POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions necessary for nerve conduction, muscle contraction, and maintenance of intracellular tonicity. Dextrose 5% provides a source of calories and is metabolized to carbon dioxide and water, supplying energy. Sodium chloride provides sodium and chloride ions for electrolyte balance and maintenance of osmotic pressure.
| Metabolism | Potassium: not metabolized, excreted primarily by kidneys. Dextrose: undergoes glycolysis and enters Krebs cycle. Sodium chloride: not metabolized, excreted by kidneys. |
| Excretion | Renal: >90% of potassium ion excreted by kidneys (distal tubular secretion and reabsorption); <10% fecal (via gastrointestinal secretion). Dextrose and sodium chloride components are fully metabolized or excreted renally. |
| Half-life | Not applicable for combined electrolyte/caloric solution; potassium distribution half-life ~1-1.5 hours; for potassium, elimination half-life depends on renal function (normal: ~6-8 hours, anuria: prolonged). |
| Protein binding | Potassium: minimal (<5%, not bound to proteins). Dextrose and sodium: not bound. |
| Volume of Distribution | Potassium: total body water (0.5-0.6 L/kg); distribution includes intracellular space (98% of total body potassium is intracellular). |
| Bioavailability | IV: 100% (complete bioavailability). No oral route for this product. |
| Onset of Action | IV infusion: immediate (within minutes) as plasma potassium and glucose levels rise; clinical effect (e.g., ECG changes) within 15-30 minutes. |
| Duration of Action | Duration of potassium effect correlates with infusion rate and renal function; typically 4-6 hours after IV infusion ends. Glucose effect: 30-60 minutes for plasma glucose elevation. |
Intravenous infusion at a rate not exceeding 10-20 mEq/hour of potassium; typical dose for hypokalemia: 20-40 mEq potassium chloride per liter of IV fluid, infused at a rate to correct deficit. Actual dose depends on serum potassium level and clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia; use with caution in mild to moderate impairment with frequent potassium monitoring. Reduce dose or prolong infusion time based on serum potassium levels. |
| Liver impairment | No specific dose adjustment required for hepatic impairment; monitor serum potassium as hepatic dysfunction can affect acid-base balance and potassium distribution. |
| Pediatric use | Dose individualized based on weight, serum potassium, and clinical condition. Typical initial infusion rate: 0.2-0.5 mEq/kg/hour; maximum rate: 1 mEq/kg/hour under continuous ECG monitoring. Maximum daily dose: 3 mEq/kg/day. |
| Geriatric use | Use with caution due to age-related decline in renal function; start at lower end of dosing range and titrate based on serum potassium and renal function. Monitor for hyperkalemia, especially in those with impaired renal function or on ACE inhibitors/ARBs. |
| 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 and chloride are normal milk constituents; dextrose is a normal sugar. Exogenous administration does not significantly alter breast milk composition. M/P ratio not established; considered compatible with breastfeeding with usual doses. Monitor for infant electrolyte imbalance if high doses administered. |
| Teratogenic Risk | Potassium chloride and dextrose are not associated with teratogenicity at usual therapeutic doses. Sodium chloride in typical amounts is not teratogenic. First trimester exposure considered low risk. Second and third trimesters: no known fetal harm. However, maternal electrolyte disturbances (e.g., hyperkalemia, hypernatremia) can affect fetal homeostasis. |
■ FDA Black Box Warning
No FDA black box warning for this specific combination product. However, potassium chloride can cause fatal hyperkalemia if administered in excess or too rapidly.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Renal failure with oliguria or anuria","Addison's disease (adrenal insufficiency)","Acute dehydration","Heat cramps","Patients with severe cardiac disease or heart block","Concurrent use of potassium-sparing diuretics or ACE inhibitors without careful monitoring"]
| Precautions | ["Risk of hyperkalemia, especially in patients with renal impairment, heart disease, or on potassium-sparing diuretics","Monitor serum potassium, glucose, and electrolytes during prolonged therapy","Administration via peripheral line may cause phlebitis; central line preferred for concentrated solutions","Use with caution in patients with cardiac arrhythmias, renal failure, or adrenal insufficiency"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, sodium, chloride), glucose, renal function, and fluid balance. Fetal monitoring not typically required unless maternal decompensation occurs. During prolonged use, assess for signs of fluid overload or electrolyte disturbances. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Underlying conditions requiring this solution (e.g., dehydration, electrolyte imbalance) may impact fertility; correction improves reproductive function. |