Medical Health Encyclopedia

None of these products should be used by people with struvite stones, urinary tract infections, bleeding disorders, or kidney damage. Patients who take citrate supplements containing potassium should not take any other medications that either contain the mineral or prevent its loss (such as so-called potassium-sparing diuretics). People with peptic ulcers should avoid them or discuss using non-tablet forms with their doctor.

Phosphates. Phosphates help reduce bone resorption (the breakdown of bone that releases calcium into the bloodstream) and are also involved in reabsorption of calcium from urine by the kidney. Certain phosphate compounds may be helpful.

• Neutral (nonacidic) sodium or potassium phosphate (K-Phos, Neutral, Neutra-Phos) is usually taken four times a day after meals to prevent kidney stones unless otherwise directed by the doctor. Diarrhea is a possible side effect.
• Cellulose phosphate (Calcibind) binds calcium in the intestine. It is recommended only for severe hypercalciuria caused by excessive absorption of calcium from the intestinal tract that is associated with recurrent calcium stones. There is a risk with this drug, however, of increasing oxalate levels and decreasing magnesium levels. Restricting dietary oxalates, calcium, and ascorbic acid and taking magnesium supplements may help offset these risks. It may also cause bloating.

Acidic forms of phosphate should not be used, since this increases the risks for both hypocitraturia and hypercalciuria.

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Cholestyramine. Cholestyramine (Questran, Questran Light) is a drug normally used to reduce cholesterol levels; it also binds with oxalate in the intestine and so reduces elevated levels in urine (hyperoxaluria). The drug is usually taken in powder form, dissolved in water, milk, or fruit juice; it is also available as a chewable bar (Cholybar). Bloating and constipation are common side effects of this drug, so many people cannot tolerate it. The drug also interferes with other medications, including digoxin (Lanoxin) and warfarin, and may contribute to calcium loss and osteoporosis. In order to prevent such interactions, other drugs should be taken one hour before or four to six hours after taking cholestyramine. If the drug is taken for a long period of time, deficiencies of vitamins A, D, E, and K can result, and vitamin supplements may be necessary.