POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for cellular homeostasis, essential for nerve conduction, muscle contraction, and acid-base balance. Dextrose 5% provides a caloric source and may reduce protein catabolism. Sodium chloride 0.45% provides sodium and chloride ions to maintain extracellular fluid volume and osmolarity.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys; dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle; sodium and chloride are excreted primarily by the kidneys. |
| Excretion | Potassium: primarily renal (>90%) via distal tubule secretion; minimal fecal. Chloride: renal reabsorption/excretion linked to sodium. Dextrose: metabolized to CO2 and water; <2% renal. Sodium: renal excretion regulated by aldosterone. |
| Half-life | Potassium: terminal half-life approximately 12 hours (3-compartment model), but distribution phase ~1 hour; clinical context: steady-state reached in 2-3 days. |
| Protein binding | Potassium: <5% bound (not significantly protein-bound). Dextrose: no binding. Chloride: minimal binding. |
| Volume of Distribution | Potassium: 0.5-0.7 L/kg (total body water); clinical meaning: reflects distribution primarily in intracellular fluid (98% intracellular). Chloride: 0.2-0.3 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100% (complete). Oral: not applicable for this formulation. |
| Onset of Action | Intravenous: immediate for electrolyte effects; dextrose may cause transient insulin release within 5-10 minutes. |
| Duration of Action | Intravenous: electrolyte effects persist as long as infusion continues; post-infusion, potassium redistribution occurs over 1-2 hours; dextrose effects last 1-2 hours. |
IV infusion at a rate dependent on patient's fluid and electrolyte needs; typical adult maintenance: 1000-2000 mL/day, providing 20-40 mEq potassium per liter.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia; for GFR 30-50 mL/min, reduce dose by 50% and monitor potassium levels closely. |
| Liver impairment | No specific adjustment required for Child-Pugh classification; caution in severe hepatic impairment due to potential for electrolyte disturbances. |
| Pediatric use | 0.5-1 mEq/kg/day IV, not to exceed 3 mEq/kg/day; administered as part of maintenance fluid therapy, adjusted for age and weight; typical rate: 2.5-5 mL/kg/hour. |
| Geriatric use | Start at lower end of adult dosing range; monitor renal function and serum potassium frequently; adjust rate based on renal function and electrolyte balance. |
| 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, dextrose, and sodium chloride are normal constituents of human milk. No specific M/P ratio available. Infusion results in minimal excess transfer; considered compatible with breastfeeding. Monitor infant for electrolyte disturbances if maternal serum levels are markedly abnormal. |
| Teratogenic Risk | Potassium chloride at physiologic concentrations is not teratogenic. Dextrose and sodium chloride at standard infusion rates do not pose teratogenic risk. Electrolyte imbalances (hyperkalemia, hyperglycemia) could indirectly affect fetal development if severe, but at prescribed doses, risk is negligible. Insufficient data for specific malformation rates. |
■ FDA Black Box Warning
No FDA black box warning.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal impairment with oliguria or anuria","Addison's disease","Acute dehydration","Heat cramps","Concurrent use of potassium-sparing diuretics or potassium supplements"]
| Precautions | ["Use with caution in patients with severe renal impairment, heart failure, or conditions predisposing to hyperkalemia","Monitor serum potassium, sodium, glucose, and fluid balance during prolonged use","Risk of hyperkalemia, especially with rapid or excessive administration","Avoid in patients with anuria or severe renal dysfunction","Solutions containing dextrose may cause hyperglycemia in diabetic patients"] |
Loading safety data…
| Fetal Monitoring | Monitor maternal serum potassium, glucose, and sodium levels periodically during prolonged infusion. Fetal monitoring indicated if signs of maternal metabolic derangement (e.g., hyperglycemia, hyperkalemia) occur. Assess fluid balance and renal function. |
| Fertility Effects | No known effect on fertility at therapeutic doses. Severe electrolyte disturbances may theoretically impair reproductive function, but no specific evidence. |