Kajos (Potassium Citrate)

Kajos, a potassium citrate preparation, is used in conditions where potassium balance and urinary alkalinisation are required.

• Hypokalemia: restores normal serum potassium concentrations in patients with low potassium levels.
• Metabolic acidosis: supplies bicarbonate precursors to correct acid‑base disturbances.
• Prevention of kidney stones: increases urinary citrate, reducing calcium stone formation.

• Potassium citrate dissociates to provide potassium ions and citrate anions. The potassium component replenishes extracellular potassium stores, while citrate is metabolised to bicarbonate, raising systemic pH and alkalinising urine. Elevated urinary citrate binds calcium, decreasing supersaturation and inhibiting calcium‑oxalate stone formation.

Potassium citrate may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild stomach upset after ingestion.
• Abdominal discomfort: cramping or pain in the abdomen.
• Diarrhea: loose stools, especially at higher doses.
• Flatulence: increased intestinal gas.
• Taste alteration: metallic or salty taste.
• Headache: mild to moderate head pain.

Serious or Rare Side Effects

• Hyperkalemia: dangerously high serum potassium levels.
• Metabolic alkalosis: excessive rise in blood pH.
• Severe allergic reaction: rash, itching, swelling, or anaphylaxis.
• Cardiac arrhythmia: irregular heart rhythm linked to electrolyte imbalance.
• Acute kidney injury: impaired renal function in susceptible individuals.

Before initiating therapy with Kajos, several safety considerations should be observed.

• Serum potassium monitoring: check levels regularly to avoid hyperkalemia.
• Acid‑base assessment: evaluate bicarbonate and pH to prevent over‑correction.
• Renal function evaluation: adjust dose in patients with reduced kidney clearance.
• Avoid in existing hyperkalemia: contraindicated when potassium is already elevated.
• Pregnancy and lactation: use only if clearly needed, as safety data are limited.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Potassium citrate can interact with several medicines, altering potassium balance or renal handling.

Major Interactions (Avoid)

• ACE inhibitors: may cause additive hyperkalemia.
• Angiotensin II receptor blockers (ARBs): increase risk of elevated potassium.
• Potassium‑sparing diuretics (e.g., spironolactone): potentiate hyperkalemia.
• NSAIDs: reduce renal potassium excretion, raising serum levels.
• Trimethoprim: can impair potassium clearance.

Moderate Interactions (Monitor Closely)

• Digoxin: serum potassium changes affect drug toxicity.
• Lithium: altered renal clearance may increase lithium levels.