POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride (KCl) provides potassium ions, essential for maintaining intracellular fluid volume, nerve impulse conduction, muscle contraction, and acid-base balance. Dextrose 5% provides water and calories for energy, correcting fluid deficits and dehydration. Sodium chloride 0.3% provides sodium and chloride ions to maintain extracellular fluid osmolarity and volume. The combination corrects electrolyte imbalances and provides maintenance fluids.
| Metabolism | Potassium is predominantly excreted renally; small amount excreted in feces. Dextrose is metabolized via glycolysis and oxidative phosphorylation. Sodium and chloride are excreted primarily in urine. |
| Excretion | Renal: ~90% of potassium is excreted by the kidneys, primarily via distal tubular secretion under aldosterone regulation; ~10% is lost in feces via colonic secretion. Biliary excretion is negligible. In this formulation, dextrose and sodium chloride are also excreted renally. |
| Half-life | Potassium does not have a classic terminal half-life as it is an electrolyte; its clearance depends on body distribution and renal function. In patients with normal renal function, the elimination half-life for an administered dose is approximately 3–6 hours, reflecting distribution into intracellular space and subsequent renal excretion. |
| Protein binding | Potassium is not significantly bound to plasma proteins; protein binding is <5%. Dextrose and sodium chloride are not protein-bound. |
| Volume of Distribution | Potassium: 0.5–0.7 L/kg (total body water), with ~98% intracellular and ~2% extracellular. The Vd is large due to extensive intracellular distribution. Dextrose has a Vd of ~0.2 L/kg (extracellular fluid); sodium chloride distributes in extracellular fluid (0.2 L/kg). |
| Bioavailability | Intravenous: 100% (complete bioavailability). Not administered orally in this formulation; oral potassium chloride has ~90% bioavailability. |
| Onset of Action | Intravenous infusion: Clinical effect (e.g., correction of hypokalemia) begins within minutes to hours, depending on the infusion rate and severity of deficiency. ECG changes may improve within 30–60 minutes at appropriate infusion rates. |
| Duration of Action | Intravenous infusion: Duration of effect is variable, typically lasting 4–6 hours post-infusion for serum potassium elevation, as potassium redistributes intracellularly and is excreted. Continuous infusion is often required for sustained correction. |
Intravenous infusion, rate determined by potassium deficit and serum potassium monitoring; typical maintenance: 20-40 mEq potassium per day in divided doses; maximum infusion rate: 10 mEq/h; maximum concentration: 40 mEq/L via peripheral line.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment; GFR 30-50 mL/min: reduce dose by 25%; GFR 10-29 mL/min: reduce dose by 50%; GFR < 10 mL/min: avoid use or use with extreme caution, not recommended. |
| Liver impairment | No specific dose adjustment required for Child-Pugh class A, B, or C; monitor serum potassium closely in hepatic impairment due to risk of electrolyte imbalances. |
| Pediatric use | Intravenous infusion: 0.5-1 mEq/kg per dose; maximum single dose: 1 mEq/kg; maximum daily dose: 3 mEq/kg/day; maximum infusion rate: 0.5 mEq/kg/h; concentration not to exceed 40 mEq/L. |
| Geriatric use | Initiate with lower doses; monitor renal function and serum potassium closely; maximum infusion rate: 5-10 mEq/h; avoid in patients with significant renal impairment (CrCl < 30 mL/min) unless benefit outweighs risk. |
| 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 is excreted into breast milk, but levels are not expected to cause adverse effects in the infant at maternal therapeutic doses. M/P ratio not well defined; estimated as similar to plasma. Use with caution, monitoring infant for hyperkalemia (unlikely at normal doses). |
| Teratogenic Risk | No known teratogenic risk. Potassium chloride is a normal constituent of body fluids; supplementation at therapeutic doses is considered safe. However, maternal hyperkalemia may cause fetal arrhythmias. First trimester: No evidence of teratogenicity. Second and third trimesters: Risk of fetal hyperkalemia and acidosis with maternal overdose but no structural anomalies. |
■ FDA Black Box Warning
Concentrated potassium solutions must be diluted before use; undiluted injection can cause cardiac arrest. Do not use plastic container in series connections; such use can result in air embolism due to residual air being drawn from the primary container.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (serum potassium >5.0 mEq/L)","Severe renal impairment with oliguria or anuria","Concurrent use with potassium-sparing diuretics","Addison's disease (untreated adrenal insufficiency)","Acute dehydration","Postoperative patients with impaired renal function","In patients with myotonia congenita","Solutions containing dextrose are contraindicated in patients with known allergy to corn or corn products"]
| Precautions | ["Monitor serum potassium, glucose, and electrolytes frequently, especially in renal impairment or heart failure.","Use with caution in patients with cardiac disease, digitalis therapy, or conditions predisposing to hyperkalemia (e.g., renal failure, adrenal insufficiency).","Do not administer rapidly; rate should not exceed 20 mEq/hr of potassium in adults without cardiac monitoring.","Dextrose-containing solutions may cause hyperglycemia; adjust insulin in diabetic patients.","Ensure solution is clear and container undamaged before use; discard unused portion."] |
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| Fetal Monitoring | Monitor serum potassium, creatinine, blood glucose, and serum sodium periodically. Fetal heart rate monitoring in cases of maternal hyperkalemia or electrolyte disturbances. Assess fluid balance and signs of hypokalemia or hyperkalemia. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Electrolyte imbalances may indirectly affect reproductive function, but potassium is essential for cellular function and no direct impairment documented. |