POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Potassium chloride (KCl) provides potassium ions, essential for maintenance of intracellular tonicity, nerve impulse transmission, muscle contraction, and enzymatic reactions. Dextrose 5% provides glucose for energy, and sodium chloride 0.45% provides sodium and chloride ions for electrolyte balance and volume expansion.
| Metabolism | Potassium is primarily eliminated by the kidneys; dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle; sodium and chloride are excreted mainly by the kidneys and are not metabolized. |
| Excretion | Renal: >90% excreted unchanged by kidneys. Fecal: <10% via secretion into feces. |
| Half-life | Terminal elimination half-life is approximately 3-5 minutes for rapid redistribution phase; effective half-life for total body potassium is 30-40 hours due to large intracellular pool. Clinical context: immediately after IV infusion, plasma potassium declines rapidly due to cellular uptake, but total elimination depends on renal function. |
| Protein binding | Not significantly protein-bound (<10%); free ion in plasma. |
| Volume of Distribution | Approximately 0.5 L/kg (range 0.4-0.6 L/kg) reflecting distribution primarily into extracellular fluid; apparent Vd larger (5-10 L/kg) for total body potassium due to intracellular compartment. |
| Bioavailability | Oral: 100% bioavailability for potassium as it is completely absorbed from the gastrointestinal tract, though immediate release formulations have high bioavailability; IV: 100%. |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for correction of hypokalemia; oral: 30-60 minutes for gastrointestinal absorption. |
| Duration of Action | Intravenous: 1-2 hours for direct plasma effect, but prolonged effect on total body potassium depends on renal excretion and cellular uptake; oral: sustained effect over 4-6 hours with KCl formulation. |
| Molecular Weight | 74.55 |
40 mEq potassium chloride intravenously at a rate not exceeding 10 mEq/hour; typically infused over 4-6 hours. Maximum 24-hour dose: 200 mEq.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 10-50 mL/min: reduce dose by 25-50%. GFR <10 mL/min: avoid use or administer with extreme caution, not to exceed 20 mEq/24h. |
| Liver impairment | No specific adjustment required; monitor serum potassium closely due to risk of hyperkalemia in severe hepatic impairment (Child-Pugh class C). |
| Pediatric use | 0.5-1 mEq/kg/dose IV, max single dose 40 mEq; infuse at 0.3-0.5 mEq/kg/hour. Maximum daily dose: 2-3 mEq/kg/day. |
| Geriatric use | Start at low end of dosing range; reduce infusion rate (max 5 mEq/hour) and monitor renal function and serum potassium frequently due to age-related decline in GFR. |
| 1st trimester | Potassium chloride is a normal constituent of body fluids. Administration during first trimester is considered safe when used to correct hypokalemia. No known teratogenic effects in humans. |
| 2nd trimester | Safe for use in second trimester when clinically indicated for potassium replacement. Monitor serum potassium levels. |
| 3rd trimester | Safe in third trimester for correction of hypokalemia. May affect uterine muscle tone if levels are abnormal; use with caution in preeclampsia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Potassium crosses the placenta by active transport; fetal serum potassium is slightly higher than maternal. No evidence of fetal harm with therapeutic use. |
| Breastfeeding | Potassium chloride is a normal component of breast milk. Exogenous potassium is excreted into breast milk but is unlikely to affect the nursing infant at therapeutic doses. Monitor infant for signs of hyperkalemia if maternal doses are high. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Potassium chloride, dextrose, and sodium chloride are not teratogenic. Dextrose and sodium chloride are physiological components. Potassium supplementation is not associated with increased fetal risk. No trimester-specific risks identified. |
| Fetal Monitoring | Monitor serum potassium, glucose, and sodium levels. Assess maternal vital signs, fluid balance, and renal function. Fetal monitoring indicated if maternal electrolyte disturbances occur. |
| Fertility Effects | No known effects on fertility from potassium, dextrose, or sodium chloride administration at therapeutic doses. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaSevere renal impairment with oliguria or anuriaConcurrent use with potassium-sparing diuretics (e.g., amiloride, spironolactone, eplerenone)Adrenal insufficiencyAcute dehydrationCrush injury with hyperkalemia
| Precautions | Monitor serum potassium levels regularly; avoid rapid or high-dose administration to prevent hyperkalemia, Use with caution in patients with renal impairment, cardiac disease, or conditions predisposing to hyperkalemia, Do not administer unless solution is clear and container is undamaged, Dextrose-containing solutions may cause hyperglycemia; monitor blood glucose in diabetic patients |
| Food/Dietary | Avoid foods high in potassium such as bananas, oranges, tomatoes, potatoes, spinach, and avocados unless specifically advised. Limit use of potassium-containing salt substitutes. Excessive intake of potassium-rich foods may lead to hyperkalemia. |
| Clinical Pearls | Administer via central line if concentration >10 mEq/100 mL; peripheral infusion max 10 mEq/100 mL to avoid phlebitis. Infusion rate should not exceed 10-20 mEq/hour in non-emergent situations; requires cardiac monitoring during rapid correction. Contraindicated in severe renal impairment, hyperkalemia, or conditions with potassium retention. Correct underlying cause of potassium deficit; avoid giving in dextrose-only solutions as dextrose can lower serum potassium temporarily. |
| Patient Advice | This medication contains potassium to treat or prevent low potassium levels in your blood. · Inform your healthcare provider about all medications you are taking, especially potassium-sparing diuretics, ACE inhibitors, or angiotensin receptor blockers. · Do not receive this treatment if you have high potassium levels, severe kidney problems, or Addison's disease without consulting your doctor. · Report any symptoms of high potassium: muscle weakness, fatigue, tingling sensations, or irregular heartbeat. · Avoid potassium-containing salt substitutes or supplements while on this therapy unless directed by your doctor. |
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