POTASSIUM CHLORIDE 0.149% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium is the major intracellular cation; it maintains cellular membrane potential, nerve impulse transmission, and muscle contraction. Sodium chloride provides sodium and chloride ions for extracellular fluid balance.
| Metabolism | Eliminated primarily by the kidneys (via renal excretion) and to a lesser extent via sweat and feces. Not metabolized. |
| Excretion | Primarily renal: approximately 90% of potassium is excreted via the kidneys, with about 10% eliminated in feces. Renal excretion is regulated by aldosterone and distal nephron secretion. |
| Half-life | Potassium has no classic terminal half-life as it is an electrolyte. In stable patients, the whole-body turnover half-life is approximately 30 minutes due to rapid distribution and renal clearance. |
| Protein binding | Potassium is not significantly protein-bound; less than 5% is bound to plasma proteins. |
| Volume of Distribution | Approximately 0.3-0.5 L/kg, reflecting distribution primarily in the extracellular fluid compartment (total body water ~0.6 L/kg, with K+ mainly intracellular). |
| Bioavailability | Oral: enteric absorption is nearly complete (~90-100%). IV: 100% bioavailable. |
| Onset of Action | IV infusion: immediate onset of clinical effect (within minutes) as potassium is directly administered into the bloodstream. |
| Duration of Action | Duration depends on infusion rate and renal function; typically lasts for 4-6 hours after discontinuation of continuous IV infusion, as redistribution and renal excretion occur. |
| Molecular Weight | 74.55 |
Intravenous infusion: Adults, 10-20 mEq/h (as potassium) via central line; rate not to exceed 10-20 mEq/h; maximum 150 mEq/day. Concentration 0.149% provides 2 mEq K+/100 mL.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: No adjustment. GFR 10-50 mL/min: Reduce dose by 50% or extend interval. GFR <10 mL/min: Avoid use or use extreme caution with frequent monitoring; starting dose 10-20 mEq/24h. |
| Liver impairment | No specific dose adjustment. Monitor serum potassium closely in severe hepatic impairment due to risk of hyperkalemia. |
| Pediatric use | Neonates and infants: 0.1-0.2 mEq/kg/dose IV, rate not to exceed 0.5 mEq/kg/h. Children: 0.1-0.3 mEq/kg/dose IV, rate 0.3-0.5 mEq/kg/h. Maximum 1 mEq/kg/h with continuous ECG monitoring. |
| Geriatric use | Initiate at lower end of dosing range due to age-related decreased renal function. Monitor serum potassium and renal function frequently. Typical starting dose 10-20 mEq/24h with 0.149% concentration at 500-1000 mL/24h. |
| 1st trimester | Potassium chloride and sodium chloride are essential electrolytes. Use only if clearly needed and when alternative treatments are insufficient. No known teratogenicity at therapeutic doses. |
| 2nd trimester | Safe when used as clinically indicated for electrolyte replacement. Monitor maternal serum electrolytes to avoid hyperkalemia or hypernatremia. |
| 3rd trimester | Safe when indicated. Excessive administration may cause maternal electrolyte imbalances that could affect fetal status. Use with caution in preeclampsia or renal impairment. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium and sodium cross the placenta freely via active transport and diffusion. Fetal serum levels are similar to maternal. No accumulation occurs. |
| Breastfeeding | Both potassium and sodium are normal constituents of breast milk and are excreted in small amounts. Administration of this solution for electrolyte replacement is considered compatible with breastfeeding. Monitor infant for signs of electrolyte imbalance if high doses are used. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Pregnancy Category C. Potassium chloride is a normal blood constituent; at therapeutic doses, it is not associated with teratogenicity. However, maternal hyperkalemia from excessive administration may cause fetal arrhythmias or adverse effects. No trimester-specific risks are established. |
| Fetal Monitoring | Monitor serum potassium, renal function, and ECG in mother. Fetal assessment via heart rate monitoring if maternal electrolyte disturbances occur. |
| Fertility Effects | No evidence of adverse effects on fertility. Potassium chloride at therapeutic doses does not impair reproductive function. |
■ FDA Black Box Warning
Concentrated potassium chloride injections are for dilution only; direct intravenous injection can cause fatal hyperkalemia. Must be diluted in a suitable IV solution before administration.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaSevere renal impairment with oliguria or anuriaConcurrent use of potassium-sparing diuretics (unless closely monitored)Addison's disease (uncorrected adrenal insufficiency)
| Precautions | Monitor serum potassium levels frequently, especially in patients with renal impairment, cardiac disease, or receiving digoxin., Rapid or high-dose infusion may cause hyperkalemia and cardiac arrest., Use with caution in patients with adrenal insufficiency or receiving potassium-sparing diuretics., Extravasation may cause tissue necrosis. |
| Food/Dietary | There are no significant food interactions with this intravenous solution. However, oral potassium intake should be considered to avoid hyperkalemia; consult with healthcare provider regarding dietary potassium if on oral supplements. |
| Clinical Pearls | This is a fixed-combination IV solution; use only for maintenance or replacement therapy when both potassium and sodium chloride are needed. Monitor serum potassium and renal function; infusion rate should not exceed 10-20 mEq/h potassium. Avoid in severe hyperkalemia, severe renal impairment, or oliguria. |
| Patient Advice | This medication is given intravenously to correct electrolyte imbalances. · Report any signs of irritation at the infusion site, chest discomfort, or muscle weakness. · Do not adjust the infusion rate; it is controlled by healthcare professionals. |
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