TEN-K
Clinical safety rating
cautionComprehensive clinical and safety monograph for TEN-K (TEN-K).
Potassium chloride is a potassium supplement that replaces potassium ions in the body, essential for maintaining intracellular osmotic pressure, acid-base balance, and nerve conduction. It acts as a cofactor for numerous enzymes and is critical for myocardial and skeletal muscle contraction.
| Metabolism | Potassium chloride is not metabolized; it is absorbed and excreted primarily by the kidneys. Approximately 90% is eliminated in urine, with the remainder in feces and sweat. |
| Excretion | Renal: >90% excreted unchanged by the kidneys; fecal: <5% |
| Half-life | Terminal elimination half-life is approximately 30-60 minutes; clinical context: short half-life necessitates frequent dosing for maintenance of potassium levels. |
| Protein binding | Minimal (<10%); not significantly bound to plasma proteins. |
| Volume of Distribution | Approximately 0.2-0.4 L/kg; reflects distribution primarily in extracellular fluid. |
| Bioavailability | Oral: 100% (potassium chloride is well absorbed); IV: 100%. |
| Onset of Action | Oral: 30-60 minutes; IV: immediate upon completion of infusion. |
| Duration of Action | Duration is dose-dependent but typically 4-6 hours for oral; continuous IV infusion provides sustained effect. |
| Molecular Weight | 74.55 |
10 mEq (one tablet) orally once daily or as directed by physician.
| Dosage form | TABLET, EXTENDED RELEASE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min). For GFR 30-60 mL/min, reduce dose by 50% and monitor serum potassium. Use with caution in mild impairment. |
| Liver impairment | No specific adjustment; however, use with caution in severe hepatic impairment due to risk of hyperkalemia. |
| Pediatric use | Not established; safety and efficacy in pediatric patients not determined. |
| Geriatric use | Start at 5 mEq orally daily; titrate slowly and monitor serum potassium due to age-related renal function decline. |
| 1st trimester | Potassium chloride crosses the placenta. Use only if clearly needed and maternal benefit outweighs fetal risk. No well-controlled studies in pregnant women. |
| 2nd trimester | Use with caution; may cause fetal bradycardia or electrolyte imbalance if maternal levels are high. |
| 3rd trimester | Avoid near term unless treating hypokalemia; high potassium levels may affect uterine contractility or fetal cardiac function. |
Clinical note
Comprehensive clinical and safety monograph for TEN-K (TEN-K).
| Placental transfer | Potassium crosses the placenta via active transport; fetal serum potassium is slightly higher than maternal. Transfer is regulated but can be altered in maternal hyperkalemia. |
| Breastfeeding | Potassium appears in human milk in low concentrations. Maternal potassium supplementation is generally considered compatible with breastfeeding, but monitor infant for diarrhea or electrolyte disturbances if maternal doses are high. |
| Lactation Rating | L2 (Probably Compatible) |
| Teratogenic Risk | No known teratogenic effects based on available data. Potassium supplementation does not increase risk of congenital anomalies above baseline. However, avoid hyperkalemia in pregnant women as high potassium levels may pose risks. First trimester: No evidence of fetal harm. Second trimester: Monitor maternal potassium levels. Third trimester: Adjusted potassium requirements may occur due to increased renal clearance; maintain normokalemia. |
| Fetal Monitoring | Monitor serum potassium levels regularly, especially during dose adjustments or in patients with renal impairment. Assess for signs of hyperkalemia (e.g., ECG changes, muscle weakness). In pregnant patients, monitor renal function and blood pressure. Fetal monitoring is not specifically required unless maternal hyperkalemia occurs. |
| Fertility Effects | No known adverse effects on fertility. Potassium is essential for cellular function; supplementation at indicated doses does not impair reproductive function. |
■ FDA Black Box Warning
None
| Serious Effects |
HyperkalemiaSevere renal impairment (oliguria, anuria, or CrCl <30 mL/min)Addison's diseaseAcute dehydrationExtensive tissue breakdown (e.g., burns, trauma)Concomitant use of potassium-sparing diuretics or ACE inhibitors with high risk of hyperkalemiaStructural gastrointestinal disease (strictures, fistulas, diverticulitis, ulcerative colitis)
| Precautions | Hyperkalemia risk, especially in patients with renal impairment, Cardiac effects: risk of arrhythmias with rapid correction or high doses, Gastrointestinal reactions: ulceration, bleeding, perforation with solid oral formulations, Use with caution in patients with renal insufficiency, adrenal insufficiency, diabetes, or cardiac disease, Monitor serum potassium levels and ECG during therapy |
| Food/Dietary | Avoid high-potassium foods (bananas, oranges, spinach, potatoes, tomatoes) in large amounts; limit salt substitutes containing potassium chloride. Take with food to minimize GI irritation. |
| Clinical Pearls | TEN-K is a high-dose potassium chloride formulation (10 mEq per tablet) used for hypokalemia. Do not split or crush tablets; they are extended-release to prevent GI irritation. Monitor serum potassium and renal function; avoid in severe renal impairment or hyperkalemia. Consider potential for esophageal ulceration if tablet lodges. |
| Patient Advice | Take with a full glass of water and with food or after a meal to reduce stomach upset. · Swallow tablets whole; do not crush, chew, or split them. · Avoid salt substitutes or potassium-containing supplements unless directed by your doctor. · Report signs of hyperkalemia: muscle weakness, irregular heartbeat, tingling in hands/feet. · Store at room temperature, away from moisture and heat. |
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