POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride dissociates to provide potassium ions, which are essential for maintenance of intracellular tonicity, nerve impulse transmission, contraction of cardiac, skeletal, and smooth muscle, and normal renal function. Dextrose provides caloric support and is metabolized via glycolysis and the Krebs cycle. Sodium chloride provides sodium and chloride ions to maintain extracellular fluid volume and osmolality.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water. Sodium and chloride are not metabolized but are excreted primarily by the kidneys. |
| Excretion | Potassium: primarily renal excretion (>90%) via distal tubular secretion; negligible biliary or fecal. Dextrose: metabolized to CO2 and water; renal excretion of unchanged glucose negligible (glycosuria if threshold exceeded). Sodium chloride: renal excretion (Na+ and Cl-) with homeostasis; extrarenal losses minimal under normal conditions. |
| Half-life | Potassium: not classically defined due to rapid cellular redistribution; terminal half-life for administered K+ is approximately 1-1.5 hours in healthy individuals. Dextrose: distribution half-life ~5-10 min; elimination depends on utilization and renal function. Sodium chloride: no defined half-life; excreted based on body needs. |
| Protein binding | Potassium: not appreciably protein-bound (<5%). Dextrose: not bound. Sodium chloride: not bound. |
| Volume of Distribution | Potassium: Vd approximately 0.5 L/kg (total body water); clinical meaning: large Vd indicates extensive cellular uptake. Dextrose: Vd ~0.2-0.3 L/kg (extracellular space). Sodium chloride: distributes primarily to extracellular fluid (Vd ~0.2 L/kg). |
| Bioavailability | Intravenous: 100% for all components (potassium, dextrose, sodium chloride). Oral: not applicable for this product. |
| Onset of Action | Intravenous: Potassium concentration effect on serum levels begins within minutes; clinical effect (e.g., cardiac repolarization) immediate with normal distribution. Dextrose: glycemic effect within minutes. Sodium chloride: volume expansion effect within minutes. |
| Duration of Action | Potassium: infusion stop leads to rapid decline; sustained effect only with continuous administration. Dextrose: hyperglycemic effect lasts for duration of infusion; post-infusion euglycemia in ~1-2 hours. Sodium chloride: effect on extracellular fluid volume persists for several hours after infusion. |
Intravenous infusion. Dose is determined by electrolyte requirements and fluid status. Typical maintenance: 1-2 mEq/kg/day potassium chloride, 100-200 mL/kg/day dextrose 10% (providing 10-20 g/kg/day dextrose), and sodium chloride 0.45% (providing 0.45 g/kg/day sodium chloride). Administer at a rate not exceeding 10 mEq/h potassium chloride via peripheral line; central line may allow up to 20 mEq/h with continuous cardiac monitoring.
| Dosage form | INJECTABLE |
| Renal impairment | eGFR <30 mL/min/1.73 m²: Use with caution; reduce potassium chloride dose by 50% or avoid if hyperkalemia risk; monitor serum potassium closely. eGFR 30-60 mL/min/1.73 m²: Reduce potassium chloride dose by 25% and monitor electrolytes. No adjustment for dextrose or sodium chloride unless oliguria/anuria present. |
| Liver impairment | Child-Pugh Class A: No adjustment. Child-Pugh Class B or C: Monitor glucose and electrolytes; no specific dose reduction required but caution with fluid overload. Dextrose 10% may require monitoring for hyperglycemia in decompensated cirrhosis. |
| Pediatric use | Neonates: IV infusion, potassium chloride 1-2 mEq/kg/day, dextrose 10% at 80-150 mL/kg/day (providing 8-15 g/kg/day dextrose), sodium chloride 0.45% adjusted for sodium needs (2-4 mEq/kg/day). Infants and Children: IV infusion, potassium chloride 1-2 mEq/kg/day (max 40 mEq/day), dextrose 10% at maintenance fluid rate (100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, 20 mL/kg for additional kg), sodium chloride 0.45% providing 0.45 g/kg/day sodium chloride. Titrate based on serum electrolytes and glucose. |
| 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 chloride are normal components of breast milk. Administration of this solution is compatible with breastfeeding. No M/P ratio is available as these are endogenous substances. Use with caution in mothers with conditions affecting electrolyte balance. |
| Teratogenic Risk | Potassium chloride is an essential electrolyte and not teratogenic at physiological levels. Dextrose and sodium chloride are also generally safe. However, hyperkalemia or severe electrolyte imbalances may pose indirect risks to the fetus, such as arrhythmias or metabolic disturbances. No specific teratogenic effects are attributed to this combination at standard doses. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (serum potassium >5.5 mEq/L)","Hypernatremia","Hyperchloremia","Anuria or severe renal impairment","Patients with known hypersensitivity to any component","Severe metabolic acidosis (use with caution)","Concurrent use of potassium-sparing diuretics or ACE inhibitors only if carefully monitored"]
| Precautions | ["Monitor serum potassium, glucose, sodium, and chloride levels frequently during therapy","Risk of hyperkalemia, particularly in patients with renal impairment, rapid infusion, or when used with potassium-sparing diuretics or ACE inhibitors","Risk of hyperglycemia due to dextrose content, especially in diabetic patients or those with impaired glucose tolerance","Use with caution in patients with heart failure, severe renal impairment, or conditions causing sodium retention (e.g., hyperaldosteronism)","Do not administer intra-arterially or via peripheral vein if hypertonic; ensure proper dilution and compatible administration sets","Avoid rapid or large-volume infusions to prevent fluid overload, pulmonary edema, or hyperkalemia"] |
Loading safety data…
| Geriatric use | Start at lower end of dosing range due to age-related decline in renal function and increased risk of hyperkalemia. Monitor serum potassium, glucose, and renal function closely. Avoid rapid infusion rates; maximum potassium chloride infusion rate 10 mEq/h. Use with caution in heart failure or hypertension due to sodium load. |
| Fetal Monitoring | Monitor serum potassium, sodium, glucose, and renal function periodically. Assess for signs of fluid overload or electrolyte disturbances in both mother and fetus. Fetal heart rate monitoring may be indicated if maternal electrolyte abnormalities occur. |
| Fertility Effects | No adverse effects on fertility are expected with physiological doses of potassium chloride, dextrose, or sodium chloride. No specific studies available for this combination. |