A fixed-dose combination supplement primarily used for the management and prevention of recurrent calcium oxalate and calcium phosphate kidney stones by increasing urinary citrate and pH. It also addresses magnesium and vitamin B6 deficiencies. Potassium citrate acts as an alkalinizing agent, magnesium citrate inhibits stone formation, and pyridoxine reduces oxalate synthesis.
Adult: One tablet orally, twice daily, after meals with a full glass of water. For stone prevention, often taken at bedtime and with morning meal. Dosage may be titrated based on 24-hour urinary citrate and pH. Maximum: 2 tablets twice daily under medical supervision.
Note: Take after meals to minimize GI upset. Swallow whole with 200-250 mL of water. Do not crush or chew. Maintain adequate fluid intake (at least 2-2.5 L/day). Space at least 2 hours apart from tetracycline, quinolone antibiotics, bisphosphonates, levothyroxine, and iron supplements.
Potassium Citrate: Dissociates to provide potassium ions and citrate. Citrate is metabolized to bicarbonate, raising blood and urinary pH. Increased urinary citrate binds calcium, reducing calcium oxalate and phosphate supersaturation and inhibiting crystal growth. Magnesium Citrate: Provides magnesium ions which compete with calcium for oxalate binding in the gut and urine, forming soluble magnesium oxalate, thus reducing free oxalate available for stone formation. It also may inhibit calcium oxalate crystal growth. Vitamin B6 (Pyridoxine): A cofactor for enzymes involved in oxalate metabolism, specifically alanine-glyoxylate aminotransferase (AGT). Adequate B6 reduces the hepatic production of oxalate, a key component of calcium oxalate stones.
Pregnancy: Category A (Indian FDA/Pregnancy Category not officially assigned for combo). Considered likely safe when used at recommended doses for indicated conditions. Potassium and magnesium are essential nutrients. High-dose Vitamin B6 (>100 mg/day) not recommended. Use only if clearly needed and under medical supervision.
Driving: Usually no effect. However, if hypermagnesemia causes drowsiness, dizziness, or muscle weakness, patients should avoid driving or operating machinery.
| ACE Inhibitors (e.g., Enalapril, Ramipril) | Increased risk of severe hyperkalemia | Major |
| Angiotensin II Receptor Blockers (ARBs e.g., Losartan) | Increased risk of severe hyperkalemia | Major |
| Potassium-Sparing Diuretics (e.g., Spironolactone, Amiloride) | Increased risk of severe hyperkalemia | Major |
| NSAIDs (e.g., Ibuprofen, Diclofenac) | May reduce renal potassium excretion, increasing hyperkalemia risk | Moderate |
| Digoxin | Hyperkalemia can potentiate digoxin toxicity. Hypomagnesemia (if present) increases digoxin toxicity risk. | Moderate |
| Neuromuscular Blocking Agents | Magnesium can potentiate and prolong neuromuscular blockade | Major |
| Quinolone/Tetracycline Antibiotics, Bisphosphonates, Levothyroxine | Magnesium and calcium can form insoluble complexes, reducing absorption of these drugs | Moderate |
| Anticholinergics | Increased risk of magnesium retention and toxicity due to reduced GI motility | Moderate |
| Levodopa | Vitamin B6 (>5 mg) can accelerate peripheral metabolism of levodopa, reducing efficacy in Parkinson's disease (not a concern with carbidopa/levodopa combinations) | Moderate |
Same composition (Potassium Citrate (1100mg) + Magnesium Citrate (375mg) + Vitamin B6 (Pyridoxine) (20mg)), different brands: