Ammonium Chloride

What is ammonium chloride?

Ammonium chloride (brand names: UriKare®, Uroeze®, Acidax®) is a urine acidifier used to treat metabolic alkalosis, dissolve certain types or urinary stones (struvite stones), treat certain toxicities, or increase the effectiveness of certain antimicrobials. Its use in small animals such as cats and dogs is now uncommon, and is more often used in large animals such as horses, sheep, and goats.

Its use in small and large animals to treat various conditions is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their direction may be significantly different from those on the label.


How is ammonium chloride given?

Ammonium chloride is administered intravenously in the hospital setting or by mouth in the form of a tablet or granules. The oral formulations should be mixed with food as they have a strong bitter taste. 

This medication should take effect within 1 to 2 hours; however, effects may not be noted outwardly and therefore laboratory tests may need to be done to evaluate this medication’s effectiveness.


What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.


Are there any potential side effects?

Side effects include pain at the injection site, or stomach irritation, nausea, and vomiting with oral administration. Adverse side effects include the development of a metabolic acidosis (too much acid in the body) or the formation of calcium oxalate urinary stones (in cats). In high doses, signs may include nausea, vomiting, thirst, increased breathing rate, low heart rate, abnormal heart rhythm, or depression.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.


Are there any risk factors for this medication?

Ammonium chloride should not be used in pets with severe liver disease, uremia (high levels of urea in the blood), severe kidney disease, severe vomiting, urate urinary stones, or respiratory acidosis. It should be used with caution in patients with lung or breathing problems or fluid retention due to heart disease. It should be used with caution in pregnant or lactating animals.


Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with ammonium chloride: aluminum hydroxide, aminoglycosides, aspirin, carbonic anhydrase inhibitors, chlorpropamide, erythromycin, methadone, and quinidine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.


Is there any monitoring that needs to be done with this medication?

While your pet is taking ammonium chloride, urine pH, blood pH, serum electrolytes, and blood gas analysis may be monitored. Urine pH will likely need to be monitored at home, daily.


How do I store ammonium chloride?

Ammonium chloride injectable formulation should be stored at room temperature and kept from freezing temperatures or extreme heat. DO NOT store with fertilizers or other strong oxidizing substances as this combination could cause an explosion.


What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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