POTASSIUM CHLORIDE 40MEQ 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 is the principal intracellular cation; it restores normal potassium levels, essential for nerve conduction, muscle contraction, and acid-base balance. Dextrose provides calories, and sodium chloride corrects electrolyte deficits; the combination maintains osmotic pressure.
| Metabolism | Potassium is not metabolized; it is excreted primarily by the kidneys. Dextrose is metabolized via glycolysis and the Krebs cycle. Sodium chloride is excreted renally. |
| Excretion | Renal: >90% excreted unchanged in urine; minimal biliary/fecal elimination (<5%). |
| Half-life | Potassium has no true terminal half-life as it is homeostatically regulated; the plasma disappearance half-life after IV administration is approximately 1-2 hours, reflecting rapid cellular uptake, but steady-state redistribution in total body stores takes days. |
| Protein binding | Potassium is not significantly protein-bound (<2%), as it exists as free ion K+. |
| Volume of Distribution | Approximately 0.5-0.6 L/kg (total body water), reflecting distribution throughout extracellular and intracellular spaces; clinical meaning: large Vd indicates extensive tissue uptake, primarily into muscle. |
| Bioavailability | Oral: 100% (but potassium is rapidly absorbed and distributed); IV: 100%. |
| Onset of Action | IV: Immediate (within minutes) for serum potassium elevation; oral: 30-60 minutes for measurable serum increase. |
| Duration of Action | IV: Effect lasts 2-4 hours after a single dose, but redistribution continues; oral: effect persists 4-6 hours; clinical duration depends on ongoing losses and intracellular shifts. |
10-40 mEq potassium chloride in 1000 mL D5 0.225% NaCl, intravenous infusion at a rate not exceeding 10 mEq/hour and 200 mEq/24 hours.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: reduce dose by 25-50%; GFR <30 mL/min: contraindicated or use with extreme caution, reduce dose by 50-100%. |
| Liver impairment | No specific guidelines; use standard dosing with monitoring of potassium levels. |
| Pediatric use | 0.5-1 mEq/kg/dose IV, not to exceed 40 mEq per dose, maximum infusion rate 0.5-1 mEq/kg/hour. |
| Geriatric use | Initiate at lower end of dosing range (10-20 mEq/24 hours), titrate based on renal function and potassium levels, maximum infusion rate 5-10 mEq/hour. |
| 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 is a normal component of breast milk. Exogenous potassium chloride is not expected to increase milk potassium significantly. M/P ratio is not established but is likely close to 1. Generally considered compatible with breastfeeding. Monitor maternal potassium levels as maternal hyperkalemia could theoretically affect infant. |
| Teratogenic Risk |
■ FDA Black Box Warning
Concentrated potassium solutions must be diluted before administration; improper dilution or rapid infusion may cause cardiac arrest or fatal arrhythmias.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (serum potassium >5.5 mEq/L)","Severe renal impairment with oliguria or anuria","Addison's disease (untreated)","Adynamia episodica hereditaria (hyperkalemic periodic paralysis)","Acute dehydration","Heat cramps","Concurrent use with potassium-sparing diuretics","Hypersensitivity to any component"]
| Precautions | ["Monitor serum potassium levels and ECG during therapy","Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia","Risk of hyperkalemia if potassium is administered too rapidly or in excessive amounts","Avoid in patients with severe renal failure unless dialysis is available","Do not use in patients with hyperkalemia","Cardiotoxicity may occur if potassium is administered in patients with digitalis toxicity"] |
Loading safety data…
| Potassium chloride is not teratogenic. No increased risk of congenital anomalies reported. Use during pregnancy is considered safe with appropriate monitoring for electrolyte imbalance. Trimester-specific risks are not applicable as potassium chloride is a physiological electrolyte. |
| Fetal Monitoring | Monitor maternal serum potassium levels, renal function, ECG, and fluid status. In pregnancy, monitor for signs of hyperkalemia: paresthesias, muscle weakness, arrhythmias. Fetal monitoring as per gestational age, not specifically for potassium. |
| Fertility Effects | No known effect on fertility. Potassium chloride is an electrolyte replacement, not associated with reproductive toxicity. |