POTASSIUM CHLORIDE 0.11% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for maintaining intracellular osmolality, acid-base balance, nerve conduction, and muscle contraction. Dextrose is a monosaccharide that provides calories and may reduce protein and nitrogen loss. Sodium chloride provides sodium and chloride ions for fluid and electrolyte balance.
| Metabolism | Potassium is primarily excreted renally; dextrose is metabolized to carbon dioxide and water via glycolysis; sodium and chloride are excreted renally. |
| Excretion | Primarily renal (90-95% as potassium ion); minimal biliary/fecal elimination; excretion of dextrose and sodium chloride components is also renal. |
| Half-life | Not applicable; potassium is an electrolyte with no classic half-life. Dextrose half-life is ~15-20 min; sodium chloride half-life is ~1-2 weeks for total body sodium. Plasma potassium clearance depends on renal function. |
| Protein binding | Potassium: minimal (<5%); dextrose and sodium chloride: not significantly protein bound. |
| Volume of Distribution | Potassium: 0.5-0.6 L/kg (primarily intracellular); dextrose: ~0.2 L/kg; sodium chloride: ~0.65 L/kg (extracellular). |
| Bioavailability | Intravenous: 100%; not administered via oral or other routes as a fixed-dose combination. |
| Onset of Action | Intravenous: Immediate (within seconds to minutes) for serum potassium changes; dextrose effect on blood glucose within minutes. |
| Duration of Action | Intravenous: Duration of potassium effect depends on infusion rate and renal function; dextrose effects last minutes to hours; sodium chloride effect depends on volume status. |
| Molecular Weight | Potassium chloride: 74.55 Da; Dextrose: 180.16 Da; Sodium chloride: 58.44 Da |
Intravenous infusion at a rate not exceeding 10 mEq/hour of potassium chloride; typical adult dose is 20-40 mEq potassium in 500-1000 mL of solution infused over 4-8 hours, adjusting based on serum potassium and clinical need.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: use only with extreme caution, reduce potassium content or avoid; monitor serum potassium closely. GFR 30-50 mL/min: reduce dose or prolong infusion interval. No specific dose adjustment for GFR >50 mL/min but monitor potassium levels. |
| Liver impairment | No specific Child-Pugh based adjustments; use standard precautions with frequent monitoring of serum potassium and acid-base status. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg of potassium chloride per dose, infused at a rate not exceeding 0.3-0.5 mEq/kg/hour; maximum single dose 40 mEq. Use smaller volumes of compatible solution. |
| Geriatric use | Use lower doses (e.g., 10-20 mEq per 500-1000 mL) and slower infusion rates (e.g., 5 mEq/hour) due to increased risk of hyperkalemia and renal impairment; monitor serum potassium and renal function frequently. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are generally considered safe when used as replacement therapy in appropriate doses. However, excessive potassium may cause fetal bradycardia or arrhythmias. Use with caution. |
| 2nd trimester | Same as T1. Monitor serum potassium levels to avoid hyperkalemia, which can affect fetal cardiac function. |
| 3rd trimester | Same as T1. Avoid maternal hyperkalemia as it may lead to fetal distress. Use only if clearly needed. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium and sodium ions cross the placenta by active transport; dextrose crosses by facilitated diffusion. All are essential nutrients. Excessive levels may affect fetal electrolyte balance. |
| Breastfeeding | Potassium, dextrose, and sodium chloride are normal constituents of breast milk and are not expected to cause adverse effects in the infant when administered intravenously at recommended doses. However, maternal hyperkalemia could theoretically affect the infant. Monitor maternal potassium levels. |
| Lactation Rating | L1: Compatible |
| Teratogenic Risk | POTASSIUM CHLORIDE 0.11% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% is an electrolyte and fluid replacement solution. Potassium chloride is considered to have low teratogenic potential. Dextrose and sodium chloride are normal physiological components. No specific fetal risks are identified at therapeutic doses. However, maternal hyperkalemia, hyperglycemia, or electrolyte imbalances could adversely affect the fetus. Use in pregnancy requires careful monitoring to avoid maternal electrolyte disturbances that might impact fetal development. |
| Fetal Monitoring | Serial serum electrolytes (potassium, sodium, glucose, chloride) should be monitored. Assess intake/output and adjust infusion rate to avoid fluid overload. Monitor fetal heart rate during labor if administered intravenously. In prolonged use, monitor for signs of hyperkalemia (ECG changes, muscle weakness) or hyperglycemia (maternal glucose levels). In preeclampsia or renal impairment, closer surveillance is warranted. |
| Fertility Effects | No known adverse effects on fertility. Potassium, dextrose, and sodium are essential nutrients and when used as replacement therapy at appropriate doses, do not impair reproductive function. No evidence of ovarian or testicular toxicity. |
■ FDA Black Box Warning
Potassium chloride injection concentrate must be diluted before use to avoid fatal hyperkalemia.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaHyperglycemiaSevere renal impairment with oliguria or anuriaEdema with sodium retentionDiabetic coma with hyperglycemia
| Precautions | Hyperkalemia risk: monitor serum potassium levels; use with caution in patients with renal impairment, heart disease, or conditions predisposing to hyperkalemia, Volume overload: caution in patients with heart failure or renal impairment, Extravasation risk: irritant, can cause tissue necrosis, Hyperglycemia risk: dextrose content may cause hyperglycemia in diabetics, Allergic reactions possible |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, avocados) and salt substitutes containing potassium chloride. Limit sodium intake as per dietary guidelines for underlying conditions. |
| Clinical Pearls | Verify serum potassium before administration in patients with renal impairment. Do not infuse at rates exceeding 10 mEq/hour unless in a monitored setting. Use a large-bore vein or central line to avoid phlebitis. Monitor for hyperkalemia, especially in patients on ACE inhibitors, ARBs, or K-sparing diuretics. This solution is hypotonic; avoid in patients at risk for cerebral edema. |
| Patient Advice | Report any pain, redness, or swelling at the IV site immediately. · Inform your healthcare provider if you have a history of kidney problems or heart disease. · Do not consume potassium-rich foods or supplements unless directed by your doctor. · This IV is used to correct electrolyte imbalances; it may cause a burning sensation during infusion. · Tell your doctor if you are taking any medications for high blood pressure or heart failure. |
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