POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% IN PLASTIC CONTAINER (POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% IN PLASTIC CONTAINER).
Potassium chloride dissociates to provide potassium ions, which are essential for maintaining intracellular fluid composition, nerve conduction, muscle contraction, and acid-base balance. Dextrose 5% provides a source of calories and water for hydration, with dextrose being metabolized to carbon dioxide and water, supplying energy.
| Metabolism | Potassium chloride is not metabolized; potassium is excreted primarily by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, with insulin facilitating cellular uptake. |
| Excretion | Potassium is primarily excreted renally (approximately 90%) via glomerular filtration and distal tubular secretion. Minor fecal elimination accounts for ~10%. Renal excretion is influenced by aldosterone, acid-base status, and potassium intake. |
| Half-life | Potassium has a biphasic elimination: distribution half-life ~1 hour, terminal elimination half-life ~12 hours in normal renal function. Clinical context: Half-life extends significantly in renal impairment, requiring dose adjustment. |
| Protein binding | Potassium is minimally protein-bound (<5%); binding proteins are not clinically significant as free ion is active. |
| Volume of Distribution | Vd is approximately 0.5-0.7 L/kg (total body water). This reflects extensive distribution into intracellular compartments, where 98% of total body potassium resides. |
| Bioavailability | Intravenous: 100%. Oral: Approximately 90% absorbed in the small intestine (bioavailability is high but absorption can be affected by gastrointestinal motility and formulation). The 0.075% solution is for IV use only. |
| Onset of Action | Intravenous infusion: Onset of serum potassium elevation occurs within minutes; maximal effect on intracellular potassium may take several hours due to slow distribution. Oral: Onset of serum increase ~30-60 minutes, full effect delayed. |
| Duration of Action | Intravenous: Serum levels decline rapidly after infusion stops; duration of clinical effect (e.g., ECG normalization) persists for 2-4 hours post-infusion. Oral: Effect may last 4-6 hours depending on dose and renal function. |
Intravenous administration at a rate not exceeding 10 mEq/hour of potassium chloride; typical adult dose is 20-40 mEq per day administered as an additive to dextrose 5% solution, titrated to serum potassium levels.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-50 mL/min: reduce dose by 25%; GFR 15-29 mL/min: reduce dose by 50%; GFR <15 mL/min: avoid use or use with extreme caution and frequent monitoring. |
| Liver impairment | In hepatic impairment (Child-Pugh Class B or C): initiate at 50% of typical dose and titrate based on serum potassium levels and electrocardiographic monitoring; no specific adjustment for Child-Pugh A. |
| Pediatric use | 0.5-1 mEq/kg per day as a continuous intravenous infusion, not to exceed 0.5 mEq/kg/hour; maximum daily dose 3 mEq/kg; must be diluted in appropriate IV fluid such as dextrose 5%. |
| Geriatric use | Start at low end of dosing range (e.g., 10-20 mEq per day) with careful titration; monitor renal function and serum potassium closely due to age-related decline in glomerular filtration rate. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% IN PLASTIC CONTAINER (POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Potassium and dextrose are normal components of breast milk. No M/P ratio available. Considered compatible with breastfeeding at therapeutic doses. |
| Teratogenic Risk | Potassium chloride and dextrose are not known teratogens. No fetal risk at therapeutic doses. Inadequate data for first trimester, risk cannot be excluded. Second and third trimesters: safe when used as indicated. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Adrenal insufficiency (e.g., Addison's disease)","Acute dehydration","Concurrent use with potassium-sparing diuretics or ACE inhibitors at high risk of hyperkalemia","Conditions causing extensive tissue breakdown (e.g., severe burns, crush injuries) as they may release intracellular potassium"]
| Precautions | ["Risk of hyperkalemia, especially in patients with renal impairment, adrenal insufficiency, or those receiving potassium-sparing diuretics","Monitor serum potassium levels and ECG during administration","Do not administer undiluted potassium chloride; must be diluted in appropriate solutions","Use with caution in patients with cardiac disease or conditions predisposing to hyperkalemia","Rapid infusion may cause hyperkalemia and cardiac arrest"] |
Loading safety data…
| Monitor serum potassium, glucose, and renal function during infusion. Assess for signs of hyperkalemia (ECG changes, arrhythmias) in mother and fetus. Fetal heart rate monitoring if indicated. |
| Fertility Effects | No known adverse effects on fertility from potassium chloride or dextrose at therapeutic doses. |