granules
potassium sodium hydrogen citrate
What Renapur is and what it is used for
Renapur is used to dissolve uric acid stones and to prevent the formation of new ones. Renapur is used on prescription from a doctor.
Renapur works by dissolving stones of uric acid or its salts. Normally, the uric acid follows the urine out of the body. A stone is formed only when the uric acid crystallizes out, ie when its solubility in the urine decreases. This is affected by the pH of the urine.
The pH value is a measure that indicates whether a solution is acidic or alkaline. A pH value of 7 is the neutral value, a higher value means that the solution is alkaline, and a value below 7, is an acidic solution.
The pH value can easily be read on an indicator paper, which when dipped in a solution changes color according to pH.
Uric acid dissolves poorly if the pH is below 6.2. Crystals can then form and in unfavorable cases grow into stones. A shift of the urine pH towards 7 improves the solubility of the uric acid and already formed stones can dissolve. It is important that the shift of the pH value becomes uniform over a longer period and that the value is kept constant between 6.2 and 6.8. This effect can be achieved with Renapur.
What you need to know before using Renapur
Do not use Renapur
- if you are allergic to potassium sodium hydrogen citrate or any of the other ingredients of this medicine (listed in section 6)
- if you have high levels of potassium in your blood (hyperkalemia)
- if you have poor kidney function ( acute kidney failure or chronic kidney failure that causes you to have high levels of potassium in your blood)
- if you have elevated blood pH (a condition called metabolic alkalosis )
- if you have a chronic urinary tract infection with certain unusual bacteria, so-called urea-degrading bacteria
Warnings and cautions
Talk to your doctor before using Renapur.
- Tell your doctor if you have severe liver problems.
Before starting treatment, kidney function and levels of salts in the blood ( electrolytes, eg potassium, and sodium ) should be checked by a doctor.
For the treatment to be successful, it is necessary to be carefully instructed on the use of Renapur. Regular medical check-ups should be done throughout the treatment.
Other medicines and Renapur
Talk to your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
Drugs that may affect or be affected by Renapur are:
- potassium-sparing diuretics (eg spironolactone , eplerenone)
- cardiac glycosides (eg digoxin )
- potassium supplements
- certain drugs such as used for high blood pressure and heart failure ( ACE inhibitors eg ramipril, enalapril or angiotensin receptor blockers eg valsartan, losartan )
- certain painkillers (non-steroidal anti-inflammatory drugs, so-called NSAIDs, eg ibuprofen, diclofenac, naproxen )
- drugs containing aluminum, e.g. certain antacids (medicines for heartburn and acid reflux). Renapur and these medicines should be taken at least 2 hours apart.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Pregnancy
Renapur is not expected to pose any risk to the fetus during recommended use.
Breast-feeding
No effects are expected on the breastfed baby.
Driving and using machines
Renapur granules do not affect the ability to drive or use machines.
Renapur contains para-orange (E 110), potassium, and sodium
The dye para-orange can cause allergic reactions.
This medicine contains approximately 425 mg of potassium per dosing spoon (1.7 g per average daily dose of 4 dosing spoons). This should be considered by patients with impaired renal function, elderly patients, and patients on a low-potassium diet.
This medicine contains approximately 250 mg sodium (the main ingredient in table salt/table salt) per dosing spoon (1 g per average daily dose of 4 dosing spoons). 1 g corresponds to 50% of the WHO’s highest recommended daily intake of sodium for adults. Talk to your doctor or pharmacist if you need more than one tablespoon daily for an extended period, especially if you have been prescribed a low-salt (sodium-poor) diet.
How to use Renapur
Always use this medicine exactly as your doctor or pharmacist has told you. Ask your doctor or pharmacist if you are unsure.
Dosage one is individual and should always be done according to the doctor’s prescription.
Dosage one of Renapur should be adjusted so that the uric acid gets its desired pH value between 6.2 and 6.8. Dose one is increased if the pH during the day falls below 6.2 and decreases if the value exceeds 6.8.
In otherwise healthy persons, the urine pH is increased by 0.2 of 1.25 g Renapur (approx. ½ dosing spoon).
The usual dose is 4 ironed dosing spoons per day (10 g granules ) divided into 3 dosing times according to the dosing table. The granules are stirred into a liquid such as water or juice and taken immediately. Dose and take after meals.
Dosage table
| Dosing occasion | Quantitydosing spoons of 2.5 g |
| In the morning after breakfast | 1 |
| In the middle of the day after lunch | 1 |
| In the evening after the meal as late as possible | 2 |
The effect of the treatment is always measured three times a day before the next dose by measuring the pH of the urine, see under Instructions for use.
Instructions for use
The indicator paper consists of about 100 yellow-brown paper strips and a color scale.
The pH is checked before each new dose. Tear off an indicator paper and moisten in fresh urine. The indicator paper now changes color tone and is immediately compared with the color scale.
The value below the color tone that corresponds to the indicator paper is recorded in the control calendar.
Then a new dose of Renapur is taken and the number of spoons is noted in the control calendar.
Use for children and adolescents
There is no dose recommendation for children and adolescents.
If you take more Renapur than you should
If you have ingested too much medicine or if e.g. If a child has ingested the medicine by mistake, contact a doctor or hospital for risk assessment and advice.
Taking too much Renapur can lead to high levels of potassium in the blood (hyperkalemia). Muscle weakness, nausea, diarrhea, and irregular heartbeat can be signs of greatly elevated potassium in the blood.
If you forget to take Renapur
Do not take a double dose to make up for a forgotten dose.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Common (may affect up to 1 in 10 people): abdominal pain.
Rare (may affect up to 1 in 1,000 people): diarrhea, nausea.
There is a risk of the formation of phosphate stones in alkaline urine, so the pH must not exceed 6.8.
How to store Renapur
Keep this medicine out of the sight and reach of children.
Used before the expiry date which is stated on the carton. The expiration date is the last day of the specified month.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
Contents of the pack and other information
Content declaration
- The active substance is potassium sodium hydrogen citrate. 100 g of granules contain potassium sodium hydrogen citrate (6: 6: 3: 5) 97.108 g.
- The other ingredients are para-orange (dye E 110) and lemon oil.
What the medicine looks like and the contents of the pack
Plastic jars with 280 grams.
The package also contains a dosing spoon, control calendar, and indicator paper.
Marketing Authorization Holder and Manufacturer
Meda AB
Box 906
170 09 Solna