DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075%
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075% (DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075%).
Dextrose 5% provides a source of carbohydrates and calories to restore blood glucose levels and correct dehydration. Potassium chloride replenishes potassium ions, which are essential for maintaining cellular membrane potential, nerve impulse transmission, and muscle contraction. The combination corrects hypokalemia and prevents potassium depletion during intravenous fluid therapy.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, yielding energy. Potassium is primarily excreted unchanged by the kidneys, with minor losses via feces and sweat. |
| Excretion | Renal: Potassium excreted primarily via kidneys (90%) with some fecal loss; dextrose is metabolized to CO2 and water, excreted renally as water and bicarbonate (less than 5% unchanged). |
| Half-life | Dextrose: not applicable (endogenous); potassium: 12-24 hours (distribution half-life), terminal phase not defined due to homeostatic regulation. |
| Protein binding | Dextrose: negligible; potassium: negligible (mainly free). |
| Volume of Distribution | Dextrose: total body water (0.45-0.75 L/kg); potassium: primarily intracellular, apparent Vd ~0.4 L/kg (but distributes into total body water with active uptake). |
| Bioavailability | Intravenous: 100% (only route of administration for this preparation). |
| Onset of Action | Immediate upon IV administration for both dextrose (caloric effect) and potassium (cardiac and neuromuscular effects). |
| Duration of Action | Duration of action is variable; dextrose effect lasts as long as infusion continues; potassium effect persists for 4-6 hours after infusion stops, depending on renal function. |
Intravenous infusion: 500-1000 mL at a rate of 100-200 mL/hour, not exceeding 25 mEq potassium per hour (or 0.5 mEq/kg/hour) and a maximum concentration of 40 mEq/L. Total daily dose depends on fluid and electrolyte needs.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: Administer with caution, reduce potassium content to 0.05% (10 mEq/L) or less; GFR <30 mL/min: Avoid use due to risk of hyperkalemia, consider alternative solutions. |
| Liver impairment | Child-Pugh Class A: No adjustment; Child-Pugh Class B: Use with caution, monitor potassium levels closely; Child-Pugh Class C: Avoid use or reduce potassium to 0.025% (5 mEq/L) and monitor electrolytes frequently. |
| Pediatric use | Intravenous infusion: 2-6 mL/kg/hour depending on dehydration and metabolic needs; potassium not to exceed 0.2-0.5 mEq/kg/hour. Maximum concentration 40 mEq/L. Dose based on weight and clinical status. |
| Geriatric use | Reduce infusion rate to 50-100 mL/hour due to decreased renal function and increased risk of hyperkalemia; monitor serum potassium and renal function; consider lower potassium concentration (0.05% or 10 mEq/L). |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075% (DEXTROSE 5% AND POTASSIUM CHLORIDE 0.075%).
| Breastfeeding | Breastfeeding safety: Excreted into breast milk in trace amounts; M/P ratio not determined. Dextrose and potassium are normal milk constituents. Intravenous administration is unlikely to affect the infant significantly at therapeutic doses. Caution with high doses due to potential for maternal hyperkalemia. |
| Teratogenic Risk | Dextrose and potassium chloride are endogenous substances required for normal fetal development. No teratogenic effects are expected at therapeutic doses. Potassium chloride infusions may cause maternal hyperkalemia, which can lead to fetal arrhythmias or bradycardia. First trimester: no known teratogenicity. Second/third trimester: risk of fetal hyperkalemia and cardiac effects only if maternal hyperkalemia occurs. |
■ FDA Black Box Warning
None
| Serious Effects |
Hyperkalemia, severe renal failure with oliguria/anuria, untreated Addison's disease, hyperkalemic periodic paralysis, patients receiving potassium-sparing diuretics or ACE inhibitors with elevated potassium levels, severe hemolytic reactions, and concomitant use of potassium supplements unless under strict monitoring.
| Precautions | Use with caution in patients with hyperkalemia, severe renal impairment, metabolic alkalosis, or conditions exacerbated by potassium elevation (e.g., adrenal insufficiency, acute dehydration, extensive tissue trauma). Monitor serum potassium and glucose levels regularly. Rapid infusion may cause hyperglycemia and hyperosmolarity; adjust rate in patients with impaired glucose tolerance. Contains aluminum from manufacturing process; prolonged use in renal impairment may lead to aluminum toxicity. |
| Food/Dietary | Avoid high-potassium foods (bananas, oranges, tomatoes, potatoes, leafy greens, salt substitutes) and potassium-containing supplements to reduce risk of hyperkalemia. Monitor dietary potassium intake. |
Loading safety data…
| Fetal Monitoring | Required monitoring: Maternal serum potassium and glucose levels, ECG for cardiac effects of hyperkalemia or hypoglycemia, fetal heart rate monitoring if maternal hyperkalemia suspected, and assessment for signs of fluid overload. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and potassium chloride are normal physiological components; their intravenous administration does not impair reproductive function. |
| Clinical Pearls | Administer via large peripheral vein or central line; never use for cardioplegia. Monitor serum potassium and cardiac rhythm closely, especially in renal impairment. Contraindicated in hyperkalemia, severe renal failure, or untreated Addison's disease. Do not use as a vehicle for medications incompatible with dextrose or potassium. |
| Patient Advice | This solution contains sugar and potassium; report any muscle weakness, irregular heartbeat, or tingling sensations. · Avoid potassium-rich foods (e.g., bananas, oranges, salt substitutes) while receiving this infusion unless directed by your doctor. · Inform your healthcare provider if you have kidney problems, heart disease, or are taking potassium-sparing diuretics or ACE inhibitors. · You may experience discomfort at the injection site; notify staff if redness, swelling, or pain occurs. |