K-LEASE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for K-LEASE (K-LEASE).
Potassium ion replacement therapy; increases extracellular potassium levels to correct hypokalemia.
| Metabolism | Not metabolized; renally excreted as potassium ion. |
| Excretion | Excreted renally as potassium chloride; elimination is 100% renal. No biliary or fecal excretion. |
| Half-life | Not applicable; exogenous potassium is not subject to terminal elimination half-life as it is rapidly redistributed and excreted. Clinical context: the half-life of redistribution is minutes to hours. |
| Protein binding | Not protein bound (0%). Potassium is a free ion. |
| Volume of Distribution | 0.33 L/kg (total body water); clinical meaning: potassium distributes throughout total body water, but primarily intracellular (98% intracellular). |
| Bioavailability | Oral: 100% (as potassium chloride; fully absorbed). |
| Onset of Action | Oral: 30-60 minutes; Intravenous: immediate (within minutes). |
| Duration of Action | Oral: 4-6 hours; Intravenous: duration depends on infusion rate and patient status, typically 1-2 hours post infusion. |
1 tablet (25 mEq) orally 2-4 times daily with meals; maximum 100 mEq/day.
| Dosage form | CAPSULE, EXTENDED RELEASE |
| Renal impairment | GFR 20-49 mL/min: reduce dose by 50%; GFR <20 mL/min: contraindicated. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B/C: contraindicated due to risk of encephalopathy. |
| Pediatric use | 1-3 mEq/kg/day in divided doses with meals; maximum 3 mEq/kg/day. |
| Geriatric use | Start at lower end of dosing range (25 mEq/day) due to decreased renal function and increased sensitivity to hyperkalemia. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for K-LEASE (K-LEASE).
| Breastfeeding | Not recommended during breastfeeding. M/P ratio unknown. Insufficient human data; potential for adverse effects in nursing infant (e.g., hyperkalemia, arrhythmias). |
| Teratogenic Risk | FDA Pregnancy Category C. First trimester: limited human data, animal studies show potential for fetal harm; avoid unless benefit outweighs risk. Second trimester: risk of hypocalcemia and arrhythmias in fetus if maternal potassium abnormal. Third trimester: possible fetal hyperkalemia if maternal overdose; monitor neonatal potassium levels. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Addison's disease","Adynamic ileus","Concurrent use with potassium-sparing diuretics"]
| Precautions | ["Hyperkalemia risk especially in renal impairment","Cardiac arrest if given too rapidly","Monitor serum potassium and ECG during administration"] |
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| Fetal Monitoring |
| Monitor maternal serum potassium, ECG, renal function, and vital signs regularly. Fetal monitoring: assess for arrhythmias and growth via ultrasound; consider fetal echocardiography if maternal potassium disturbances severe. |
| Fertility Effects | No known effects on fertility in humans. Animal studies show no impairment at therapeutic doses. |