POTASSIUM CHLORIDE 5MEQ 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 chloride dissociates to provide potassium ions, which are essential for maintaining cellular membrane potential, nerve impulse transmission, muscle contraction, and acid-base balance. Dextrose provides caloric support, and sodium chloride corrects sodium and chloride deficits.
| Metabolism | Potassium is primarily excreted renally; dextrose undergoes glycolysis and oxidation; sodium and chloride are excreted renally. No significant hepatic metabolism. |
| Excretion | Renal: >90% excreted unchanged. A small fraction is lost in sweat and feces (<5%). |
| Half-life | Potassium itself has a distribution half-life of ~1 hour and an elimination half-life of ~12 hours in healthy individuals; clinical effect depends on intracellular shift and renal function. |
| Protein binding | Minimal (<5%); potassium is free in solution. |
| Volume of Distribution | 0.4–0.7 L/kg; approximates total body water; potassium distributes primarily into intracellular fluid. |
| Bioavailability | IV: 100% (bioequivalent to administered dose); oral: 80–90% (well-absorbed) but not relevant for this IV formulation. |
| Onset of Action | IV: Within minutes; onset of clinical effect (e.g., ECG changes) occurs as potassium is infused. |
| Duration of Action | IV: Duration is short-lived after infusion stops (minutes to hours) unless deficits are large; continuous infusion is often needed to maintain steady state. |
Intravenous infusion: 5 mEq potassium chloride in 100 mL D5 1/4 NS (0.225% NaCl) administered at a rate not exceeding 10 mEq/hour. Typical dose ranges from 10-40 mEq/day, depending on serum potassium level and clinical need.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: Reduce dose by 25-50% and monitor serum potassium closely. GFR 15-29 mL/min: Reduce dose by 50-75% and avoid if possible. GFR <15 mL/min: Use with extreme caution; maximum dose 10-20 mEq/day with frequent monitoring. Contraindicated in oliguric renal failure. |
| Liver impairment | No specific dose adjustment required for Child-Pugh A or B. For Child-Pugh C, monitor potassium levels closely and reduce dose by 25-50% due to increased risk of hyperkalemia. |
| Pediatric use | Intravenous infusion: 0.5-2 mEq/kg/day, administered at a rate not exceeding 0.5 mEq/kg/hour. Maximum concentration 40 mEq/L. Dose based on serum potassium deficit and continuous monitoring. |
| Geriatric use | Initiate at lower end of dosing range (10-20 mEq/day) due to age-related decline in renal function. Infusion rate not to exceed 5 mEq/hour. Monitor serum potassium and renal function frequently. |
| 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 chloride: Excreted into breast milk (M/P ratio ~1.1, based on total potassium); not expected to affect infant when maternal serum levels normal. Dextrose: No data; glucose levels in milk unaffected by infusion. Sodium chloride: Excreted; minimal risk. Safe with professional oversight. |
| Teratogenic Risk | Potassium chloride: Not teratogenic at therapeutic doses; fetal hyperkalemia possible with maternal overdose. Dextrose: No teratogenic risk at standard concentrations. Sodium chloride: No teratogenic risk. First trimester: No increased malformation risk. Second/third trimester: Risk of maternal hypervolemia or electrolyte imbalance affecting fetal homeostasis; avoid excessive potassium causing fetal arrhythmia. |
■ FDA Black Box Warning
Concentrated potassium chloride for injection must be diluted before use. Bolus administration can cause fatal hyperkalemia. Do not administer undiluted.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia (>5.5 mEq/L)","Severe renal impairment with oliguria or anuria","Untreated Addison's disease (adrenal insufficiency)","Acute dehydration with heat cramps","Patients with hyperkalemic periodic paralysis","Concomitant use of potassium-sparing diuretics or eplerenone unless close monitoring"]
| Precautions | ["Monitor serum potassium levels frequently, especially in patients with renal impairment or cardiac disease.","Use with caution in patients receiving potassium-sparing diuretics, ACE inhibitors, or angiotensin receptor blockers due to hyperkalemia risk.","Avoid rapid infusion to prevent localized pain, phlebitis, and extravasation.","Dextrose-containing solutions may cause hyperglycemia; monitor blood glucose in diabetic patients."] |
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| Fetal Monitoring | Maternal: Serum potassium, glucose, sodium, chloride, renal function, ECG if high potassium. Fetal: Heart rate monitoring during labor, especially if maternal potassium >5.5 mEq/L to detect arrhythmia. |
| Fertility Effects | No direct adverse effects on fertility at therapeutic doses. Chronic hyperkalemia or severe electrolyte imbalance may impair reproductive function. No known impact on spermatogenesis or oogenesis. |