POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% IN PLASTIC CONTAINER (POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% IN PLASTIC CONTAINER).
Potassium is the major intracellular cation, essential for maintaining cellular membrane potential, nerve impulse transmission, and muscle contraction. Dextrose provides caloric supplementation.
| Metabolism | Potassium is not metabolized; excreted primarily by kidneys. Dextrose undergoes glycolysis and oxidation to carbon dioxide and water. |
| Excretion | Primarily renal; >90% of potassium is excreted by the kidneys, with approximately 10% lost in feces. In steady state, urinary potassium excretion matches dietary intake (typically 40-120 mEq/day). Dextrose is completely metabolized; unchanged dextrose excretion is negligible (<1% renal) in normoglycemic individuals. |
| Half-life | Potassium has no true elimination half-life as it is homeostatically regulated; the terminal half-life of a potassium load is approximately 8-12 hours in healthy individuals, but this is highly variable and dependent on renal function, aldosterone status, and body stores. In anuric patients, potassium clearance is minimal, and dangerous accumulation can occur within hours. |
| Protein binding | Potassium: negligible (<2%) protein binding; it is present as free ions. Dextrose: not protein bound. |
| Volume of Distribution | Potassium: Vd ~0.5 L/kg (total body water); essentially distributes throughout the entire body water. Over 98% of total body potassium is intracellular; the Vd for administered potassium is larger than that for extracellular markers due to rapid cellular uptake. Dextrose distributes into total body water (Vd ~0.6 L/kg). |
| Bioavailability | Intravenous: 100% bioavailability. Not administered by other routes for potassium repletion due to poor tolerability and absorption (e.g., oral bioavailability of potassium chloride is 80-90%, but GI irritation limits use). |
| Onset of Action | Intravenous infusion: Correction of hypokalemia begins within minutes; cellular uptake of potassium occurs rapidly, and serum potassium levels rise promptly. Clinical effects (e.g., ECG normalization, muscle strength improvement) are seen within 1-2 hours depending on infusion rate and severity of deficiency. |
| Duration of Action | Duration depends on ongoing losses and redistribution. After a single IV dose, effects on serum potassium last 4-6 hours; continuous infusion is typically required for sustained correction. Dextrose is rapidly metabolized; its caloric effect lasts for the duration of the infusion. |
Intravenous infusion at a rate not exceeding 10 mEq/h (using 0.11% potassium chloride in 5% dextrose), typically 10-20 mEq over 4-6 hours for mild hypokalemia, with a maximum concentration of 40 mEq/L via peripheral line.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min: avoid use unless documented hypokalemia; maximum infusion rate 5 mEq/h. GFR 30-50 mL/min: reduce rate to 5-10 mEq/h. GFR >50 mL/min: standard dosing. |
| Liver impairment | No dose adjustment required for Child-Pugh class A or B. Class C: use with caution, monitor potassium levels and infusion rate; reduce maximum rate to 5 mEq/h. |
| Pediatric use | 0.5-1 mEq/kg/dose IV, infused at a rate not exceeding 0.5-1 mEq/kg/h; maximum concentration 40 mEq/L for peripheral infusion. Adjust based on serum potassium levels. |
| Geriatric use | Reduce initial infusion rate to 5 mEq/h; monitor renal function and serum potassium closely due to age-related decline in GFR; maximum concentration 40 mEq/L. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% IN PLASTIC CONTAINER (POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Potassium and dextrose are normal constituents of breast milk. Intravenous administration results in minimal changes to milk composition. M/P ratio not applicable. Considered compatible with breastfeeding. |
| Teratogenic Risk | Potassium chloride and dextrose are not teratogenic at therapeutic doses. No increased risk of fetal malformations when used as electrolyte/carbohydrate replacement. However, maternal hyperkalemia or severe acidosis/fluid shifts may adversely affect fetal outcome. Trimester-specific risks not established. |
■ FDA Black Box Warning
Potassium chloride injections are concentrated and must be diluted before administration. Rapid infusion may cause fatal hyperkalemia.
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Untreated Addison's disease","Hyperchloremia","Conditions exacerbated by fluid overload"]
| Precautions | ["Risk of hyperkalemia, especially in renal impairment","Monitor serum potassium and ECG during administration","Do not administer undiluted","Use with caution in patients with cardiac disease, metabolic acidosis, or hypovolemia","Extravasation risk may cause tissue necrosis"] |
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| Fetal Monitoring | Monitor maternal serum potassium, glucose, and acid-base status. Fetal heart rate monitoring indicated if maternal metabolic disturbances occur. Assess for fluid overload (e.g., edema, pulmonary congestion). |
| Fertility Effects | No known effects on fertility. Potassium chloride and dextrose are physiologic substances; no reproductive toxicity expected at therapeutic doses. |