POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Potassium is the major intracellular cation; it is essential for maintenance of intracellular tonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle, and maintenance of normal renal function. Dextrose is a monosaccharide that provides calories and is metabolized to carbon dioxide and water, yielding energy. Sodium chloride maintains electrolyte balance and osmolality.
| Metabolism | Potassium is primarily excreted unchanged by the kidneys; small amounts are excreted in feces. Dextrose is metabolized via glycolysis to pyruvate/lactate, then enters the citric acid cycle. Sodium and chloride are largely excreted in urine and sweat. |
| Excretion | Primarily renal (90%); minor fecal (10%) |
| Half-life | Not applicable as potassium is an electrolyte; distribution half-life approximately 8-12 hours; elimination dependent on renal function |
| Protein binding | Negligible (<2%) |
| Volume of Distribution | 0.5-0.7 L/kg (total body water) |
| Bioavailability | Oral: 70-90%; intravenous: 100% |
| Onset of Action | Intravenous: immediate; oral: 30 minutes |
| Duration of Action | Intravenous: several hours; oral: 4-6 hours |
Intravenous infusion: 10-20 mEq/hour, not exceeding 10-20 mEq/hour or 200 mEq/day, with rate not exceeding 1 mEq/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 10-50 mL/min: reduce dose by 25-50%. GFR <10 mL/min: avoid or use with extreme caution and monitor ECG. |
| Liver impairment | No specific adjustment; monitor electrolytes and acid-base status in severe hepatic impairment. |
| Pediatric use | IV: 0.5-1 mEq/kg/dose, maximum 20 mEq/dose, infused at 0.5-1 mEq/kg/hour; maximum daily dose 3 mEq/kg/day. |
| Geriatric use | Start at low end of dosing range; monitor renal function and serum potassium closely; avoid rapid infusion. |
| 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 and chloride are normal breast milk components; dextrose and sodium chloride are safe. M/P ratio not applicable as potassium is endogenously regulated. Use considered compatible with breastfeeding at recommended doses. |
| Teratogenic Risk | Potassium chloride is a normal physiological constituent; no teratogenic risk at recommended doses. Dextrose and sodium chloride are standard maintenance components. No known fetal risks in any trimester when used appropriately. Overdose may cause maternal hyperkalemia leading to fetal bradycardia or arrhythmia. |
■ FDA Black Box Warning
No FDA black box warning specific to this combination product; however, potassium chloride has been associated with hyperkalemia-related cardiac arrhythmias and death if administered too rapidly or in excessive amounts.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Renal failure with oliguria or anuria","Severe metabolic acidosis","Severe hypovolemia with hypotension","Concurrent use of potassium-sparing diuretics (relative)"]
| Precautions | ["Risk of hyperkalemia, especially in patients with renal impairment, heart failure, or metabolic acidosis","Do not administer rapidly; infusion rate should not exceed 10-20 mEq/hour","Monitor serum potassium, glucose, and electrolyte levels frequently","Use with caution in patients with cardiac disease, hypervolemia, or conditions predisposing to hyperkalemia","Extravasation may cause tissue necrosis"] |
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| Fetal Monitoring | Monitor serum electrolytes (potassium, sodium, chloride), blood glucose, renal function, cardiac rhythm (ECG for hyperkalemia), and fluid balance. In pregnancy, monitor maternal vital signs, fetal heart rate, and uterine activity if indicated. |
| Fertility Effects | No known adverse effects on fertility from potassium chloride, dextrose, or sodium chloride at therapeutic doses. Electrolyte imbalances could theoretically impact reproductive function, but not expected with proper use. |