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Ural

Effervescent Granules

Pleasantly Flavoured Urinary Alkalinizer

 

Each 4g sachet contains:

Sodium bicarbonate  1.76 g

Citric acid, anhydrous  0.72 g

Sodium citrate, anhydrous  0.63 g

Tartaric acid  0.89 g

 

Also contains Nature Identical Lemon Flavour oil, Terpeneless and saccharin sodium.

 

Each sachet contains 4g of white effervescent granules powder to be dissolved in cold water to give clear colourless liquid.

 

Pharmacology:

Sodium bicarbonate acts as urinary alkaliser by increasing the excretion of free bicarbonate ions in the urine, thus effectively raising the urinary pH. By maintaining an alkaline urine, the actual dissolution of uric acid stones may be accomplished. It also acts as antacid by chemically neutralizing or buffering existing quantities of stomach acid but has no direct effect in its output. This action results in increased pH value of stomach contents, thus providing relief of hyperacidity symptoms.

 

Sodium Citrate and Citric Acid:

Sodium citrate is metabolized to bicarbonates, which increases urinary pH by increasing the excretion of free bicarbonate ions, without producing systemic alkalosis when administered in recommended doses. A rise in urinary pH increases the solubility of cystine in the urine and the ionization of uric acid to more soluble urate ion. By maintaining an alkaline urine, the actual dissolution of uric acid stones may be accomplished, It also reacts chemically to neutralize or buffer existing quantities of gastric hydrochloric acid but has no direct effects in its output. Sodium bicarbonate is excreted through renal and also via lung by forming C02. Sodium citrate, citric acid and absorbed tartaric acid are excreted through urine.


Indications:

Indicated for relieving of discomfort in mild UTI; symptomatic relief of dysuria; to enhance the action of certain antibiotics, especially some sulphonamides; in gout therapy as urinary alkalinisers to prevent crystallisation of urates.


Contraindications:

Renal failure or hypernatremia; in conjunction with hexamine mandelate or hexamine hippurate therapy because an acidic urine is needed. Caution is advised in overt and occult cardiac failure. Concomitant use of urinary alkalinisers and quinolone antibiotics should be avoided; crystalluria may be more likely to occur in alkaline urine.


Side Effects/Adverse Reactions:

The tartrate component of Ural may be incompletely absorbed. Because of this Ural may exert a mild laxative effect. Prolonged and excessive use may cause a systemic alkalosis and / or hypernatremia.

 

Precautions/Warnings:

This preparation contains 644mg of sodium per sachet which should be taken into account by those on a low sodium diet.

 

Drug Interactions:

Alkalinization of the urine due to the use of Ural, theoretically, may result in a decreased therapeutic affect of the following medications, chlorpropamide, lithium, salicylates and tetracyclines.


Alternatively, alkalinization of the urine due to the use of Ural, theoratically, may result in an increased therapeutic effect of the following medications, amphetamines and ephadrine / pseudoepherine.


Antacid: Concurrent use of antacids with sodium citrate and sodium bicarbonate may promote the development of calcium stones in patients with uric acid stones and may also cause hypernatremia.


Concurrent use at aluminium-containing entacids with salts can increase aluminium absorption, possibly resulting in acute aluminium toxicity, especially in patients with renal insufficiency.


Quinolones: Citrates may reduce the solubility of ciprofloxacin, norfloxacin, or ofloxacin in the urine. Patients should be observed for signs of crystalluria and nephrotoxicity.


Laxatives: Concurrent administration of citrates with laxatives may have an additive effect.


Pregnancy:

Studies regarding the effect of citrates on pregnancy have not been done.


Nursing Mothers:

Caution should be exercised when administered to a nursing mother.


Overdosage:

Overdosage may result in metabolic alkalosis Ural should be discontinued, appropriate treatment instituted and electrolyte and acid-base determinations should be carried out as appropriate.

 

Dosage and Administration:

4g to 8g (1 to 2 sachets) dissolved in cold water four times daily or as prescribed.

 

Pack Size:

Effervescent granules, 12x4g or 28x4g sachets per pack.

 

Storage Conditions:

Store at temperature below 30C.

 

Shelf Life:

36 months

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