Alkalinising agents

Urinary pH significantly affects the activity of nitrofurantoin, with loss of potency as the urine becomes more alkaline. For this reason, women with lower UTI who are prescribed nitrofurantoin should be advised not to take alkalinising agents such as potassium citrate (Effercitrate). 

Alkalinising agents are the only treatments available specifically for cystitis without prescription. 

First statement Alkalinising agents containing sodium or potassium salts should not be sold to patients taking drugs for hypertension. 

Rhabdomyolysis may result from prolonged pressure on muscles, from agents that cause muscle spasm or convulsions (phencyclidine, theophylline) or be aggravated by hyperthermia due to muscle contraction, e.g. with MDMA ( ecstasy ). Aggressive volume repletion and correction of acid-base abnormality may be needed, and urine alkalinisation may prevent acute tubular necrosis. 

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