May cause gastrointestinal upset and lead to gastrointestinal ulceration, bleeding, perforation and/or obstruction. Oral liquid preparations (not solid) should be used in esophageal compression or delayed gastric emptying. Severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (e.g. heart block, ventricular arrhythmias, asystole). Changes in serum potassium concentrations can occur during acid/base correction (use with caution in acid/base alterations). Patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia (use with caution in cardiovascular disease (e.g. heart failure, cardiac arrhythmias)). Conversion of citrate to bicarbonate in liver may be blocked in hepatic failure, and in patients who are severely ill or in shock. Use with caution in disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (e.g. untreated Addison’s disease, heat cramps, severe tissue breakdown from trauma or burns). Use with caution in renal impairment (contraindicated with severe impairment), in digitalized patients (may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations), and in patients receiving concomitant medications or therapies which increase potassium (e.g. ACEI, potassium-sparing diuretics, potassium-containing salt substitutes).