DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15%
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15% (DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15%).
Dextrose serves as a source of calories and water for hydration, and is metabolized to carbon dioxide and water, yielding energy. Potassium chloride provides potassium ions to maintain electrolyte balance, necessary for nerve conduction, muscle contraction, and acid-base regulation. The combination replenishes fluid and electrolytes in patients with hypokalemia and dehydration.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle. Potassium is primarily excreted unchanged by the kidneys, with minor losses via feces and sweat. |
| Excretion | Potassium: >90% renal (glomerular filtration and tubular secretion). Dextrose: metabolized to CO2 and water; negligible renal excretion (<5%). |
| Half-life | Dextrose: not applicable (rapidly metabolized). Potassium: distribution half-life ~1 h, terminal half-life ~8 h (in patients with normal renal function); prolonged in renal impairment. |
| Protein binding | Potassium: minimal binding (<2%); dextrose: not protein bound. |
| Volume of Distribution | Potassium: Vd ~0.6 L/kg (total body water); dextrose: Vd ~0.2 L/kg (extracellular water). |
| Bioavailability | IV: 100% for both components. Not administered orally; no oral bioavailability for potassium chloride in this formulation (parenteral only). |
| Onset of Action | IV infusion: immediate (within seconds) for dextrose effects; potassium repletion onset within minutes, peak effect after completion of infusion. |
| Duration of Action | Dextrose: effect lasts as long as infusion continues; after cessation, blood glucose declines within 15-30 min. Potassium: duration depends on total dose and renal function; effect persists for 4-6 h after infusion stop. |
Intravenous infusion of 1000-2000 mL/day (providing 50-100 g dextrose and 1.5-3 g potassium chloride) at a rate of 50-100 mL/hour; adjust based on fluid and electrolyte requirements.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: reduce dose by 25-50% or use with caution. GFR 10-29 mL/min: reduce dose by 50-75% and monitor potassium closely. GFR <10 mL/min: avoid use unless serum potassium is low and replacement is necessary; use with extreme caution. |
| Liver impairment | Child-Pugh Class A: no adjustment. Child-Pugh Class B: reduce infusion rate by 25-50% and monitor glucose and potassium. Child-Pugh Class C: avoid use; consider alternative fluid replacement. |
| Pediatric use | Infants and children: 2-4 mL/kg/hour of solution; maximum infusion rate 10 mL/kg/day or as needed to maintain fluid balance; adjust dextrose and potassium based on age and weight (e.g., term neonates: dextrose 5% at 80-100 mL/kg/day with potassium 0.15% if needed). |
| Geriatric use | Elderly patients: start at lower end of adult dosing (e.g., 50-75 mL/hour); monitor renal function and serum potassium closely due to age-related decline in GFR; avoid rapid infusion to prevent fluid overload. |
| 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 0.15% (DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15%).
| Breastfeeding | Both dextrose and potassium are normal constituents of breast milk. Intravenous administration of 5% dextrose with 0.15% KCl does not significantly alter breast milk composition. M/P ratio: Not applicable as both are endogenous substances. Considered compatible with breastfeeding; no special precautions needed. |
| Teratogenic Risk | Dextrose and potassium chloride are generally not associated with teratogenicity when used as intravenous replacement therapy. However, underlying maternal conditions requiring infusion (e.g., severe hyperemesis, diabetic ketoacidosis) may pose fetal risks. First trimester: No known teratogenic effects from the components. Second trimester: Use is safe for correction of maternal electrolyte imbalances. Third trimester: Excessive dextrose may cause fetal hyperinsulinism and neonatal hypoglycemia; monitor fetal glucose and electrolytes if prolonged infusion. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperkalemia","Hypersensitivity to any component","Severe renal impairment with oliguria or anuria","Uncompensated adrenal insufficiency (Addisonian crisis)","Acute dehydration with hypernatremia","Concurrent use of potassium-sparing diuretics unless carefully monitored"]
| Precautions | ["Risk of hyperkalemia, especially in patients with renal impairment or conditions predisposing to hyperkalemia","Risk of hyperglycemia in patients with diabetes mellitus or glucose intolerance","Avoid extravasation due to risk of tissue necrosis","Use with caution in patients with heart failure, edema, or conditions requiring sodium restriction (if combined with sodium)","Monitor serum potassium, glucose, and fluid balance regularly"] |
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| Fetal Monitoring | Monitor maternal serum glucose, potassium, and electrolytes periodically during prolonged therapy. In pregnancy, monitor fetal heart rate and uterine activity if infusion is high-rate or for conditions like preterm labor or diabetic ketoacidosis. Assess for signs of fluid overload or hyperglycemia in mother and neonate post-delivery. |
| Fertility Effects | No direct effects on fertility from dextrose or potassium chloride at therapeutic doses. Underlying conditions requiring these infusions (e.g., malnutrition, electrolyte disturbances) may impact fertility, but the components themselves do not impair reproductive function. |