POTASSIUM CHLORIDE 0.15% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride dissociates to provide potassium ions, which are essential for maintaining intracellular osmolarity, acid-base balance, nerve impulse conduction, and muscle contraction, including myocardial function. Dextrose provides glucose for cellular energy metabolism, and sodium chloride provides sodium and chloride ions to maintain extracellular fluid volume and osmolality.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys. Dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle. Sodium and chloride are not metabolized; they are excreted primarily in urine. |
| Excretion | Renal excretion of potassium and chloride is the primary route of elimination. Potassium is almost entirely excreted by the kidneys (90-95%), with a small amount lost in feces (5-10%) and negligible biliary excretion. Dextrose and sodium are fully metabolized or excreted renally. |
| Half-life | Potassium has no true elimination half-life as it is homeostatically regulated. The terminal half-life of infused potassium is approximately 1-1.5 hours, reflecting rapid cellular uptake and renal excretion. The half-life of dextrose is minutes (insulin-dependent uptake). |
| Protein binding | Potassium is not protein bound (0%). Dextrose and sodium are also not bound to plasma proteins. |
| Volume of Distribution | Potassium: 0.5-1.0 L/kg, reflecting distribution into total body water (predominantly intracellular). Dextrose distributes into total body water (~0.6 L/kg). Sodium distributes primarily extracellularly (~0.2 L/kg). |
| Bioavailability | Intravenous administration: 100% bioavailability for all components. Not applicable for oral route as this is an IV solution. |
| Onset of Action | Intravenous infusion: Immediate onset for potassium, as serum levels rise within minutes. Dextrose and sodium effects begin within minutes. |
| Duration of Action | Intravenous infusion: Potassium effects persist as long as infusion continues; after cessation, serum levels normalize within 1-2 hours. Dextrose effects last 1-2 hours post-infusion. |
| Molecular Weight | 74.55 |
Intravenous infusion. Dose based on serum potassium, rate not exceeding 10 mEq/hour (0.15% KCl = 20 mEq/L; typical rate 100-200 mL/hour).
| Dosage form | INJECTABLE |
| Renal impairment | eGFR <30 mL/min: avoid use, risk of hyperkalemia. eGFR 30-50 mL/min: reduce dose by 50% and monitor potassium. |
| Liver impairment | No specific Child-Pugh based adjustment; use cautiously in severe hepatic impairment due to risk of hyperkalemia. |
| Pediatric use | Weight-based: 0.5-1 mEq/kg/dose IV, infuse at ≤0.5 mEq/kg/hour, maximum 40 mEq/day. |
| Geriatric use | Use lower initial doses (e.g., 20 mEq/day) and monitor renal function and serum potassium frequently. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are essential nutrients; use is generally safe when indicated for electrolyte maintenance. No known teratogenic effects at recommended doses. |
| 2nd trimester | Safe for use when clinically indicated for correction of electrolyte imbalances. Monitor serum electrolytes to avoid hyperkalemia or fluid overload. |
| 3rd trimester | Safe for use when clinically indicated. Avoid excess potassium to prevent neonatal hyperkalemia. Monitor maternal serum levels closely. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium, glucose, and sodium freely cross the placenta via active transport and facilitated diffusion. Degree of transfer depends on maternal serum levels. No significant harm at therapeutic doses. |
| Breastfeeding | Potassium, dextrose, and sodium chloride are normal constituents of breast milk. Administration of this solution does not pose a risk to the nursing infant when used at recommended doses. However, high doses of potassium could theoretically affect milk composition. |
| Lactation Rating | Safe |
| Teratogenic Risk | POTASSIUM CHLORIDE 0.15% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% is a maintenance fluid. Potassium chloride is not teratogenic; however, maternal hyperkalemia can cause fetal arrhythmias. Dextrose and sodium chloride are physiologic. No increased risk of major birth defects. |
| Fetal Monitoring | Monitor serum potassium, sodium, glucose, and renal function. Assess for signs of fluid overload or electrolyte imbalance. Fetal heart rate monitoring if maternal hyperkalemia develops. |
| Fertility Effects | No known adverse effects on fertility. Electrolyte disturbances may impact reproductive function indirectly. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAddison's diseaseHyperchloremiaHypernatremiaSevere metabolic alkalosisConcurrent use of potassium-sparing diuretics
| Precautions | Risk of hyperkalemia: can cause cardiac arrest; monitor serum potassium and ECG; avoid in patients with severe renal impairment or conditions causing potassium retention., Extravasation risk: can cause tissue necrosis; ensure proper IV access., Fluid overload: caution in patients with heart failure, renal impairment, or conditions with salt retention., Hyperglycemia: dextrose content may cause hyperglycemia, especially in patients with diabetes mellitus or glucose intolerance., Metabolic alkalosis: sodium chloride administration may exacerbate alkalosis. |
| Food/Dietary | Avoid large amounts of potassium-rich foods (e.g., bananas, oranges, tomatoes, spinach, potatoes) unless directed. Avoid salt substitutes containing potassium chloride. Limit intake of high-sodium foods if fluid retention is a concern. |
| Clinical Pearls | Monitor serum potassium closely, especially in renal impairment. Avoid rapid infusion to prevent hyperkalemia. Use with caution in patients on ACE inhibitors, ARBs, or potassium-sparing diuretics. Ensure adequate urine output before administration. Incompatible with amphotericin B and certain antibiotics. |
| Patient Advice | Do not stop taking this medication without consulting your doctor. · Report symptoms of high potassium (e.g., muscle weakness, irregular heartbeat, tingling). · Maintain consistent dietary potassium intake; avoid salt substitutes containing potassium. · Inform your healthcare provider of all medications you are taking, especially those affecting potassium levels. |
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