POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium is the principal intracellular cation. It is necessary for the maintenance of intracellular tonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle, and maintenance of normal renal function. Dextrose is a source of calories and water for hydration. Sodium chloride is an electrolyte replenisher and maintains extracellular fluid balance.
| Metabolism | Potassium: primarily excreted unchanged by the kidneys with minimal hepatic metabolism. Dextrose: metabolized via glycolysis and oxidative phosphorylation. Sodium chloride: not metabolized, excreted by kidneys. |
| Excretion | Potassium is primarily excreted renally (about 90%), with the remainder via feces (10%). Renal excretion involves glomerular filtration and active secretion in the distal tubule. Dextrose is metabolized to CO2 and water; sodium and chloride are excreted renally. |
| Half-life | The terminal half-life of potassium is approximately 12–24 hours, reflecting the time to redistribute and be eliminated, dependent on renal function and total body stores. |
| Protein binding | Potassium is minimally protein-bound (<5%); dextrose, sodium, and chloride are not significantly bound. |
| Volume of Distribution | Potassium Vd is approximately 0.5 L/kg, reflecting distribution primarily in the intracellular compartment (98%) with extracellular fluid being 2%. |
| Bioavailability | Intravenous: 100% bioavailability. Not administered orally via this formulation. |
| Onset of Action | Intravenous administration: onset within minutes for potassium repletion; dextrose and sodium/chloride effects begin immediately upon infusion. |
| Duration of Action | Duration of potassium effect is variable, typically lasting 8–12 hours after IV infusion, depending on ongoing losses and redistribution. Dextrose and sodium/chloride effects last as long as infusion or shortly after. |
| Molecular Weight | 74.55 |
Intravenous infusion. Adult dose based on serum potassium and fluid/electrolyte requirements. Typical maintenance: 20-40 mEq potassium per 24 hours, infused at a rate not exceeding 10-20 mEq/hour. Concentration should not exceed 40 mEq/L for peripheral infusion.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) with oliguria or anuria. For mild to moderate impairment (GFR 30-60 mL/min), reduce total daily potassium dose by 50% and monitor serum potassium; avoid potassium administration if GFR <30 mL/min without dialysis. |
| Liver impairment | No specific dose adjustment recommended. However, monitor serum potassium and renal function closely in patients with hepatic impairment due to increased risk of hyperkalemia. |
| Pediatric use | Dose based on body weight and serum potassium levels. Typical maintenance: 1-2 mEq/kg/day, infused at a rate not exceeding 0.5-1 mEq/kg/hour. Concentration should not exceed 40 mEq/L for peripheral infusion. |
| Geriatric use | Use with caution due to age-related decline in renal function. Start at lower end of dosing range (e.g., 10-20 mEq per 24 hours) and monitor serum potassium closely. Avoid rapid infusion. |
| 1st trimester | Potassium chloride in this formulation is generally considered safe in recommended doses for maintaining electrolyte balance. However, excessive potassium intake should be avoided due to potential adverse effects on the fetus. Use with caution. |
| 2nd trimester | Safe when used as directed for electrolyte replacement. Monitor serum potassium levels to avoid hyperkalemia. |
| 3rd trimester | Safe for use, but avoid excessive potassium which may cause neonatal hyperkalemia or arrhythmias. Use only if clearly needed. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta, but its transfer is regulated by active transport mechanisms. Fetal serum potassium levels are slightly higher than maternal. Clinically significant transfer is unlikely with normal maternal potassium levels. |
| Breastfeeding | Potassium chloride is normally present in breast milk. Supplementation is generally considered compatible with breastfeeding as potassium levels are closely regulated. However, high doses may affect maternal potassium balance and could theoretically affect the infant. Monitor infant for signs of hyperkalemia if mother receives large doses. |
| Lactation Rating | L1 (Compatible) |
| Teratogenic Risk | Potassium chloride at usual therapeutic doses is not associated with teratogenicity. Dextrose 5% and sodium chloride 0.33% are standard maintenance solutions; no known fetal risks at recommended infusion rates. However, maternal electrolyte imbalances (e.g., hyperkalemia, hypernatremia, hypoglycemia/hyperglycemia) from improper use may adversely affect the fetus. During first trimester, no specific structural malformations reported. Second and third trimesters: risk of fetal electrolyte disturbances or metabolic acidosis if maternal homeostasis is not maintained. Intravenous administration should be carefully controlled to avoid maternal volume overload which may lead to fetal edema or placental insufficiency. |
| Fetal Monitoring | Monitor maternal serum electrolytes (K+, Na+, Cl-), glucose levels, and fluid balance (intake/output, weight, signs of edema). Fetal monitoring includes heart rate and growth parameters in prolonged therapy; consider ultrasound for fluid status if signs of maternal overload. In high-risk pregnancies (e.g., preeclampsia, diabetes), more frequent assessment is required. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Electrolyte abnormalities from misuse could theoretically impair reproductive function, but no direct evidence for this formulation. |
■ FDA Black Box Warning
Concentrated potassium solutions are for intravenous use only and must be diluted before administration. Rapid infusion may cause fatal hyperkalemia and cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or azotemiaAddison's disease (untreated)Hyperkalemic periodic paralysisConcurrent use of potassium-sparing diuretics (e.g., spironolactone) unless monitoredSevere hemolytic reactions
| Precautions | Monitor serum potassium levels frequently during therapy, Risk of hyperkalemia, especially in patients with renal impairment, heart disease, or those taking ACE inhibitors, ARBs, or potassium-sparing diuretics, Avoid extravasation as potassium chloride can cause tissue necrosis, Use with caution in patients with severe hyponatremia or fluid overload, Solution should be used only if clear and container undamaged |
| Food/Dietary | Avoid excessive dietary potassium intake (e.g., bananas, oranges, potatoes, salt substitutes) during therapy, especially in patients with renal impairment or hyperkalemia risk. |
| Clinical Pearls | This formulation is a maintenance IV fluid providing potassium chloride (0.075% = 10 mEq/L K+), dextrose 5% (calories), and sodium chloride 0.33% (56.5 mEq/L Na+). Use with caution in patients with renal impairment, hyperkalemia, or cardiac conditions. Do not administer rapidly to avoid hyperkalemia. Monitor serum potassium levels. Incompatible with blood products due to hemolysis risk. Plastic container may adsorb certain drugs; check compatibility. |
| Patient Advice | Do not stop or adjust the infusion rate unless instructed by your healthcare provider. · Report any symptoms such as chest pain, irregular heartbeat, muscle weakness, or tingling in the extremities. · Inform your doctor if you have kidney disease, heart problems, or are on potassium-sparing diuretics. · This fluid provides sugar and electrolytes; it is not a substitute for food. |
Loading safety data…