POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride serves as a source of potassium and chloride ions for parenteral nutrition and fluid replacement. Potassium is the principal intracellular cation, essential for maintaining cellular membrane potential, nerve impulse transmission, muscle contraction, and acid-base balance. Dextrose provides calories and sodium chloride provides sodium and chloride ions for electrolyte balance.
| Metabolism | Potassium and chloride are not metabolized; they are eliminated primarily by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle. |
| Excretion | Renal: >90% of potassium chloride is excreted via the kidneys, primarily through glomerular filtration and tubular secretion, with minimal fecal loss (<5%). Dextrose and sodium are fully metabolized or excreted renally. |
| Half-life | The terminal elimination half-life of potassium is approximately 12 hours, reflecting redistribution and renal excretion, but this varies with renal function and total body potassium stores. Dextrose has a half-life of <1 hour due to rapid cellular uptake. |
| Protein binding | Potassium: None bound to plasma proteins. Dextrose: <1% bound. Sodium: none bound. |
| Volume of Distribution | Potassium: 0.5 L/kg, reflecting distribution primarily into intracellular fluid (98% of body potassium is intracellular). Dextrose: 0.2 L/kg (extracellular space). Sodium: 0.2 L/kg (extracellular). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (within seconds to minutes) for electrolyte effects due to direct infusion into bloodstream. Clinical effect on serum potassium levels is observed within minutes, but maximal effect on intracellular stores may take hours. |
| Duration of Action | Duration of electrolyte effect is 2-4 hours post-infusion, depending on distribution and renal clearance. Continuous infusion is often required for sustained correction. Dextrose effect lasts <1 hour post-infusion. |
Continuous IV infusion, rate determined by clinical need; typical adult dose: 5-10 mEq/hour (10-20 mL/hour) of this solution, not to exceed 10 mEq/hour or 150 mEq/day. Route: IV. Frequency: Continuous infusion.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: No adjustment required but monitor potassium closely. GFR <30 mL/min: Use with extreme caution; consider alternative therapy; maximum dose 20 mEq/day with continuous monitoring. Not recommended if GFR <10 mL/min. |
| Liver impairment | No dosage adjustment required for Child-Pugh Class A or B. Child-Pugh Class C: Use with caution; monitor potassium levels closely as metabolic alkalosis may occur; typical dose reduction not defined but start at lower end of dosing range. |
| Pediatric use | IV infusion: 0.5-1 mEq/kg/day (1-2 mL/kg/day) of this solution, rate not to exceed 0.5 mEq/kg/hour. Maximum daily dose: 2 mEq/kg/day (4 mL/kg/day). Monitor serum potassium and ECG continuously. |
| Geriatric use | Start at low end of adult dosing (5 mEq/hour, 10 mL/hour) due to decreased renal function; maximum 10 mEq/hour (20 mL/hour) with close monitoring. Avoid if eGFR <30 mL/min or with concurrent potassium-sparing diuretics. |
| 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 pass into breast milk but are normal milk constituents. No adverse effects reported. M/P ratio not established but considered safe. |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride at these concentrations are essential nutrients and not associated with teratogenicity. No increased risk of fetal malformations with standard doses. Trimester-specific risks are not applicable. |
■ FDA Black Box Warning
Potassium chloride concentrate must be diluted before use to prevent fatal hyperkalemia. Bolus administration is contraindicated due to risk of cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
["Severe hyperkalemia","Anuria or severe renal failure","Addison's disease","Untreated hyperkalemia from any cause","Concurrent use of potassium-sparing diuretics or ACE inhibitors without careful monitoring"]
| Precautions | ["Monitor serum potassium, glucose, and electrolytes during infusion","Use with caution in patients with renal insufficiency, cardiac disease, or conditions predisposing to hyperkalemia","Do not administer undiluted or via rapid infusion","Risk of hyperglycemia and metabolic acidosis with high dextrose loads"] |
Loading safety data…
| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, glucose), fluid balance, renal function, and urine output. Fetal monitoring is not routinely required unless maternal electrolyte disturbances are present. |
| Fertility Effects | No known adverse effects on fertility at standard doses. |