POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride replenishes potassium stores; potassium is the major intracellular cation and is essential for nerve conduction, muscle contraction, and acid-base balance. Dextrose provides calories and sodium chloride supplies sodium and chloride ions to maintain electrolyte balance.
| Metabolism | Potassium is primarily excreted renally; dextrose undergoes glycolysis and oxidative metabolism; sodium chloride is renally excreted. |
| Excretion | Renal excretion: >90% of potassium is eliminated via kidneys; <10% fecal. Dextrose and sodium are primarily metabolized or renally excreted. |
| Half-life | Potassium: not applicable (homeostatic regulation); dextrose and sodium: endogenous, no elimination half-life. For exogenous potassium, distribution half-life ~1-1.5 h. |
| Protein binding | Potassium: essentially zero; dextrose: not bound; sodium: negligible binding. |
| Volume of Distribution | Potassium: ~0.5 L/kg (body weight), representing total body water; sodium: ~0.2 L/kg (extracellular fluid); dextrose: ~0.2 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100%; oral: 100% (for potassium, if no malabsorption; dextrose and sodium fully absorbed). |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for plasma potassium elevation; oral: 30–60 minutes. |
| Duration of Action | Intravenous: 1–2 hours after infusion cessation; oral: 4–6 hours, depending on potassium load and renal function. |
IV infusion: 1 L contains 20 mEq K+, 50 g dextrose, and 77 mEq Na+ and Cl- each. Adjust rate based on potassium deficit and serum potassium. Typical adult rate: 10-20 mEq/hour via peripheral IV, not to exceed 40 mEq/hour or 200 mEq/day.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment. GFR 30-50: reduce rate by 50% or use with caution. GFR 10-29: avoid use or give with extreme caution, monitor ECG and serum K+. GFR <10: contraindicated. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: use with caution, monitor serum K+ closely. Child-Pugh C: contraindicated due to risk of hyperkalemia. |
| Pediatric use | IV infusion: 0.5-1 mEq/kg/dose, max 20 mEq per dose, given over 1-2 hours. Alternatively, 0.1-0.2 mEq/kg/hour. Max infusion rate: 0.5 mEq/kg/hour. Dextrose concentration should be monitored to avoid hypoglycemia. |
| Geriatric use | Start at lower infusion rates (10-15 mEq/hour) due to reduced renal function. Monitor serum potassium and renal function frequently. Consider maximum daily dose of 100 mEq. |
| 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 and chloride are normal milk constituents; dextrose is also present. Infusion of these substances at therapeutic levels does not increase milk concentrations significantly. No specific M/P ratio available; considered compatible with breastfeeding. However, monitor infant for gastrointestinal effects if high doses given. |
| Teratogenic Risk |
■ FDA Black Box Warning
Concentrated potassium solutions (e.g., >40 mEq/L) are for intravenous use only and must be diluted and administered slowly to avoid fatal hyperkalemia or cardiac arrest. Do not administer undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal failure with oliguria or anuria","Addison's disease (untreated)","Adynamia episodica hereditaria (hyperkalemic periodic paralysis)","Concomitant use of potassium-sparing diuretics (e.g., spironolactone, amiloride)","Acute dehydration or heat cramps"]
| Precautions | ["Monitor serum potassium levels frequently; risk of hyperkalemia especially in renal impairment or with potassium-sparing diuretics.","Avoid rapid infusion to prevent hyperkalemia-induced cardiac arrhythmias.","Use with caution in patients with heart failure, severe renal insufficiency, or conditions predisposing to hyperkalemia.","Intravenous administration may cause phlebitis or extravasation injury."] |
Loading safety data…
| Potassium chloride and dextrose are pregnancy category C. No adequate studies in pregnant women. Potassium chloride at therapeutic doses is unlikely to cause fetal harm. Dextrose is a normal constituent of fetal blood. Sodium chloride at physiologic concentrations is safe. However, maternal electrolyte imbalances could affect fetal homeostasis. First trimester: Theoretical risk of teratogenicity from electrolyte disturbances but no evidence with IV infusion. Second/third trimester: Risk of neonatal hypoglycemia or electrolyte abnormalities if maternal levels are abnormal. Use only if clearly needed. |
| Fetal Monitoring | Monitor maternal serum potassium, sodium, chloride, glucose, and renal function. Assess for signs of fluid overload (edema, hypertension). Fetal monitoring if maternal electrolyte disturbances occur. In high-risk pregnancies, consider intermittent fetal heart rate monitoring. |
| Fertility Effects | No known adverse effects on fertility from therapeutic use. Electrolyte disturbances could theoretically affect gametogenesis but not reported with this combination. |