POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions, which are essential for maintaining intracellular tonicity, nerve impulse conduction, muscle contraction, and acid-base balance. Dextrose 5% provides glucose for energy, and sodium chloride 0.45% provides sodium and chloride ions for electrolyte balance.
| Metabolism | Potassium is primarily excreted by the kidneys; dextrose is metabolized via glycolysis and oxidative phosphorylation; sodium and chloride are excreted via renal and extrarenal routes. |
| Excretion | Primarily renal (90-95% of potassium is excreted by the kidneys); minimal fecal (5-10%) and negligible biliary elimination. |
| Half-life | Potassium has no true elimination half-life as it is not metabolized; its body distribution and excretion are rapid, with a distribution half-life of about 1 hour and a terminal elimination half-life of approximately 2-4 hours in normal renal function, reflecting renal excretion kinetics. |
| Protein binding | Potassium is not significantly bound to plasma proteins (<5%); minimally bound to albumin. |
| Volume of Distribution | Approximately 0.4-0.6 L/kg in adults; higher in infants; represents distribution primarily into intracellular space (98% of total body potassium is intracellular). |
| Bioavailability | Intravenous: 100% bioavailable; oral: approximately 90% absorbed, but clinical use in this product is intravenous only. |
| Onset of Action | Intravenous: rapid, within minutes; onset depends on infusion rate and degree of deficiency. |
| Duration of Action | Intravenous: duration of action is short-lived (minutes to hours) after infusion stops; continuous infusion or frequent dosing is needed to maintain effect. |
| Molecular Weight | 74.55 |
30 mEq potassium chloride in 1000 mL D5 1/2 NS intravenously at a maximum rate of 10 mEq/hour (20 mEq/hour in critical hypokalemia) via infusion pump; central line preferred for concentrations >10 mEq/100 mL.
| Dosage form | INJECTABLE |
| Renal impairment | GFR ≥30 mL/min: usual dose. GFR 15-29 mL/min: reduce dose by 50% and monitor potassium closely. GFR <15 mL/min: avoid unless severe deficiency with frequent monitoring; maximum 20 mEq per day. |
| Liver impairment | No specific adjustment; monitor potassium levels due to risk of hyperkalemia in cirrhosis (especially Child-Pugh C). Use cautiously in hepatic impairment with concurrent renal dysfunction. |
| Pediatric use | 0.5-1 mEq/kg/dose intravenously, maximum single dose 40 mEq, infused at ≤0.5 mEq/kg/hour; maximum infusion rate 1 mEq/kg/hour under continuous cardiac monitoring. Dilute to ≤0.1 mEq/mL for peripheral veins. |
| Geriatric use | Lower initial dose (e.g., 20 mEq) and slower infusion rate (≤5 mEq/hour) due to age-related renal decline; monitor serum potassium and renal function every 4-6 hours during infusion. |
| 1st trimester | Potassium chloride is generally considered safe in pregnancy when used at recommended doses for the treatment or prevention of hypokalemia. However, excessive potassium intake may pose risks. Use with caution and monitor serum potassium levels. |
| 2nd trimester | Same as first trimester; potassium chloride can be used if clearly indicated. Normal physiological changes in pregnancy may affect potassium balance, so monitoring is advised. |
| 3rd trimester | Use with caution near term; hyperkalemia may affect uterine tone and fetal heart rate. Continuous monitoring of maternal potassium levels is recommended. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium readily crosses the placenta, but fetal serum potassium levels are regulated by active transport mechanisms. Therapeutic maternal doses do not typically cause significant fetal hyperkalemia, but excessive doses may lead to fetal electrolyte disturbances. |
| Breastfeeding | Potassium chloride is a normal component of breast milk. At therapeutic doses, no adverse effects on the nursing infant are expected. However, caution is advised for high parenteral doses, as infant exposure would be minimal but theoretical risk of hyperkalemia exists. |
| Lactation Rating | L1 - Compatible |
| Teratogenic Risk | Pregnancy Category C. Potassium chloride is a normal constituent of body fluids; no teratogenic effects are expected when administered at physiological levels. However, maternal electrolyte imbalances (hyperkalemia or hypokalemia) may adversely affect fetal development. First trimester: No known teratogenic effects at therapeutic doses. Second and third trimesters: Risk of fetal arrhythmias or electrolyte disturbances if maternal levels are abnormal. High doses may cause maternal hyperkalemia, which can lead to fetal bradycardia or cardiac arrest. |
| Fetal Monitoring | Monitor serum potassium levels frequently during pregnancy, especially in patients with renal impairment, diabetes, or preeclampsia. Continuous fetal heart rate monitoring may be indicated if maternal hyperkalemia occurs. Assess maternal ECG for signs of hyperkalemia (e.g., peaked T waves, widened QRS). |
| Fertility Effects | No known adverse effects on fertility from potassium chloride at therapeutic doses. However, underlying conditions requiring potassium supplementation (e.g., diuretic use, renal disease) may impact fertility indirectly. |
■ FDA Black Box Warning
No FDA black box warning for this product.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperkalemia (serum potassium >5.5 mEq/L)Severe renal impairment with oliguria or anuriaAddison's disease (untreated or severe)Acute dehydration with oliguriaConcurrent use of potassium-sparing diuretics (unless carefully monitored)
| Precautions | Rapid intravenous administration may cause hyperkalemia and cardiac arrest, Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia, Monitor serum potassium and ECG during infusion, Avoid administration with potassium-sparing diuretics |
| Food/Dietary | Avoid high-potassium foods (e.g., bananas, oranges, tomatoes, potatoes, spinach) and potassium-containing salt substitutes unless directed by a healthcare provider. |
| Clinical Pearls | Do not administer undiluted potassium chloride; always use in a compatible IV solution. Monitor serum potassium levels closely, especially in patients with renal impairment. Consider ECG monitoring during infusion. Ensure IV access is patent to avoid extravasation, which can cause tissue necrosis. Use with caution in patients on ACE inhibitors, ARBs, or potassium-sparing diuretics due to risk of hyperkalemia. |
| Patient Advice | This medication contains potassium; do not consume potassium supplements or salt substitutes without consulting your doctor. · Report symptoms of high potassium such as muscle weakness, fatigue, irregular heartbeat, or tingling sensations. · Keep all appointments for blood tests to check your potassium levels. · Do not suddenly stop taking this medication without your doctor's advice. |
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