Drug General Information (ID: DDIMDUIQKJ)
Drug Name			Potassium citrate		Drug Info		Belladonna		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Minerals And Electrolytes				Anticholinergic Agents/Antispasmodics
Structure

Mechanism of Potassium citrate-Belladonna Interaction (Severity Level: Major)
Increased risk of GI mucosal injury/bleeding risk Click to Show/Hide Mechanism Graph
Drug Name		Potassium citrate				Belladonna
Mechanism		GI mucosal injury/bleeding risk				Decrease gastrointestinal motility
Key Mechanism Factor 1
		Factor Name		Gastrointestinal toxicity
		Factor Description		The risk and severity of gastrointestinal toxicity, including inflammation, bleeding, ulceration, and perforation, increases when drugs with gastrointestinal mucosal irritant effects are combined.
Mechanism Description		Increased risk of GI mucosal injury/bleeding risk by the combination of Potassium citrate and Belladonna

Recommended Action
Management		The use of oral solid formulations of potassium citrate is considered contraindicated in patients receiving agents with anticholinergic properties at sufficient doses to exert anticholinergic effects. A liquid formulation of potassium citrate should be considered. Patients prescribed a solid oral formulation should be advised to discontinue potassium therapy and contact their physician if they experience potential symptoms of upper GI injury such as severe vomiting, abdominal pain, distention, and gastrointestinal bleeding.

References
1	Farquharson-Roberts MA, Giddings AE, Nunn AJ "Perforation of small bowel due to slow release potassium chloride (slow-K)." Br Med J 3 (1975): 206. [PMID: 1148734]
2	Heffernan SJ, Murphy JJ "Ulceration of small intestine and slow-release potassium tablets." Br Med J 2 (1975): 746. [PMID: 1139204]
3	Lambert JR, Newman A "Ulceration and stricture of the esophagus due to oral potassium chloride (slow release tablet) therapy." Am J Gastroenterol 73 (1980): 508-11. [PMID: 7424872]
4	Leijonmarck CE, Raf L "Gastrointestinal lesions and potassium chloride supplements." Lancet 1 (1985): 56-7. [PMID: 2856988]
5	Leijonmarck CE, Raf L "Ulceration of the small intestine due to slow-release potassium chloride tablets." Acta Chir Scand 151 (1985): 273-8. [PMID: 4013604]
6	Lofgren RP, Rothe PR, Carlson GJ "Jejunal perforation associated with slow-release potassium chloride therapy." South Med J 75 (1982): 1154-5. [PMID: 7123349]
7	McMahon FG, Ryan JR, Akdamar K, Ertan A "Effect of potassium chloride supplements on upper gastrointestinal mucosa." Clin Pharmacol Ther 35 (1984): 852-5. [PMID: 6734038]
8	McMahon FG, Ryan JR, Akdamar K, Ertan A "Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial." Lancet 2 (1982): 1059-61. [PMID: 6127542]
9	Product Information. K-Dur (potassium chloride). Schering Laboratories, Kenilworth, NJ.
10	Product Information. Urocit (potassium citrate). Mission Pharmacal Company, San Antonio, TX.
11	Weiss SM, Rutenberg HL, Paskin DL, Zaren HA "Gut lesions due to slow-release KCI tablets." N Engl J Med 296 (1977): 111-2. [PMID: 830293]
12	Wynn V "Potassium chloride and bowel ulceration." Br Med J 5477 (1965): 1546. [PMID: 5850476]