ALKA-UR Granules/Effervescent

What is ALKA-UR

ALKA-UR is an effervescent urinary alkalinizing agent available in sachet form, each containing 4 grams of granules. This formulation is commonly used to relieve symptoms associated with mild urinary tract infections (UTIs), cystitis, and discomfort caused by acidic urine.

The active ingredients in ALKA-UR include:

• Sodium bicarbonate: A systemic alkalizer that helps neutralize excess acid in the urine.
• Tartaric acid & Citric acid: React with bicarbonate to produce effervescence and aid absorption.
• Sodium citrate anhydrous: Converts to bicarbonate in the body, increasing urinary pH and providing sustained alkalization.

By altering the pH of urine, ALKA-UR helps reduce irritation and burning during urination, which often accompanies bladder infections or inflammation. It is not an antibiotic but provides symptomatic relief while the body or an accompanying antimicrobial agent addresses the infection.

How to use ALKA-UR

Using ALKA-UR correctly is crucial for achieving the desired therapeutic effect and avoiding potential side effects. Here are the general usage guidelines:

• Dissolution: Dissolve the entire contents of one sachet in a glass (about 200 ml) of cold water. Allow the effervescence to subside completely before drinking.
• Administration: Take orally after meals to minimize gastrointestinal discomfort. Can be used up to three times daily depending on medical advice.
• Hydration: Increase fluid intake during treatment to support urinary flow and aid in flushing out irritants or pathogens.
• Duration of use: Do not use for more than 5 consecutive days without consulting a healthcare provider. If symptoms persist, medical evaluation is necessary.
• Children: Use in children should be supervised by a physician. Dosage adjustments may be required based on body weight and renal function.

As with any effervescent product, ensure the granules are fully dissolved and do not inhale the effervescence. Always check the label for full instructions specific to the brand or manufacturer.

Mode of Action ALKA-UR

ALKA-UR exerts its therapeutic effect by chemically altering the pH of the urine, providing symptomatic relief from discomfort associated with urinary acidity. Here’s how each ingredient contributes to its overall mechanism:

• Sodium bicarbonate: A base that reacts with hydrogen ions (H⁺) in the urine, neutralizing acidity and increasing urinary pH.
• Sodium citrate (anhydrous): Metabolized in the liver to produce bicarbonate, which is then excreted by the kidneys, enhancing systemic and urinary alkalinity.
• Tartaric acid and citric acid: These acids, although acidic themselves, play a critical role in the effervescent reaction. When combined with bicarbonate, they help dissolve the granules, improve taste, and speed up absorption of the active alkalizing agents.

Increasing the pH of urine helps relieve irritation of the urinary tract mucosa, reduce dysuria (painful urination), and may inhibit the growth of certain acid-tolerant uropathogens. While it doesn't treat infections directly, it complements antimicrobial treatment by creating a more favorable urinary environment.

ALKA-UR Interactions ALKA-UR

While ALKA-UR is generally well tolerated, its alkalinizing properties can interfere with the absorption or efficacy of certain drugs. Notable interactions include:

• Antibiotics: Drugs like nitrofurantoin may be less effective in alkaline urine. Conversely, it may increase the efficacy of others like sulfonamides.
• Salicylates (e.g., aspirin): Alkaline urine may increase renal excretion of salicylates, potentially reducing their effectiveness or causing withdrawal symptoms.
• Quinolones (e.g., ciprofloxacin): Urinary alkalinization can affect solubility, altering absorption and risk of crystalluria.
• Potassium supplements or potassium-sparing diuretics (e.g., spironolactone): Combined use may increase risk of hyperkalemia, especially in patients with impaired renal function.
• Antacids or other alkalinizing agents: Cumulative effect may lead to excessive systemic alkalosis.
• pH-sensitive drugs: Drugs with a narrow absorption pH window (e.g., iron, ketoconazole) may have altered absorption and efficacy.

To avoid interactions, it is recommended to space ALKA-UR at least 2 hours apart from the administration of other medications. Always consult a healthcare provider before combining with other drugs.

Dosage of ALKA-UR

The appropriate dosage of ALKA-UR depends on the patient’s condition, age, and overall health status. The standard dosing recommendations are:

• Adults: One sachet (4 g) dissolved in a glass of water, taken 1 to 3 times per day, preferably after meals.
• Children over 6 years: May use the same dosage as adults under medical supervision, though some practitioners may recommend a reduced frequency or volume.
• Children under 6 years: Use only if prescribed by a physician, as the product is not routinely recommended for this age group.
• Renal or hepatic impairment: Use with caution. Adjustments may be needed depending on the patient's electrolyte balance and overall renal function.

Never exceed the maximum recommended dose of 3 sachets per day. Discontinue use if symptoms resolve early or if there are signs of adverse effects. If symptoms persist beyond 5 days or worsen, seek medical attention.

Possible side effects of ALKA-UR

Like all medications, ALKA-UR can cause side effects, although not everyone experiences them. Most side effects are mild and related to the bicarbonate or citrate content:

• Gastrointestinal discomfort: Nausea, bloating, or flatulence due to effervescence and gas production in the stomach.
• Alkalosis (rare): Excessive use may cause metabolic alkalosis, particularly in patients with kidney dysfunction. Symptoms may include muscle twitching, confusion, or hand tremors.
• Electrolyte imbalance: Prolonged use or overdose may alter sodium and potassium levels, potentially leading to symptoms like fatigue, weakness, or irregular heartbeat.
• Allergic reactions (rare): Skin rash, itching, swelling of the lips or face, or difficulty breathing. These require immediate medical attention.
• Diuresis: Some users may experience increased urination due to the systemic effects of citrate metabolism.

If any side effects become troublesome or persistent, discontinue the medication and consult a healthcare provider. Avoid using the product in higher-than-recommended doses to minimize risks.

ALKA-UR Contraindications ALKA-UR

ALKA-UR is not suitable for all patients. The following conditions contraindicate its use:

• Hypersensitivity: Known allergy to any of the ingredients, including sodium bicarbonate, citric acid, tartaric acid, or sodium citrate.
• Severe renal impairment: Impaired excretion of electrolytes may lead to metabolic alkalosis or sodium overload.
• Heart failure or edema: Due to the sodium content, which can worsen fluid retention.
• Hypertension: Sodium-containing preparations may elevate blood pressure, especially if taken chronically or in large amounts.
• Respiratory alkalosis or metabolic alkalosis: The use of alkalinizing agents can worsen the acid-base imbalance.
• Sodium-restricted diets: Patients on low sodium regimens should avoid this medication unless advised otherwise by their healthcare provider.

Before starting ALKA-UR, always review the patient’s medical history, current medications, and electrolyte status to avoid potential complications.

Storage of ALKA-UR

Proper storage of ALKA-UR is essential to preserve its quality and therapeutic effect. Follow these storage guidelines:

• Temperature: Store at room temperature (20°C to 25°C or 68°F to 77°F). Avoid extreme heat.
• Humidity: Keep in a dry place, as moisture can compromise the integrity of the granules and their effervescence.
• Packaging: Leave sachets in their original packaging until use. Do not transfer to another container to prevent contamination.
• Light: Protect from direct sunlight and strong artificial light.
• Child safety: Store out of reach of children to prevent accidental ingestion.

Do not use ALKA-UR after the expiry date printed on the sachet or box. If the sachets appear swollen, discolored, or unusually clumpy, discard them. Follow local pharmaceutical waste disposal regulations when discarding unused or expired medication.