POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for maintenance of electrolyte balance, cardiac function, and neuromuscular transmission. Dextrose provides caloric support and prevents ketosis. Sodium chloride maintains osmolarity and fluid balance.
| Metabolism | Potassium is not metabolized; excreted primarily by kidneys. Dextrose is metabolized via glycolysis and citric acid cycle to carbon dioxide and water. Sodium and chloride are not metabolized. |
| Excretion | Potassium is primarily excreted renally (90%) via the kidneys, with about 10% eliminated in feces. In the kidney, potassium is filtered, reabsorbed in the proximal tubule and loop of Henle, and secreted in the distal tubule and collecting duct. Excretion rates adapt to dietary intake and hormonal influences (e.g., aldosterone). |
| Half-life | The terminal elimination half-life of potassium is not typically reported as a single value due to extensive body distribution. The redistribution half-life between intracellular and extracellular compartments is approximately 1-2 hours, while overall body elimination half-life is about 8-12 hours in individuals with normal renal function. In renal impairment, half-life is prolonged. |
| Protein binding | Potassium is not significantly bound to plasma proteins; protein binding is less than 5%. |
| Volume of Distribution | The apparent volume of distribution of potassium is approximately 0.5 L/kg, indicating distribution primarily in total body water. However, potassium is predominantly intracellular (98% of total body potassium), with a Vd reflecting exchangeable pool of about 0.3-0.5 L/kg. |
| Bioavailability | Oral potassium chloride has high bioavailability (approximately 90-100%) due to complete absorption in the small intestine. Intravenous administration results in 100% bioavailability. |
| Onset of Action | Intravenous administration of 0.075% KCl in D5 0.45% NaCl: onset of correction of hypokalemia is immediate as the infusion begins, with peak plasma potassium concentration achieved within 2-3 hours after starting the infusion. Oral administration (enteric-coated tablets) has onset of 30 minutes to 1 hour. |
| Duration of Action | Duration of action for intravenous potassium is continuous during infusion; effects on serum potassium levels last as long as the infusion is maintained. For oral administration, the duration of action is approximately 8 hours, but depends on overall potassium balance and renal function. |
| Molecular Weight | 74.55 |
Intravenous, 1000 mL at a rate of 100-200 mL/hour; each liter provides 10 mEq potassium, 50 g dextrose, and 77 mEq sodium chloride.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR < 30 mL/min/1.73 m²) or oliguria. For GFR 30-50 mL/min/1.73 m², reduce infusion rate and monitor serum potassium closely; maximum infusion rate 10 mEq/hour. |
| Liver impairment | Dextrose content may require monitoring in hepatic impairment; no specific Child-Pugh dose adjustment for potassium chloride. Use with caution in severe hepatic insufficiency due to risk of fluid overload. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg/day of potassium chloride, not to exceed 3 mEq/kg/day. Typical maintenance rate: 5-10 mL/kg/hour of this solution, adjust based on serum potassium and glucose levels. |
| Geriatric use | Use with caution due to decreased renal function; monitor potassium and glucose levels. Lower starting infusion rates (50-100 mL/hour) recommended; do not exceed 10 mEq/hour potassium. |
| 1st trimester | Potassium chloride in this concentration is generally considered safe. No teratogenic effects known, but use only if clearly needed. Monitor potassium levels. |
| 2nd trimester | Safe for use when indicated. Monitor maternal potassium levels to avoid hyperkalemia or hypokalemia. |
| 3rd trimester | Safe for use. Avoid hyperkalemia in mother as it may cause fetal arrhythmias. Monitor serum potassium closely. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta; fetal serum levels are similar to maternal. No reported harm at therapeutic doses. |
| Breastfeeding | Potassium chloride is a normal constituent of breast milk. No reported adverse effects in nursing infants at therapeutic doses. Excretion into milk is not significant to affect infant serum levels. |
| Lactation Rating | L1: Compatible |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride at these concentrations are physiological electrolytes and nutrients. No teratogenic risk has been established. Use during pregnancy is considered safe when indicated, as electrolyte imbalances pose greater risk. Specific trimester risks are not identified; however, careful monitoring of maternal electrolytes and fluid status is recommended, especially in the third trimester due to increased plasma volume. |
| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, glucose), fluid balance, and renal function periodically. Fetal monitoring as per standard obstetric care. In cases of maternal hyperglycemia, assess fetal growth and amniotic fluid volume. |
| Fertility Effects | No known adverse effects on fertility. Potassium chloride, dextrose, and sodium chloride are essential nutrients and do not impair reproductive function when used appropriately. |
■ FDA Black Box Warning
No FDA black box warning exists for this product.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment (oliguria, anuria)Severe dehydrationAcute acidosisAddison's diseaseConcurrent use of potassium-sparing diureticsSick sinus syndrome or AV block (relative, but caution)
| Precautions | Avoid rapid intravenous administration to prevent hyperkalemia and cardiac arrhythmias, Monitor serum potassium levels and renal function, Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia, Do not administer unless solution is clear and container undamaged |
| Food/Dietary | Avoid high-potassium foods (bananas, oranges, potatoes, spinach, tomatoes) and salt substitutes containing potassium chloride. Consistent carbohydrate intake is recommended for patients with diabetes. |
| Clinical Pearls | Monitor serum potassium and glucose levels frequently. Infusion rate should not exceed 10-20 mEq/hour of potassium; avoid rapid infusion to prevent hyperkalemia. Use with caution in renal impairment, cardiac disease, or patients on digoxin. Do not administer undiluted; ensure adequate urine output (>30 mL/hour). |
| Patient Advice | Do not adjust the infusion rate yourself; it is controlled by healthcare providers. · Report any symptoms of hyperkalemia (muscle weakness, tingling, irregular heartbeat) or hypoglycemia (sweating, dizziness, confusion). · Inform your doctor if you have kidney disease, heart problems, or are taking medications like ACE inhibitors or potassium-sparing diuretics. · This solution contains dextrose; if you have diabetes, blood sugar monitoring is important. |
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