POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for cellular electrophysiology and maintenance of acid-base balance; dextrose provides caloric support; sodium chloride provides sodium and chloride ions to maintain extracellular fluid volume and osmolarity.
| Metabolism | Potassium chloride is excreted primarily by the kidneys; dextrose is metabolized via glycolysis and oxidative phosphorylation; sodium chloride is not metabolized. |
| Excretion | Potassium: renal >90% (urine), fecals ~10%; chloride: renal >95% (urine); dextrose: fully metabolized to CO2 and water; sodium: renal >98% (urine) |
| Half-life | Potassium: terminal half-life ~12-18 hours in normal renal function; clinically, doses may need adjustment in renal impairment due to prolonged elimination |
| Protein binding | Potassium is not significantly protein-bound (<2%); chloride is minimally bound; dextrose and sodium are not bound |
| Volume of Distribution | Potassium: Vd ~0.4-0.6 L/kg (total body water); clinically, reflects distribution into intracellular space (98% of total body potassium is intracellular) |
| Bioavailability | Intravenous: 100% |
| Onset of Action | Intravenous infusion: immediate onset for electrolyte effects (within minutes); clinical effect on serum potassium levels is rapid but depends on infusion rate |
| Duration of Action | Intravenous: effect persists as long as infusion continues and for several hours post-infusion; potassium equilibrium may take 24-48 hours for full distribution |
| Molecular Weight | 74.55 |
Intravenous infusion. Adult dose is 1000-2000 mL per 24 hours, providing 20-40 mEq potassium, 100-200 g dextrose, and 77-154 mEq sodium. Rate not exceeding 10 mEq/hour potassium. Adjust based on serum electrolytes and fluid status.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hyperkalemia. For GFR 30-60 mL/min, reduce potassium dose by 50% and monitor serum potassium. For GFR >60 mL/min, no adjustment. |
| Liver impairment | No specific dose adjustment required. Use with caution in severe hepatic impairment due to potential glucose intolerance and fluid retention. Monitor serum potassium and glucose. |
| Pediatric use | Weight-based: 5-20 mL/kg per 24 hours as needed. Provide potassium at 0.5-1 mEq/kg/day. Dextrose infusion rate not to exceed 0.5 g/kg/hour in neonates. Adjust for age and clinical condition. |
| Geriatric use | Elderly patients: Use lower end of dose range due to decreased renal function and risk of fluid overload. Initiate at 1000 mL per 24 hours, monitor serum potassium, creatinine, and fluid balance. Avoid rapid infusion. |
| 1st trimester | Potassium chloride is essential for cellular function; however, high doses can cause hyperkalemia and potentially teratogenic effects. Use only if clearly needed and monitor serum potassium closely. |
| 2nd trimester | Use with caution. Maternal hyperkalemia can affect fetal cardiac function. Monitor potassium levels and adjust infusion rates accordingly. |
| 3rd trimester | Use cautiously near term as hyperkalemia may cause fetal bradycardia or arrhythmias. Continuous fetal monitoring recommended during infusion. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta via active transport mechanisms; fetal serum levels are generally maintained within a narrow range. High maternal potassium can lead to fetal hyperkalemia. |
| Breastfeeding | Potassium chloride is a normal constituent of breast milk and is not expected to cause adverse effects in nursing infants at therapeutic doses. However, monitor maternal potassium levels to avoid hyperkalemia, which could indirectly affect the infant. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are physiological components. No teratogenic risk identified. Trimester 1, 2, 3: No evidence of fetal harm when used as indicated. |
| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, glucose), renal function, fluid balance, and fetal heart rate if administered intravenously during labor. |
| Fertility Effects | No known effect on fertility. |
■ FDA Black Box Warning
No FDA boxed warning exists for this combination product.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAddison's diseaseAcute dehydrationHeat crampsConcurrent use with potassium-sparing diuretics (e.g., spironolactone) without close monitoring
| Precautions | Monitor serum potassium levels frequently to avoid hyperkalemia, especially in patients with renal impairment or on potassium-sparing diuretics., Monitor serum sodium and chloride levels to avoid hypernatremia or fluid overload., Monitor blood glucose levels in diabetic patients as dextrose may cause hyperglycemia., Do not administer if solution is cloudy or contains particulate matter. |
| Food/Dietary | No specific food interactions. Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, potatoes, spinach, salt substitutes) to prevent hyperkalemia. |
| Clinical Pearls | This combination provides maintenance fluid, electrolytes, and calories. Monitor serum potassium closely in renal impairment. Do not exceed infusion rate of 10 mEq/h potassium. Use with caution in patients with hyperkalemia, severe renal failure, or adrenal insufficiency. Contraindicated in hyperkalemia, anuria, or conditions with potassium retention. |
| Patient Advice | Inform your healthcare provider if you have kidney problems, heart disease, or are taking potassium-sparing diuretics or ACE inhibitors. · Report symptoms of high potassium such as muscle weakness, irregular heartbeat, or tingling sensations. · This medication is given intravenously; do not adjust the infusion rate yourself. · Tell your doctor if you experience pain, redness, or swelling at the IV site. · Maintain a balanced diet unless advised otherwise by your doctor. |
Loading safety data…