POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride provides potassium ions for cellular ion exchange, restoring normal electrolyte balance, membrane potential, and acid-base regulation. Dextrose 5% is a caloric source, and sodium chloride 0.3% supplies sodium and chloride to maintain extracellular fluid tonicity.
| Metabolism | Potassium is excreted primarily by the kidneys (90%), with minor losses in feces and sweat. Dextrose undergoes glycolysis and oxidative metabolism. Sodium and chloride are predominantly renally excreted. |
| Excretion | Renal excretion of potassium >90% as K+ ions; glucose metabolism yields CO2 and water; sodium and chloride are excreted renally. Minimal biliary/fecal elimination. |
| Half-life | Terminal half-life of potassium is approximately 6-8 hours in patients with normal renal function; may be prolonged in renal impairment. |
| Protein binding | Potassium is not significantly protein-bound (<2%); dextrose and sodium chloride are not protein-bound. |
| Volume of Distribution | Potassium: 0.5-0.7 L/kg (total body water distribution); dextrose distributes into total body water (~0.55 L/kg). |
| Bioavailability | Intravenous: 100% bioavailable. Not applicable for oral routes as this is an IV formulation. |
| Onset of Action | Intravenous: rapid onset within minutes; complete distribution by 1 hour. |
| Duration of Action | Intravenous: duration of action 4-6 hours post-infusion; effect on serum potassium lasts as long as infusion continues and distribution is maintained. |
| Molecular Weight | 74.55 |
Intravenous infusion. Typical adult dose is 40 mEq potassium chloride in 1000 mL of D5NS (D5 0.3% NaCl) infused at a rate not exceeding 10 mEq/hour (or 250 mL/hour of this solution). Maximum 24-hour dose usually 200 mEq.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) unless documented hypokalemia. For GFR 30-50 mL/min, reduce dose by 25-50% and monitor serum potassium. For GFR >50 mL/min, no adjustment typically needed. |
| Liver impairment | No specific dose adjustment for Child-Pugh class A or B. For Child-Pugh class C, use with caution due to risk of hyperkalemia associated with concurrent metabolic alkalosis or renal dysfunction; consider reduced rate and monitoring. |
| Pediatric use | Intravenous infusion. Dose 0.5-1 mEq/kg/dose, maximum 40 mEq/dose, infused at a rate not exceeding 0.5 mEq/kg/hour. Total daily dose 2-3 mEq/kg/day. Use with appropriate diluent (same vehicle composition per product label). |
| Geriatric use | Start at lower end of dosing, typically 20-40 mEq per day, with infusion rate ≤10 mEq/hour. Monitor renal function and serum potassium closely due to age-related decline in GFR and increased risk of hyperkalemia. |
| 1st trimester | Potassium chloride is essential for maternal and fetal health. Use only if clearly needed; monitor serum potassium levels. No known teratogenicity. |
| 2nd trimester | Use with caution; maintain electrolyte balance. No known fetal risks. |
| 3rd trimester | Use with caution; avoid hyperkalemia which may cause fetal bradycardia. Monitor serum potassium closely. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta by active transport to maintain fetal homeostasis; maternal infusion increases fetal levels proportionally. |
| Breastfeeding | Potassium chloride is a normal constituent of breast milk. Intravenous administration may slightly increase milk levels but is generally considered safe. Monitor infant for signs of hyperkalemia if high doses used. |
| Lactation Rating | L1 - Safe |
| Teratogenic Risk | Potassium chloride and dextrose are generally considered low risk. No teratogenic effects reported. Sodium chloride 0.3% is isotonic. However, hyperkalemia or hypokalemia may indirectly affect fetal development. Trimester-specific: first trimester – no known malformation risk; second/third – electrolyte imbalance risks, but potassium itself not teratogenic. |
| Fetal Monitoring | Serum potassium, glucose, sodium, chloride, renal function, ECG for arrhythmias, and fluid balance. Fetal heart rate monitoring if maternal electrolyte disturbance. |
| Fertility Effects | No known adverse effects on fertility. Electrolyte imbalances may impair reproductive function indirectly. |
■ FDA Black Box Warning
Potassium chloride concentrate must be diluted before use. Intravenous administration of undiluted potassium chloride can cause fatal cardiac arrest.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaConcurrent use with potassium-sparing diureticsAddison's diseaseAcute dehydrationHeat crampsHyperkalemic periodic paralysisCrush syndromeSevere hemolytic reactions
| Precautions | Cardiac monitoring required during IV administration due to risk of hyperkalemia and arrhythmias, Use with caution in renal impairment, cardiac disease, or conditions predisposing to hyperkalemia (e.g., adrenal insufficiency, diabetes mellitus), Extravasation may cause tissue necrosis; ensure proper IV access, Monitor serum potassium, glucose, and electrolytes regularly, Do not administer rapidly; maximum infusion rate generally 10-20 mEq/hour |
| Food/Dietary | Avoid salt substitutes containing potassium chloride. No significant food interactions beyond potassium-rich foods; monitor intake if hypokalemic. |
| Clinical Pearls | Use with caution in patients with renal impairment; monitor serum potassium and ECG during infusion. Maximum infusion rate is 10 mEq/hr for peripheral lines, 20 mEq/hr via central line. Do not administer undiluted. Avoid in patients with hyperkalemia, severe metabolic acidosis, or anuria. |
| Patient Advice | Report any irregular heartbeat, muscle weakness, or tingling immediately. · This medication is given through an IV; do not adjust the infusion rate yourself. · Tell your doctor if you are taking potassium supplements or salt substitutes. · Inform your healthcare provider about any kidney problems or heart conditions. |
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