POTASSIUM CHLORIDE 0.149% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No 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. |
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 | 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 chloride is a normal component of breast milk. At therapeutic doses, no adverse effects in nursing infants are expected. M/P ratio not applicable as it is an endogenous ion. |
| 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. |
■ 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 |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Adrenal insufficiency (Addison disease)","Acute dehydration","Concomitant use with potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene)","Hyperchloremia (for sodium chloride component)"]
| 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."] |
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| 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. |