POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions necessary for maintenance of acid-base balance, isotonicity, and electrodynamic characteristics of cells. Potassium is the principal intracellular cation and is essential for nerve impulse transmission, muscle contraction, and enzymatic function. Dextrose provides calories and may reduce protein and nitrogen loss. Sodium chloride maintains osmotic pressure and fluid balance.
| Metabolism | Potassium chloride is not metabolized; excreted renally. Dextrose undergoes metabolism via glycolysis. Sodium chloride is not metabolized. |
| Excretion | Potassium is primarily excreted renally (approximately 90%) via glomerular filtration and tubular secretion, with about 10% eliminated in feces and minimal biliary excretion. Dextrose and sodium are fully metabolized or excreted renally. |
| Half-life | Potassium's terminal half-life is approximately 12-24 hours in patients with normal renal function, reflecting redistribution and slow elimination; prolonged in renal impairment. Dextrose half-life is minutes due to rapid metabolism. Sodium half-life is 2-3 days. |
| Protein binding | Potassium: 0% bound. Dextrose: 0% bound. Sodium: 0% bound. |
| Volume of Distribution | Potassium Vd: approximately 0.5 L/kg (reflects distribution into intracellular and extracellular fluid). Dextrose Vd: ~0.2 L/kg (extracellular and total body water). Sodium Vd: 0.3-0.5 L/kg (extracellular fluid volume). |
| Bioavailability | Intravenous: 100% for all components. |
| Onset of Action | Intravenous infusion: Immediate correction of hypokalemia is concentration/rate-dependent; dextrose effects on blood glucose occur within minutes; sodium effects on volume and osmolality begin within minutes. |
| Duration of Action | Potassium effect lasts 1-2 hours after acute infusion; sustained repletion requires continuous administration. Dextrose action lasts 1-2 hours post-infusion. Sodium effect persists for hours to days depending on fluid balance. |
Intravenous infusion, 1000 mL to 2000 mL per day at a rate of 100-200 mL/hour, providing 37 mEq potassium per liter, adjusted based on serum potassium and fluid/electrolyte needs.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: Avoid use due to risk of hyperkalemia; consider alternative potassium replacement. GFR 30-50 mL/min: Use with caution, monitor serum potassium closely; maximum infusion rate 10 mEq/hour. GFR >50 mL/min: No adjustment necessary. |
| Liver impairment | Child-Pugh A: No adjustment needed. Child-Pugh B: Monitor serum potassium; consider reduced rate if ascites present. Child-Pugh C: Avoid use unless potassium deficit severe; monitor closely. |
| Pediatric use | Weight-based dosing: 0.5-1 mEq/kg potassium per day, administered as continuous infusion in compatible IV fluid; maximum rate 0.5 mEq/kg/hour. For solution concentration, each liter provides 37 mEq potassium; adjust volume accordingly. |
| Geriatric use | Start at lower end of dosing range (e.g., 1000 mL/day) with infusion rate not exceeding 100 mL/hour; monitor renal function and serum potassium frequently due to age-related decline in GFR and increased risk of hyperkalemia. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Potassium, chloride, dextrose, and sodium are normal milk constituents. Exogenous potassium, dextrose, and sodium chloride are unlikely to produce adverse effects in breastfed infants. No M/P ratio available; considered compatible with breastfeeding. |
| Teratogenic Risk | Potassium chloride is not teratogenic. Dextrose and sodium chloride are physiological components; high doses of dextrose may cause fetal hyperinsulinemia and hypoglycemia at delivery. First trimester: no known teratogenic risk. Second trimester: no known fetal harm. Third trimester: maternal hyperglycemia from dextrose may cause fetal macrosomia and neonatal hypoglycemia. |
■ FDA Black Box Warning
No black box warning for this combination product. Potassium chloride concentrate for injection (not this product) has a boxed warning regarding fatal hyperkalemia if administered undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Acute dehydration or heat cramps","Hypersensitivity to any component","Addison's disease","Concomitant use with potassium-sparing diuretics"]
| Precautions | ["Risk of hyperkalemia, which can be fatal; monitor serum potassium levels.","Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia.","Solution may contain aluminum; use with caution in renal impairment.","Do not administer simultaneously with blood products through same IV line."] |
Loading safety data…
| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, chloride), blood glucose, and renal function. Fetal monitoring: assess for fetal distress via heart rate monitoring if oxytocin used. Neonatal monitoring: observe for hypoglycemia if maternal hyperglycemia. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and sodium chloride are physiological; potassium chloride at therapeutic doses does not impair reproductive function. |