POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride replenishes intracellular potassium, essential for nerve conduction, muscle contraction, and acid-base balance. Dextrose provides caloric support and may prevent ketosis. Sodium chloride maintains extracellular fluid volume and osmolarity.
| Metabolism | Potassium: primarily excreted unchanged by kidneys (small fecal loss). Dextrose: metabolized via glycolysis and oxidative pathways. Sodium chloride: excreted mainly in urine, regulated by renal function. |
| Excretion | Potassium chloride is primarily excreted renally (>90% as potassium ions). Fecal elimination accounts for approximately 10% via gastrointestinal secretions. The dextrose and sodium chloride components are fully metabolized or excreted renally. |
| Half-life | The terminal elimination half-life of potassium is approximately 12-24 hours in healthy individuals, but the clinical context involves rapid redistribution and homeostatic regulation. Half-life may be prolonged in renal impairment. Dextrose has a half-life of minutes to hours due to insulin-mediated clearance. |
| Protein binding | Potassium is not significantly protein-bound (<2%). Dextrose and sodium chloride are not protein-bound. |
| Volume of Distribution | Potassium has a Vd of approximately 0.1-0.2 L/kg for extracellular space, but total body potassium is mostly intracellular. Clinical meaning: initial distribution reflects extracellular fluid; equilibration with intracellular stores is slower. |
| Bioavailability | Intravenous administration: 100% bioavailability. Oral bioavailability of potassium chloride is approximately 90-100% (not applicable to this IV formulation). |
| Onset of Action | Intravenous administration: onset of effect on serum potassium levels within minutes to hours, depending on infusion rate and clinical status. Oral potassium (not applicable here) has delayed onset. |
| Duration of Action | Intravenous infusion: duration of effect on serum potassium lasts hours, dependent on infusion rate and ongoing losses. Continuous infusion may be needed to maintain effect. Dextrose effect on blood glucose is brief. |
| Molecular Weight | 74.55 |
Intravenous infusion; adult dose: 1-2 L per day at a rate of 100-200 mL/hour, providing 10-20 mEq potassium chloride per liter. Titrate based on serum potassium and clinical response.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-59 mL/min: reduce infusion rate by 25-50%; GFR 15-29 mL/min: reduce rate by 50-75%; GFR <15 mL/min: avoid use or use with extreme caution, monitoring serum potassium frequently. |
| Liver impairment | Child-Pugh Class A: no adjustment; Class B: consider lower initial rate and monitor potassium closely; Class C: avoid use or use with extreme caution due to risk of hyperkalemia. |
| Pediatric use | Intravenous infusion: 0.5-1 mEq/kg/day of potassium chloride, adjusted according to electrolyte needs; typical administration in 5% dextrose and 0.2% sodium chloride at maintenance rates (e.g., 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day thereafter). |
| Geriatric use | Initiate at lower end of dosing range; monitor renal function and serum potassium frequently; adjust infusion rate based on creatinine clearance; consider reduced total daily volume to avoid fluid overload. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are essential nutrients; no known teratogenic risk at physiological doses. Use only if clearly needed. |
| 2nd trimester | Safe when used to correct electrolyte or fluid imbalances. Monitor serum electrolytes and glucose. |
| 3rd trimester | Safe when indicated. Avoid fluid overload; monitor for maternal hyperglycemia and neonatal hypoglycemia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium, chloride, dextrose, and sodium cross the placenta freely to maintain fetal-maternal equilibrium. |
| Breastfeeding | Potassium, chloride, dextrose, and sodium are normal milk constituents. IV infusion does not pose risk; use as clinically indicated. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are normal physiological components; no teratogenic risk is expected when used as a replacement solution. No fetal risk has been associated with therapeutic use. |
| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, chloride, glucose), renal function, and fluid balance. Assess for signs of hyperkalemia, hypernatremia, or fluid overload. Fetal monitoring as per standard obstetric care. |
| Fertility Effects | No known adverse effects on fertility. |
■ FDA Black Box Warning
No FDA black box warning specific to this fixed combination product. However, potassium chloride preparations carry a boxed warning regarding concentrated solutions requiring dilution to avoid fatal hyperkalemia.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHyperchloremiaHypernatremiaHyperglycemiaSevere renal impairment (oliguria, anuria)Concurrent use of potassium-sparing diuretics (unless close monitoring)
| Precautions | Risk of hyperkalemia, especially in patients with renal impairment, adrenal insufficiency, or those receiving potassium-sparing diuretics., Monitor serum potassium, glucose, and electrolytes; adjust infusion rate based on clinical status., Use caution in patients with cardiac disease, digitalis therapy, or conditions predisposing to hyperkalemia., Do not administer simultaneously with blood products (risk of hemolysis)., Solutions with dextrose may cause hyperglycemia, especially in diabetics. |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes, tomatoes, leafy greens) and salt substitutes containing potassium chloride. Limit sodium intake as per dietary guidelines. |
| Clinical Pearls | Monitor serum potassium and glucose levels closely, especially in renal impairment or diabetic patients. Use with caution in patients with hyperkalemia, severe renal failure, or concomitant potassium-sparing diuretics. Rapid infusion may cause hyperkalemia and cardiac arrhythmias; do not exceed 10-20 mEq/hour unless in a monitored setting. |
| Patient Advice | Report any signs of hyperkalemia, such as muscle weakness, numbness, or irregular heartbeat. · Do not consume potassium-rich foods or supplements without consulting your healthcare provider. · If you have diabetes, monitor blood glucose more frequently as the dextrose in this solution may affect levels. · Tell your doctor all other medications you are taking, especially potassium-sparing diuretics or ACE inhibitors. · This solution is administered intravenously; you may experience burning or pain at the infusion site. |
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