POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride (KCl) dissociates to K+ ions, which are essential for maintaining intracellular osmolarity, nerve impulse transmission, cardiac and skeletal muscle contraction, and acid-base balance. Dextrose 5% provides calories and may help prevent ketosis. Sodium chloride 0.225% provides sodium and chloride ions to maintain electrolyte balance.
| Metabolism | Potassium is primarily absorbed from the gastrointestinal tract and excreted mainly by the kidneys (90%) with minor losses in feces and sweat. Dextrose is metabolized via glycolysis and the Krebs cycle. Sodium chloride is not metabolized and is excreted primarily by the kidneys. |
| Excretion | Primarily renal (90-95% excreted unchanged in urine); minimal fecal (~5%) |
| Half-life | Not applicable for intravenous potassium; rapid distribution and elimination with first-order kinetics; serum potassium half-life ~2-3 hours with normal renal function |
| Protein binding | Not significantly protein bound (<1%); freely filtered at glomerulus |
| Volume of Distribution | 0.5-0.7 L/kg; distributes primarily into extracellular fluid; only ~2% of total body potassium is extracellular |
| Bioavailability | Intravenous: 100% |
| Onset of Action | Intravenous: immediate (within minutes) upon infusion |
| Duration of Action | Intravenous: duration depends on infusion rate and renal function; typically 4-6 hours after infusion ends; continuous infusion maintains steady state |
The typical adult dose is 10 mEq of potassium chloride (as 20 mL of 10 mEq/20 mL solution) administered intravenously at a rate not exceeding 10 mEq per hour, diluted in an appropriate IV fluid such as D5W or NS. For this product (10 mEq KCl in D5 0.225% NaCl), the entire container is infused at a rate to deliver potassium at 10 mEq/hour or slower, with continuous ECG monitoring.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: Use 50-75% of standard dose and monitor serum potassium closely. GFR 10-29 mL/min: Use 25-50% of standard dose; avoid if possible. GFR <10 mL/min: Use only if severe hypokalemia and with extreme caution, consider alternative therapy; maximum dose 40 mEq per day with frequent monitoring. |
| Liver impairment | No specific Child-Pugh based dose adjustment is required for potassium chloride. However, in severe hepatic impairment (Child-Pugh C), monitor serum potassium and acid-base status due to increased risk of hyperkalemia from associated renal dysfunction. |
| Pediatric use | Weight-based dose: 0.5-1 mEq/kg per dose, up to a maximum of 10 mEq per dose, administered IV at a rate not exceeding 0.5 mEq/kg per hour. Use only after dilution; this product may be used if the potassium content and dilution are appropriate for the child's weight and needs. |
| Geriatric use |
| 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, chloride, dextrose, and sodium are normal constituents of breast milk. IV administration is unlikely to affect milk composition significantly. The M/P ratio is not applicable or known. Use during breastfeeding is considered compatible. |
| Teratogenic Risk | Potassium chloride is not teratogenic. Dextrose and sodium chloride are physiological components. No fetal risk is expected from potassium or chloride at therapeutic doses. However, maternal electrolyte imbalances (hyperkalemia, hypernatremia) could adversely affect fetal development. No trimester-specific risks identified. |
■ FDA Black Box Warning
No FDA boxed warning specific to this product. However, potassium chloride injection has a known boxed warning: 'Concentrated potassium chloride injection is for dilution only; must be diluted before administration to avoid fatal hyperkalemia.'
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (serum potassium >5.5 mEq/L)","Severe renal impairment with oliguria or anuria","Addison's disease (adrenal insufficiency) untreated","Acute dehydration","Heat cramps","Concomitant use with potassium-sparing diuretics or ACE inhibitors may increase hyperkalemia risk"]
| Precautions | ["Hyperkalemia risk, especially in patients with renal impairment, adrenal insufficiency, or excessive potassium supplements","Risk of cardiac arrest if administered too rapidly or in concentrated form","Monitor serum potassium levels, renal function, and cardiac status during therapy","Use with caution in patients with heart disease, metabolic acidosis, or conditions predisposing to hyperkalemia","Avoid in patients with oliguria, anuria, or severe renal impairment unless careful monitoring is in place","Dextrose may cause hyperglycemia in diabetic patients"] |
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| Elderly patients often have reduced renal function; start with low end of dosing (e.g., 10 mEq over 2-4 hours) and titrate based on serum potassium and renal function. Avoid rates >10 mEq/hour; monitor ECG and electrolytes frequently due to increased risk of hyperkalemia. |
| Fetal Monitoring | Monitor serum potassium, sodium, glucose, and chloride levels frequently. Assess renal function, urine output, and ECG for arrhythmias. Monitor for signs of fluid overload (edema, hypertension) and electrolyte disturbances. Fetal monitoring is not specifically required unless maternal status is compromised. |
| Fertility Effects | No direct effects on fertility are known. Electrolyte imbalances may indirectly affect reproductive function, but potassium chloride at therapeutic doses does not impair fertility. |