POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium is the major intracellular cation, essential for maintaining cell membrane potential, nerve impulse transmission, muscle contraction, and acid-base balance. Dextrose provides caloric supplementation. Sodium chloride provides sodium and chloride ions for electrolyte balance.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys. Dextrose is metabolized via glycolysis and the citric acid cycle. Sodium and chloride are not metabolized. |
| Excretion | Renal: >90% as potassium and chloride ions, with potassium excretion primarily via distal tubular secretion and reabsorption; minimal fecal or biliary elimination. |
| Half-life | Not applicable as potassium chloride is an electrolyte; elimination follows first-order kinetics with a distribution half-life of ~8-10 minutes; plasma levels depend on infusion rate and renal function. |
| Protein binding | None (0%); potassium ions are free in plasma; chloride ions are also unbound. |
| Volume of Distribution | Potassium: 0.5-0.6 L/kg (total body water); chloride: 0.3-0.4 L/kg (extracellular fluid). Clinical meaning: Reflects distribution into intracellular and extracellular compartments. |
| Bioavailability | Intravenous: 100%. Oral: 100% (as potassium chloride is fully absorbed). |
| Onset of Action | Intravenous: Within seconds for ECG effects; parenteral infusion requires 1-2 hours for significant serum potassium elevation. |
| Duration of Action | Intravenous: 2-4 hours after cessation of infusion due to rapid redistribution; clinical effects persist while infusion continues. |
| Molecular Weight | 74.55 |
Intravenous infusion. Adult dose is determined by fluid, electrolyte, and caloric requirements. Typically, 1000-3000 mL per day at a rate of 125-150 mL/hour, providing 0.22% KCl (2 mEq/L), 10% dextrose, and 0.2% NaCl (34 mEq/L Na+). Adjust based on serum potassium and glucose monitoring.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia. With caution in moderate impairment (GFR 30-60 mL/min); reduce infusion rate and monitor potassium closely. For GFR >60 mL/min, no adjustment necessary. |
| Liver impairment | No specific adjustment for mild to moderate hepatic impairment (Child-Pugh A or B). In severe hepatic impairment (Child-Pugh C), use with caution due to increased risk of fluid overload and electrolyte imbalances; monitor potassium and glucose levels. |
| Pediatric use | Dose individualized based on age, weight, and clinical condition. For fluid maintenance, use Holliday-Segar method: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for remaining. Potassium concentration should not exceed 0.22% (2 mEq/L) unless severe deficiency confirmed. Infuse at a rate not exceeding 0.5 mEq/kg/hour of potassium. |
| Geriatric use | Use with caution due to decreased renal function, cardiac comorbidities, and risk of fluid overload. Start at lower end of dose range, monitor renal function, serum potassium, and glucose. Avoid rapid infusion to prevent hyperkalemia or hyperglycemia. |
| 1st trimester | Potassium chloride, dextrose, and sodium chloride are physiologic components. At therapeutic doses, no increased risk of fetal harm. Use only if clearly needed. |
| 2nd trimester | Safe when used as indicated. Monitor maternal electrolytes and glucose. |
| 3rd trimester | Safe; may be used for fluid and electrolyte maintenance. Avoid excessive potassium administration. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium and sodium cross placenta by active transport; dextrose crosses readily. Clinically insignificant at physiologic levels. |
| Breastfeeding | Potassium and sodium are normal milk components; dextrose is metabolized. No known adverse effects from maternal infusion at standard doses. |
| Lactation Rating | L1 |
| Teratogenic Risk | No known teratogenic effects with standard electrolyte replacement. Potassium chloride, dextrose, and sodium chloride are endogenous substances. At therapeutic doses, no increased risk of major malformations. However, severe electrolyte disturbances may affect fetal development. Trimester 1: No specific risk; trimester 2 and 3: Risk of electrolyte imbalance-related complications (e.g., hyperkalemia causing fetal arrhythmias). |
| Fetal Monitoring | Monitor maternal serum electrolytes (potassium, glucose, sodium), fluid balance, and vital signs. Fetal monitoring indicated if maternal electrolyte disturbances or dehydration occur. |
| Fertility Effects | No known effect on fertility. Use only for electrolyte or fluid replacement; not associated with reproductive impairment. |
■ FDA Black Box Warning
Concentrated potassium chloride injections (not this formulation) have a boxed warning for fatal cardiac arrhythmias if administered too rapidly or in excessive doses. This specific low-concentration solution does not have a boxed warning.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment (oliguria/anuria)Hypertonic dehydration (relative)Hypersensitivity to any component
| Precautions | Monitor serum potassium, glucose, and electrolytes. Use with caution in patients with hyperkalemia, severe renal impairment, cardiac disease, or metabolic alkalosis. Rapid infusion can cause hyperkalemia and cardiac arrest. |
| Food/Dietary | No specific food interactions; patient may eat normally if oral intake is tolerated. However, potassium-rich foods (e.g., bananas, oranges, potatoes) should be considered in context of total potassium intake. |
| Clinical Pearls | Contains 0.22% KCl (2 mEq/L), 10% dextrose (100 g/L), and 0.2% NaCl (34 mEq/L Na+, 34 mEq/L Cl-). Caloric content: 340 kcal/L. Osmolality ~780 mOsm/L. Administer via central line if peripheral access is inadequate due to high osmolality. Monitor serum potassium, glucose, and sodium. Use with caution in renal impairment, hyperkalemia, or heart failure. May cause phlebitis or extravasation. |
| Patient Advice | This intravenous solution provides fluids, sugar, and electrolytes to treat or prevent dehydration and electrolyte imbalances. · Your healthcare team will monitor your blood levels of potassium, sodium, and glucose during treatment. · Tell your doctor if you have a history of kidney problems, heart disease, or diabetes. · Report any pain, redness, or swelling at the IV site immediately. · This solution contains sugar; if you are diabetic, your blood sugar will be checked frequently. |
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