and wonder when I should take the prescription again. Very frightened of yet another recurrence.
Irene
thank you
Hi Irene, Colectomy is a special branch of stone disease. I presume the pouch is small bowel, not colon. Fluid losses and dehydration, acid urine, potassium losses – all these matter. Generally you can use sodium or potassium alkali, depending on your urine sodium. If the latter is low, I prefer sodium to ward off potential for kidney damage from fluid depletion. The stone can be calcium oxalate or uric acid or mixed. I am sorry I have not as yet written about this condition. Of greatest import is for you to have blood and 24 hour urine testing and for your physician to use it to guide your treatment. This is not a condition where patients can help themselves safely. Regards, Fred Coe
I have read that instant coffee is high in oxalate but brewed is not. Is this correct?
Also, I never see an oxalate value for buttercup squash. I think it might be high. Do you have info on this?
I used to get polycitra k in packets that you mix with water. It has been discontinued. Is there another product like this? My urologist does not know of any and the pills are hard for me to swallow. I found a product called effer-k but it may not be the same thing. Can you help?
Hi Dian,
Having a cup a coffee a day, whether instant or brewed is not an oxalate issue. Just stick to a true cup a day though as the caffeine can be dehydrating if you drink too much. We do not have numbers for butternut squash so when we don’t, my advice is to eat in normal portion size and once a week. Do you have an oxalate problem? Don’t cut out healthy foods unless you need to.
I am unsure of the substitute for polycitra K beside pills so I will ask Dr. Coe to chime in on this part of the question.
Best,
Jill
I have read that instant coffee is high in oxalate but brewed is not. Is this correct?
Also, I never see an oxalate value for buttercup squash. I think it might be high. Do you have info on this?
I used to get polycitra k in packets that you mix with water. It has been discontinued. Is there another product like this? My urologist does not know of any and the pills are hard for me to swallow. I found a product called effer-k but it may not be the same thing. Can you help?
Hi Dian,
Having a cup a coffee a day, whether instant or brewed is not an oxalate issue. Just stick to a true cup a day though as the caffeine can be dehydrating if you drink too much. We do not have numbers for butternut squash so when we don’t, my advice is to eat in normal portion size and once a week. Do you have an oxalate problem? Don’t cut out healthy foods unless you need to.
I am unsure of the substitute for polycitra K beside pills so I will ask Dr. Coe to chime in on this part of the question.
Best,
Jill
Potassium citrate is very cheap – a kilogram (2.2 lbs) is $28 from the vendor I use – including shipping. Simply search Ebay for “potassium citrate ll or kg or powder. Amazon.com also has this product, and it can also be found by using a general google internet search. Caveat – you do have to know how to zero, calibrate and accurately use a scale. It is not difficult. Inexpensive electronic scales are available from $10 on Ebay and Amazon. I’ve used one for years, with .01 gram accuracy. They produce stable reliable numbers. I’ve avoided using any brand names intentionally – I don’t want people to think I have any conflict of interest. The idea of using expensive tablets, when it’s so easy to measure out 1 gram of Kcitrate 3 times a day is abhorrent to my frugal nature.
Addendum to inexpensive K citrate post: Potassium bicarbonate (used in wine making) can be found on the internet for as low as $10 / lb in powder form. Interesting alternative to sodium bicarbonate for those who are salt intolerant. Just search for potassium bicarbonate powder, or lb, and many sources should come up.
Potassium citrate is very cheap – a kilogram (2.2 lbs) is $28 from the vendor I use – including shipping. Simply search Ebay for “potassium citrate ll or kg or powder. Amazon.com also has this product, and it can also be found by using a general google internet search. Caveat – you do have to know how to zero, calibrate and accurately use a scale. It is not difficult. Inexpensive electronic scales are available from $10 on Ebay and Amazon. I’ve used one for years, with .01 gram accuracy. They produce stable reliable numbers. I’ve avoided using any brand names intentionally – I don’t want people to think I have any conflict of interest. The idea of using expensive tablets, when it’s so easy to measure out 1 gram of Kcitrate 3 times a day is abhorrent to my frugal nature.
Addendum to inexpensive K citrate post: Potassium bicarbonate (used in wine making) can be found on the internet for as low as $10 / lb in powder form. Interesting alternative to sodium bicarbonate for those who are salt intolerant. Just search for potassium bicarbonate powder, or lb, and many sources should come up.
Hi Michael, If you look through older comments you will find some before you in complete agreement. But I also agree with your caveat: This is not for those who do not know how to use a scale properly. As for me, I always believe patients who do this should let their physicians know and be sure those physicians are willing to stay responsible. Best, Fred Coe
Told by Urologist after 24 hr urine test to take 2 Potassium Citrate 15 mEq. I take 240 mg Cartia XT for Super Ventricular Tachycardia & worry that the potassium citrate will raise my heartbeat.
Hi Wayne, That is a complex one. In general potassium loading reduces cardiac irritability, but alkali reduce blood calcium ion concentration and that increases irritability. I am afraid your cardiologist needs to decide between these two poles. Regards, Fred Coe
Told by Urologist after 24 hr urine test to take 2 Potassium Citrate 15 mEq. I take 240 mg Cartia XT for Super Ventricular Tachycardia & worry that the potassium citrate will raise my heartbeat.
Hi Wayne, That is a complex one. In general potassium loading reduces cardiac irritability, but alkali reduce blood calcium ion concentration and that increases irritability. I am afraid your cardiologist needs to decide between these two poles. Regards, Fred Coe
Hi, I was in the hospital with a 3mm Stone &diverticulosis , both surprised me and caused excruciating pain(the stone) they told me drink a lot of lemon water and watch for sodium intake . It’s very confusing but you & Jill have made things more clear to me.
Hi Karen, Jill knows how to fashion a proper diet, but your physicians have to be ultimately responsible so be sure and check with them. Regards, Fred Coe
Hi, I was in the hospital with a 3mm Stone &diverticulosis , both surprised me and caused excruciating pain(the stone) they told me drink a lot of lemon water and watch for sodium intake . It’s very confusing but you & Jill have made things more clear to me.
I have monitored my urine pH with OTC dipsticks and I have struggled with getting my urine above 6.5. I am a diagnosed CaOx former and I eat a relatively healthy diet, which includes oxalates in moderate amounts from my daily salad greens. I have yet to do a 24 hour urine test. I have been consuming fresh squeezed lemon and apple cider vinegar daily, as well as magnesium citrate at night, with a minimal effect on raising urine pH. I decided to try a bulk potassium citrate supplement (labeled 448 mg potassium per 1.4 g or 1/4 tsp, other ingredients: none). Surprisingly I’ve raised my urine pH to almost 8 (yes, dipsticks are subjective but the rising trend appears accurate) by taking one or two teaspoons per day divided into a few drinks or meals throughout the day. My question is why does the supplement affect urine pH so much more as compared to the lemon citrate? Also, why is this bulk supplement not listed as a potential therapeutic in most of my searches? I realize this could be dangerous in high doses but sodium bicarbonate is dangerous if consumed in large amounts, too. Any thoughts would be appreciated.
Hi Gary, The lemon materials may have less alkali content than the potassium citrate. But, are you sure this is a sound approach. Given calcium oxalate stones raising urine pH is not the issue – they are indifferent to pH – but rather urine citrate levels, and they are unknown in your case lacking 24 hour urine samples. Possibly I can imagine your treatment worsening things and would advise you get fully tested. As for ads about efficacy, they are not allowed for bulk materials, so far as I know. Also, be careful; 10 mEq of potassium citrate – a standard pill – is 1080 mg. If you do not have perfectly normal renal function, or are diabetic, or any number of other possibilities self dosing with potassium can be dangerous. So let your physician know what you are doing. Keep safe. Here is a reasonable direction. Regards, Fred Coe
I will ask for a 24 hour urine ASAP and discontinue pH monitoring. I was extrapolating from canine models of CaOx urolithiasis monitoring and control. Thanks for your thoughtful input.
I have monitored my urine pH with OTC dipsticks and I have struggled with getting my urine above 6.5. I am a diagnosed CaOx former and I eat a relatively healthy diet, which includes oxalates in moderate amounts from my daily salad greens. I have yet to do a 24 hour urine test. I have been consuming fresh squeezed lemon and apple cider vinegar daily, as well as magnesium citrate at night, with a minimal effect on raising urine pH. I decided to try a bulk potassium citrate supplement (labeled 448 mg potassium per 1.4 g or 1/4 tsp, other ingredients: none). Surprisingly I’ve raised my urine pH to almost 8 (yes, dipsticks are subjective but the rising trend appears accurate) by taking one or two teaspoons per day divided into a few drinks or meals throughout the day. My question is why does the supplement affect urine pH so much more as compared to the lemon citrate? Also, why is this bulk supplement not listed as a potential therapeutic in most of my searches? I realize this could be dangerous in high doses but sodium bicarbonate is dangerous if consumed in large amounts, too. Any thoughts would be appreciated.
Hi Gary, The lemon materials may have less alkali content than the potassium citrate. But, are you sure this is a sound approach. Given calcium oxalate stones raising urine pH is not the issue – they are indifferent to pH – but rather urine citrate levels, and they are unknown in your case lacking 24 hour urine samples. Possibly I can imagine your treatment worsening things and would advise you get fully tested. As for ads about efficacy, they are not allowed for bulk materials, so far as I know. Also, be careful; 10 mEq of potassium citrate – a standard pill – is 1080 mg. If you do not have perfectly normal renal function, or are diabetic, or any number of other possibilities self dosing with potassium can be dangerous. So let your physician know what you are doing. Keep safe. Here is a reasonable direction. Regards, Fred Coe
I will ask for a 24 hour urine ASAP and discontinue pH monitoring. I was extrapolating from canine models of CaOx urolithiasis monitoring and control. Thanks for your thoughtful input.
Hello,
I have been using pure lemon juice in my water thruout the day. Is this a good alternative because I canot tolerate potassium citrate?
Thanks Lesley
Hi Lesley, If you like it as a flavor, it may be effective. But firstly do you need potassium citrate? If so, you can increase urine citrate with a lot more than lemon juice; all fruits and veggies have a lot of citrate in them. What I worry about here is whether you have a coherent program for prevention or are just stuck on one particular remedy. Take a look here and see. Regards, Fred Coe
Hello,
I have been using pure lemon juice in my water thruout the day. Is this a good alternative because I canot tolerate potassium citrate?
Thanks Lesley
Hi Lesley, If you like it as a flavor, it may be effective. But firstly do you need potassium citrate? If so, you can increase urine citrate with a lot more than lemon juice; all fruits and veggies have a lot of citrate in them. What I worry about here is whether you have a coherent program for prevention or are just stuck on one particular remedy. Take a look here and see. Regards, Fred Coe
My urologist prescribed polycitra K powder three times daily for a very low urinary citrate level. I can’t use an extended release tablet because of my ileostomy. I was daunted by the $90 price for one month supply. I am a pharmacist, so I formulated a 3 to 1 mixture of food grade Potassium Citrate and Citric Acid, purchased though Amazon. This mimics the proportions of the commercial product. I then take about 4g of this in water three times daily. This is also more palatable for me as the polcyitra has a sickeningly sweet flavoring. I will have my blood tested for electrolytes after one month and then a repeat 24 hour urine in 3 months. My stones are chronic and calcium oxalate.
Hi Ken, Many have done what you are doing, and so long as you are confident in your measuring and your physician is involved it is a reasonable way around price gouging. You might note your urine sodium; often it is very low in ileostomy and sodium alkali – like sodium bicarbonate pills – can help. Very cheap, and the sodium deficit is sometimes better remedied. Ask your physician. Regards, Fred Coe
Thanks for the info. In the same boat. No stones in 4 years. But med is too expensive.
Hi Thomas, there are many workarounds in the comments to this article – especially if you look back. Perhaps you do not even need potassium citrate. Take a look here and see where you would be. Regards, Fred Coe
My urologist prescribed polycitra K powder three times daily for a very low urinary citrate level. I can’t use an extended release tablet because of my ileostomy. I was daunted by the $90 price for one month supply. I am a pharmacist, so I formulated a 3 to 1 mixture of food grade Potassium Citrate and Citric Acid, purchased though Amazon. This mimics the proportions of the commercial product. I then take about 4g of this in water three times daily. This is also more palatable for me as the polcyitra has a sickeningly sweet flavoring. I will have my blood tested for electrolytes after one month and then a repeat 24 hour urine in 3 months. My stones are chronic and calcium oxalate.
Hi Ken, Many have done what you are doing, and so long as you are confident in your measuring and your physician is involved it is a reasonable way around price gouging. You might note your urine sodium; often it is very low in ileostomy and sodium alkali – like sodium bicarbonate pills – can help. Very cheap, and the sodium deficit is sometimes better remedied. Ask your physician. Regards, Fred Coe
Thanks for the info. In the same boat. No stones in 4 years. But med is too expensive.
Hi Thomas, there are many workarounds in the comments to this article – especially if you look back. Perhaps you do not even need potassium citrate. Take a look here and see where you would be. Regards, Fred Coe
Hi. My urologist believes my body is producing uric acid stones. He has just prescribed the 24-hr urine test. He prescribed 15 mEq potassium citrate twice a day. The cost is $140 for 60 pills/1-month supply. I’d like to avoid this price gouging myself. I’m pretty good at math as long as I know the correct conversions. How many milligrams of potassium citrate (as can be purchased commercially on Amazon.com for example) is equivalent to a 15 mEq pill (or a 10 mEq pill as you mostly cite in your articles)?
Hi Paul, 1080 mg of potassium citrate in 10 mEq capsule. But be sure you buy a balance that can measure to the nearest mg, and know how to use it. Likewise your physician must know and take responsibility. People with uric acid stones often have kidney issues that interfere with potassium excretion. Be careful, use your physician. Regards, Fred Coe
Thank you. I promise to run this by my physician.
My prescription costs $140/month. I found on Amazon potassium citrate powder for $17/680g. My prescription is for 15 mEq twice a day or 30 mEq/day.
30 mEq/day x 1080 mg/10 mEq x $17/680,000 mg x 30 days/month = $2.43/month << $140/month
This seems to be a no-brainer. Am I missing something?
Hi Paul, No it is correct. But be sure you weight properly – these are one gram amounts so you need the right scale and technique. If your physician is involved, I have no concerns – he/she has them all. Potassium is hazardous if taken incorrectly so good measurement is important. Regards, Fred Coe
Thank you for your answer. Now the question is why is the prescription more than 50 times (!) more? (Just venting–you don’t have to answer.)
[Would you delete my last name from my initial question, please?]
Hi Paul, I think you know why and so do I. I will try to track down your prior note and delete the last name – if I can. Fred
Hi. My urologist believes my body is producing uric acid stones. He has just prescribed the 24-hr urine test. He prescribed 15 mEq potassium citrate twice a day. The cost is $140 for 60 pills/1-month supply. I’d like to avoid this price gouging myself. I’m pretty good at math as long as I know the correct conversions. How many milligrams of potassium citrate (as can be purchased commercially on Amazon.com for example) is equivalent to a 15 mEq pill (or a 10 mEq pill as you mostly cite in your articles)?
Hi Paul, 1080 mg of potassium citrate in 10 mEq capsule. But be sure you buy a balance that can measure to the nearest mg, and know how to use it. Likewise your physician must know and take responsibility. People with uric acid stones often have kidney issues that interfere with potassium excretion. Be careful, use your physician. Regards, Fred Coe
Thank you. I promise to run this by my physician.
My prescription costs $140/month. I found on Amazon potassium citrate powder for $17/680g. My prescription is for 15 mEq twice a day or 30 mEq/day.
30 mEq/day x 1080 mg/10 mEq x $17/680,000 mg x 30 days/month = $2.43/month << $140/month
This seems to be a no-brainer. Am I missing something?
Hi Paul, No it is correct. But be sure you weight properly – these are one gram amounts so you need the right scale and technique. If your physician is involved, I have no concerns – he/she has them all. Potassium is hazardous if taken incorrectly so good measurement is important. Regards, Fred Coe
Thank you for your answer. Now the question is why is the prescription more than 50 times (!) more? (Just venting–you don’t have to answer.)
[Would you delete my last name from my initial question, please?]
Hi Paul, I think you know why and so do I. I will try to track down your prior note and delete the last name – if I can. Fred
Thanks for all the info. I have cal/ox stones. Was taking 4 meq daily. Cut back on my own to two daily, plus lemon juice & Apple cider vinegar. Urologist didn’t seem to mind. Four years stone free. I’m 66.
Thanks for all the info. I have cal/ox stones. Was taking 4 meq daily. Cut back on my own to two daily, plus lemon juice & Apple cider vinegar. Urologist didn’t seem to mind. Four years stone free. I’m 66.
Thanks for the info. In the same boat. No stones in 4 years. But med is too expensive. Also did the 24 hour urine test multiple times.
Hi Thomas, sorry I missed this among your four entries. Did your tests reveal a low urine citrate? Was that the reason for your stones? Perhaps you might want to review your lab findings and see. Regards, Fred Coe
Thanks for the info. In the same boat. No stones in 4 years. But med is too expensive. Also did the 24 hour urine test multiple times.
Hi Thomas, sorry I missed this among your four entries. Did your tests reveal a low urine citrate? Was that the reason for your stones? Perhaps you might want to review your lab findings and see. Regards, Fred Coe
Just tried to reorder my rx for potassium citrate and Humana mail order wanted $165.00 for 150 pills @ 1 pill taken twice a day
No way is this affordable. They tell me it’s my copay, yet my out of pocket for rx is only $100.00.
Just tried to reorder my rx for potassium citrate and Humana mail order wanted $165.00 for 150 pills @ 1 pill taken twice a day
No way is this affordable. They tell me it’s my copay, yet my out of pocket for rx is only $100.00.
I am a productive kidney stone maker. I have cystine stones. Passing forty years. I have been taking potassium citrate 1080 mg 10 mEQ for about 10 years. It is the only med that woks. pH is always 7.5 or so. Humana has taken it off list. Cost is 131.00 for 540 pills for 90 days. In the 90s I took Thiola and it almost did me in. It depleated my protein. Hope this can be of some help for someone. Thanks
What is the citrate content of an actual lemon?
Hi Paul, very hard to tell. Total citrate species citrate + citric acid would be a few mEq depending on the size. But if the pH is on the low side as is common, much will be citric acid and that will do nothing to raise urine citrate. So lemons and lemonade – as noted in the table of the article are not a robust source of citrate ion per se. Regards, Fred Coe
What is the citrate content of an actual lemon?
Hi Paul, very hard to tell. Total citrate species citrate + citric acid would be a few mEq depending on the size. But if the pH is on the low side as is common, much will be citric acid and that will do nothing to raise urine citrate. So lemons and lemonade – as noted in the table of the article are not a robust source of citrate ion per se. Regards, Fred Coe
Hello there – thank you for your interested and informative page. My husband takes 3 x 10 mEq daily but, like others has no insurance, and find the price too much. Would it be pertinent for him to change over to Cytra-2 liquid ? It looks like it may be cheaper(?), but my maths is dodgy at the very least lol.
kind regards Clair
Hi Cytra 2 contains 1 mEq of sodium and one mEq of citrate per ml of fluid. Your husband takes 30 mEq of potassium citrate daily. So he would need 30 ml daily. That would provide an additional 30 mEq of sodium instead of potassium. If he is trying to follow a low sodium diet 100 mEq or less, this would comprise 30% of the day’s intake. I do not know the costs of the product except the site above gives 3000 (100 x 30 milliliters), $0.07/ml, $216.97/100 doses of 30 ml, meaning $2.16 for one day at 30 ml/d, or about $65/month. The only drawback is the sodium load, that is quite high. His personal physician needs to decide about that. Regards, Fred Coe
Thank you for your prompt reply, I truly appreciate your assistance. Be blessed sir, C
Hello there – thank you for your interested and informative page. My husband takes 3 x 10 mEq daily but, like others has no insurance, and find the price too much. Would it be pertinent for him to change over to Cytra-2 liquid ? It looks like it may be cheaper(?), but my maths is dodgy at the very least lol.
kind regards Clair
I have a question about the difference in mg… I have a history of kidney stones, but haven’t had in about 8 years since my doctor put me on potassium citrate 10mg, once a day. When I became pregnant a few years later, I was told it was safe to take during pregnancy as well. I moved a couple years ago, and had to switch doctors, who then put me on 15mg 2x a day, and said it was basically the same as what I’d been taking anyway. (I only take one pill a day, bc I felt if the 10mg once a day worked for many years and I wasn’t producing kidney stones, there’s no reason to take more). Now, we switched insurances and the price for the drug is $70 for 60 pills, as opposed to $10 for 60 pills. I checked online and just found Walmart carrying the same drug for around $5 for 180 pills at 99mg. What is the difference with the change in mg? Is it harmful to be taking that much? And, as a side note, if we plan to get pregnant soon, would 99mg be safe to take? Are there are other suggestions of over the counter potassium citrate with a lower dosage? Is it possible that the mg from prescription drugs is different than the mg for over the counter? Thanks for any advice you can give me.
One more thing to add- I just checked and it’s actually 15 MEQ TB, if that means anything. Thanks!
Hi Lauren, The 10 and 15 refer to mEq, not mg. One mEq of potassium citrate is about 108 mg, so a ten mEq tablet is about 1080 mg. The 99 mg is only about 1 mEq so you would need 10 of them to match one 10 mEq pill. Profiteering is the reason prices went up, unfair to patients, and I detest that it happens. Regards, Fred Coe
I have a question about the difference in mg… I have a history of kidney stones, but haven’t had in about 8 years since my doctor put me on potassium citrate 10mg, once a day. When I became pregnant a few years later, I was told it was safe to take during pregnancy as well. I moved a couple years ago, and had to switch doctors, who then put me on 15mg 2x a day, and said it was basically the same as what I’d been taking anyway. (I only take one pill a day, bc I felt if the 10mg once a day worked for many years and I wasn’t producing kidney stones, there’s no reason to take more). Now, we switched insurances and the price for the drug is $70 for 60 pills, as opposed to $10 for 60 pills. I checked online and just found Walmart carrying the same drug for around $5 for 180 pills at 99mg. What is the difference with the change in mg? Is it harmful to be taking that much? And, as a side note, if we plan to get pregnant soon, would 99mg be safe to take? Are there are other suggestions of over the counter potassium citrate with a lower dosage? Is it possible that the mg from prescription drugs is different than the mg for over the counter? Thanks for any advice you can give me.
One more thing to add- I just checked and it’s actually 15 MEQ TB, if that means anything. Thanks!
Hi Lauren, The 10 and 15 refer to mEq, not mg. One mEq of potassium citrate is about 108 mg, so a ten mEq tablet is about 1080 mg. The 99 mg is only about 1 mEq so you would need 10 of them to match one 10 mEq pill. Profiteering is the reason prices went up, unfair to patients, and I detest that it happens. Regards, Fred Coe
I’ve been battling Uric Acid stones for about 3 years now. The first one I was aware of got infected and then when treated, dislodged and got stuck in a ureter and had to be roto-rooter’d out. After a year of K-Citrate 15 Meq x 2, another stone was found. This one passed eventually and my dosage was raised to x 3.
I found that K-Citrate 15 Meq x 3 per day still was not enough as I manufactured a 5mm stone shown on my last Ultrasound. I measure my PH regularly now and try to keep it above 6.5 at all times using 99mg K-Citrate supplement pills I purchased on Amazon. $15 for 500 pills. I take 2 when my PH drops below 6.5.
My PH seems to fluctuate rather wildly! I take my 15Meq tabs at 8am, 4pm and midnight, but quite often take 2 – 99mg K-Citrate tablets per hour until I can get the PH back up. I suspect my diet is the reason.
I mentioned that I was taking the supplemental tablets to my urologist and his only comment was to order a blood test. I’ve been back since and he didn’t suggest any changes except to drink much more water. I had fallen off on that and am doing much better now.
As for cost of the script, before I meet my deductible, it’s $505 for 270 15Meq tabs for 3 months. After I meet my deductible, it drops to $40, which is decent.
I have three questions.
1. Sometimes my PH rises too much when I’m trying to get it up some. Is there a risk to a PH of 8 at times?
2. How long is the delay from the time I take K-citrate and I see a difference on the test strips?
3. I’m trying to dissolve the existing stone with the PH at 7 or more. Should I back off of the 99mg tabs and just see if a water intake increase does the job?
I’m due back in 3 months with a fresh ultrasound in hand.
Hi Mike, Test strips are too variable and I never recommend using them. The 24 hour urine pH is far better being an average, considering that organic crystals like uric acid will more or less integrate the overall average supersaturation of the urine which is controlled by pH. A value of 6’5 is too high because you could produce calcium phosphate stones. I would recommend taking 20 mEq of potassium citrate – about 9 of your small pills 3 times a day, measuring a proper kidney stone risk urine, serum potassium, and adjusting thereafter. Here is a reasonable article on uric acid stones. Because the citrate is metabolized to bicarbonate – loosely speaking, 2 to three times daily dosing is reasonable. If you indeed choose to use the drug as I have written, check with your physician first and be sure you check your blood potassium after 1 week; likewise he//she can assure that your kidney function is adequate to the dose. I am too far away to be safe in this area. Regards, Fred Coe
Hello,
I found this article very helpful. I am currently battling with my insurance company to cover my urocit k. I am a 28 year old male recently diagnosed with not only a minor kidney stone, but also with having been born with 1 kidney (found out 3 years ago). Long story short, my current insurance does not cover the cost of the urocit script that i’ve been proscribed. I have been told to take 4, 10 MEQ tablets every day, because in addition to only having one kidney and a history of kidney stones myself and within my family, I also have a very low level of citrate in my urine. The 4 pills are to boost my natural levels.
My prescription is currently 483.00 for roughly a 67 day supply (270 pills divided by 4 pills a day), an amount that I can not afford to pay. Do you have any recommendation as to what I can attempt to do to get the cost of my medically necessary medication covered by my insurance company?
Hi Michael, The mass of older comments have a wealth of ideas. I would read through the long string and see which work for you. The article points to some beverage alternatives, as well. It is a real horror, and an example of industry selfishness beyond comprehension. Regards, Fred Coe