POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER (POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER).
Potassium is the major intracellular cation. It is essential for the maintenance of intracellular tonicity, nerve impulse transmission, cardiac muscle contractility, and skeletal muscle contraction. Dextrose provides a source of calories and may help to correct hypoglycemia.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys. Dextrose is metabolized via glycolysis and subsequent pathways to carbon dioxide and water, yielding energy. |
| Excretion | Renal: >90% of potassium excreted by kidneys, with distal tubular secretion and reabsorption. Fecal: ~10% eliminated via gastrointestinal tract. Biliary: negligible. |
| Half-life | Potassium has no true elimination half-life as it is an endogenous electrolyte; redistribution half-life is approximately 1–1.5 hours for exogenous loads, reflecting cellular uptake and renal excretion. In anephric patients, half-life extends to 12–24 hours due to reliance on gastrointestinal and dialysis excretion. |
| Protein binding | ~10% bound to plasma proteins (albumin). Unbound fraction is physiologically active. |
| Volume of Distribution | Total body potassium Vd ~0.5 L/kg (approximates lean body mass). For intravenously administered potassium: initial Vd approximates extracellular fluid (0.2 L/kg) with redistribution into cells over 15–30 minutes. Clinical meaning: Low Vd indicates rapid equilibration; loading doses must account for intracellular shift to avoid hyperkalemia. |
| Bioavailability | Intravenous: 100%. Oral: ~90% (absorbed in small intestine). No other routes relevant. |
| Onset of Action | Intravenous infusion: Immediate upon administration due to direct plasma potassium elevation; clinical effect (cardiac repolarization) occurs within minutes. Onset correlates with infusion rate and patient volume status. |
| Duration of Action | Intravenous infusion: Duration of action continues as long as potassium is infused; after infusion stops, plasma levels decline over 1–2 hours via cellular uptake and renal excretion. Clinical effect (normalization of serum potassium) persists for 4–6 hours post-infusion depending on underlying deficits. |
| Molecular Weight | 74.55 |
Intravenous infusion at a rate not exceeding 10 mEq/hour (0.75 mEq/kg/hour). Typical dose: 20-40 mEq potassium chloride in 1 liter D5W administered over 8-12 hours.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: No adjustment. GFR 30-50 mL/min: Reduce dose by 25-50%. GFR 10-30 mL/min: Reduce dose by 50-75%. GFR <10 mL/min: Avoid use or use with extreme caution; consider alternative. |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B: Reduce dose by 25-50% due to risk of hyperkalemia. Child-Pugh C: Avoid use; alternative therapy recommended. |
| Pediatric use | Neonates and infants: 0.5-1 mEq/kg/dose IV, not to exceed 0.5 mEq/kg/hour. Children: 1-3 mEq/kg/day IV, maximum infusion rate 0.5-1 mEq/kg/hour; maximum concentration 40 mEq/L. |
| Geriatric use | Start at lower end of dosing range (e.g., 10-20 mEq per liter) and titrate slowly. Monitor renal function and serum potassium frequently. Maximum infusion rate: 5-10 mEq/hour. |
| 1st trimester | Potassium chloride and dextrose are commonly used in pregnancy for fluid and electrolyte maintenance. No evidence of teratogenicity at therapeutic doses. Use only if clearly needed and monitor serum potassium. |
| 2nd trimester | Considered safe during second trimester when used as directed. Monitor for hyperkalemia, especially in preeclampsia or renal impairment. |
| 3rd trimester | Use with caution; high potassium may affect uterine tone. Avoid if mother has hyperkalemia or severe renal impairment. Monitor fetal heart rate if administered intravenously. |
Clinical note
Comprehensive clinical and safety monograph for POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER (POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Potassium crosses placenta by active transport; dextrose readily crosses. Fetal serum potassium is regulated by maternal levels. Risk of fetal hyperkalemia if maternal levels elevated. |
| Breastfeeding | Potassium chloride and dextrose are endogenous substances excreted into breast milk in small amounts. Very low risk to the infant; compatible with breastfeeding. Monitor infant if mother has renal impairment or receives high doses. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride and dextrose are not teratogenic. There is no evidence of fetal harm from potassium chloride or dextrose at standard doses. Trimester-specific risks are not applicable. |
| Fetal Monitoring | Monitor serum potassium, glucose, and electrolytes; renal function; cardiac monitoring if high doses or rapid infusion; fetal heart rate monitoring if maternal electrolyte disturbances. |
| Fertility Effects | No adverse effects on fertility reported; potassium chloride and dextrose are normal physiological substances and do not impair reproduction. |
■ FDA Black Box Warning
Potassium chloride injections are for intravenous use only. Rapid infusion may cause hyperkalemia and cardiac arrest. Concentrated potassium chloride solutions (>=2 mEq/mL) must be diluted before use. Do not administer undiluted.
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAddison's diseaseAcute dehydrationConcurrent use of potassium-sparing diuretics (e.g., spironolactone) unless closely monitoredCrush injury or extensive tissue necrosis
| Precautions | Monitor serum potassium levels frequently to avoid hyperkalemia, Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia, Do not administer if solution is discolored or contains particulate matter, Check for compatibility with other medications in the same line |
| Food/Dietary | Avoid excessive consumption of potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, avocados) and salt substitutes containing potassium chloride. Limit high-sodium foods as they may affect fluid and electrolyte balance. |
| Clinical Pearls | Administer via central line if concentration exceeds 0.1% (20 mEq/L) to avoid phlebitis. Do not exceed infusion rate of 10 mEq/hour. Contraindicated in severe renal impairment (CrCl <30 mL/min), hyperkalemia, or Addison's disease. Monitor ECG for peaked T waves and serum potassium levels. Use with caution in patients on ACE inhibitors, ARBs, or potassium-sparing diuretics. |
| Patient Advice | Report any signs of hyperkalemia such as muscle weakness, palpitations, or tingling sensations. · Avoid potassium-containing salt substitutes or supplements unless approved by your doctor. · This solution contains dextrose; if you have diabetes, monitor blood glucose closely. · Inform your healthcare provider about all medications, especially heart or blood pressure medicines. · Do not stop or change the infusion rate on your own. |
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