POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions, which are essential for maintaining cellular membrane potential, nerve impulse transmission, muscle contraction, and acid-base balance. Dextrose 5% provides a source of calories and water, while sodium chloride 0.225% provides sodium and chloride ions to maintain electrolyte balance.
| Metabolism | Potassium is not metabolized; it is excreted primarily renally (90%) with minor fecal loss. Dextrose undergoes glycolysis and subsequent metabolism via the citric acid cycle. |
| Excretion | Renal excretion: >90% as potassium ions via distal tubular secretion and glomerular filtration. Fecal: <10%. Biliary: negligible (under 1%). |
| Half-life | Potassium has no classic elimination half-life; its clearance is highly dependent on renal function, acid-base status, and hormonal influences (insulin, aldosterone). In normal renal function, rapid redistribution and excretion yield an effective half-life of approximately 2-4 hours for an acute load. In chronic kidney disease, half-life may extend to >24 hours. |
| Protein binding | Potassium is minimally bound to plasma proteins (<2%); it exists predominantly as free ions in solution. |
| Volume of Distribution | Approximately 0.5-0.7 L/kg in adults (total body water). Clinically, potassium is primarily intracellular (98% of total body stores); the Vd reflects distribution across all fluid compartments but is not a linear parameter for loading doses. |
| Bioavailability | Oral: 90-100% (well absorbed from gastrointestinal tract). Intravenous: 100%. |
| Onset of Action | Intravenous: Onset within minutes (infusion-dependent); serum potassium begins to rise during infusion. Oral: Onset within 30-60 minutes after ingestion. |
| Duration of Action | Intravenous: Duration of pharmacodynamic effect (elevated serum K+) persists for 1-2 hours after infusion ends, followed by redistribution and renal elimination. Oral: Duration of effect is 4-6 hours for an immediate-release dose, with sustained levels if multiple doses or extended-release formulations are used. |
| Molecular Weight | 74.55 |
Intravenous infusion: 20 mEq potassium chloride in 1000 mL D5-0.225% NaCl at a rate not exceeding 10 mEq/hour and 200 mEq/24 hours.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: Administer with caution, reduce dose by 50% or extend dosing interval. GFR <30 mL/min: Avoid use or reduce dose by 75% with serum potassium monitoring. |
| Liver impairment | No specific adjustment required for Child-Pugh class A or B; use with caution in class C due to risk of hyperkalemia from renal impairment. |
| Pediatric use | Dose: 0.5-1 mEq/kg per dose, maximum 20 mEq per dose; administered as a slow IV infusion over 2-4 hours, not exceeding 0.5 mEq/kg/hour. |
| Geriatric use | Use lower end of dosing range due to age-related renal decline; monitor potassium levels closely. Typical maximum infusion rate: 5-10 mEq/hour. |
| 1st trimester | Potassium chloride is essential for cellular homeostasis; no teratogenic effects reported at physiologic doses. Use only if clearly needed and monitor serum potassium. |
| 2nd trimester | Generally safe at therapeutic doses; caution in renal impairment or conditions predisposing to hyperkalemia. |
| 3rd trimester | Safe when used as indicated; avoid hyperkalemia as it may cause fetal arrhythmias. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta via active transport; maternal-fetal gradient maintained. Fetal serum potassium levels are slightly higher than maternal. No known adverse effects at physiologic doses. |
| Breastfeeding | Potassium is a normal component of breast milk; supplementation at recommended doses does not pose risk to infant. Monitor maternal potassium levels to avoid excessive intake. |
| Lactation Rating | Safe |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are not associated with teratogenicity when used appropriately. Potassium is essential for fetal development, but hyperkalemia or hypokalemia may cause fetal arrhythmias. Dextrose and sodium chloride are standard components of parenteral nutrition; no teratogenic risk reported in trimesters 1-3. |
| Fetal Monitoring | Monitor maternal serum potassium, glucose, sodium, and chloride levels; renal function; urine output; fetal heart rate tracing during infusion to detect maternal or fetal electrolyte disturbances or fluid overload. |
| Fertility Effects | No known adverse effects on fertility when used at therapeutic doses for electrolyte maintenance. |
■ FDA Black Box Warning
Potassium chloride injection should be administered only in carefully diluted solutions via a large central vein to avoid fatal hyperkalemia and cardiac arrest. Concentrated potassium solutions should not be administered undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaAddison's diseaseAcute dehydrationHeat crampsConcurrent use of potassium-sparing diuretics without careful monitoring
| Precautions | Risk of hyperkalemia, especially in patients with renal impairment, adrenal insufficiency, or rapid infusion. Monitor serum potassium levels., Extravasation can cause tissue necrosis. Use central line for concentrated solutions., Dextrose-containing solutions may cause hyperglycemia, particularly in diabetic patients., Sodium chloride content may exacerbate conditions such as heart failure, hypertension, or edema. |
| Food/Dietary | Avoid excessive intake of potassium-rich foods (e.g., bananas, oranges, tomatoes, potatoes, spinach, avocados, dried fruits) and potassium-containing salt substitutes. Dietary potassium intake should be consistent and monitored. |
| Clinical Pearls | Monitor serum potassium levels closely, especially in patients with renal impairment or those on ACE inhibitors/ARBs. Infusion rate should not exceed 10-20 mEq/hour in non-emergent situations. Use central line for concentrations > 40 mEq/L. Rapid infusion can cause cardiac arrest; continuous ECG monitoring recommended for rates > 10 mEq/hour. Do not administer undiluted. Check for compatibility when co-infusing with other medications. |
| Patient Advice | This medication is given intravenously to correct low potassium levels. · Report any chest pain, shortness of breath, or palpitations immediately. · Avoid potassium-rich foods and salt substitutes unless directed by healthcare provider. · Do not stop or change the infusion rate on your own. · Tell your doctor about all medications you take, especially heart or blood pressure medicines. |
Loading safety data…