Potassium Chloride Dosage
Applies to the following strength(s): 8 mEq10 mEq20 mEq40 mEq/15 mL20 mEq/15 mL2 mEq/mL1.5 mEq/mL10 mEq/100 mL10 mEq/50 mL20 mEq/100 mL30 mEq/100 mL20 mEq/50 mL40 mEq/100 mL500 mg25 mEq15 mEq30 mEq/15 mL6.7 mEq3 mEq/mL99 mg40 mEq/250 mL-NaCl 0.9%40 mEq/500 mL-NaCl 0.9%50 mEq/500 mL-LR20 mEq/250 mL-NaCl 0.9%4 mEq/10 mL-NaCl 0.9%2 mEq/5 mL-NaCl 0.9%3 mEq/7.5 mL-NaCl 0.9%595 mg
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Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Hypokalemia
40 to 100 mEq potassium chloride for injection diluted in an appropriate amount and type of solution to be intravenously infused once at a rate not to exceed 10 to 40 mEq/hour.
40 to 100 mEq orally once a day given in equally divided doses using formulations which include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution or powder for dissolution mixed with an appropriate volume of water or juice.
Usual Adult Dose for Prevention of Hypokalemia
10 to 40 mEq potassium chloride for injection diluted in an appropriate amount and type of solution to be intravenously infused once at a rate not to exceed 40 mEq/hour.
10 to 20 mEq orally once a day given in equally divided doses using formulations which include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution or powder for dissolution mixed with an appropriate volume of water or juice.
Usual Pediatric Dose for Hypokalemia
Treatment of hypokalemia: Note: High variability exists in dosing/infusion rate recommendations; therapy should be guided by patient condition and specific institutional guidelines.
Infants and Children:
Oral: 2 to 5 mEq/kg/day in divided doses; not to exceed 1 to 2 mEq/kg as a single dose; if deficits are severe or ongoing losses are great, IV route should be considered preferred route of administration.
Intermittent IV infusion (must be diluted prior to administration): 0.5 to 1 mEq/kg/dose (maximum dose: 40 mEq) to infuse at 0.3 to 0.5 mEq/kg/hour (maximum dose/rate: 1 mEq/kg/hour); then repeated as needed based on frequently obtained lab values; severe depletion or ongoing losses may require more than 200% of normal daily limit needs.
Usual Pediatric Dose for Prevention of Hypokalemia
IV doses in children should be incorporated into the maintenance IV fluids. Intermittent IV potassium administration should be reserved for severe depletion situations. Continuous ECG monitoring should be used for intermittent doses greater than 0.5 mEq/kg/hour.
Normal daily requirements: Oral or IV:
Infants: 2 to 6 mEq/kg/day
Children: 2 to 3 mEq/kg/day
Prevention of hypokalemia during diuretic therapy:
Infants and Children: 1 to 2 mEq/kg/day orally in 1 to 2 divided doses
Renal Dose Adjustments
CrCl less than 25 mL/min: Extreme caution is recommended because of the high risk of hyperkalemia. Chronic potassium chloride therapy is generally not required nor recommended for patients with renal dysfunction.
Liver Dose Adjustments
Data not available
Initial dosages may be adjusted to specific patient needs based on steady state serum potassium concentrations.
Potassium chloride (KCl) is contraindicated in the presence of hyperkalemia; renal failure and conditions in which potassium retention is present, including the concomitant use of potassium-sparing diuretics (such as triamterene, amiloride, or spironolactone); oliguria or azotemia; anuria; crush syndrome; severe hemolytic reactions; adrenocortical insufficiency (untreated Addison's disease); adynamical episodica hereditaria; acute dehydration; heat cramps; and early postoperative oliguria except during gastrointestinal drainage.
Solid dosage forms of potassium supplements are contraindicated in any patient in whom there is cause for arrest or delay in tablet passage throughout the GI tract (including patients who are also taking drugs with anticholinergic properties). Wax matrix KCl preparations have produced esophageal ulceration in cardiac patients with esophageal compression due to an enlarged left atrium. If KCl is necessary for these patients, potassium supplementation as a liquid preparation is recommended.
Some KCl products contain tartrazine, and are contraindicated in patients with tartrazine sensitivity.
Patients should not use potassium-rich salt substitutes without the advice of their healthcare professional during KCl therapy.
In patients with renal insufficiency, use of potassium chloride may cause potassium intoxication and life-threatening hyperkalemia.
The administration of intravenous solutions can cause fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, pulmonary edema or congested states. The risk of dilutional states is inversely proportional to the electrolyte concentration. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentration.
Serum potassium levels are not necessarily indicative of tissue potassium levels. Solutions containing potassium should be administered with caution in the presence of cardiac or renal disease.
Solid oral dosage forms of potassium chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract. Potassium chloride should be discontinued immediately and the possibility of ulceration, obstruction, or perforation should be considered if severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occurs.
Clinical evaluation and periodic laboratory evaluations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation. Significant deviations from normal concentrations may require the administration of additional electrolyte supplements, or the administration of electrolyte-free dextrose solutions to which individualized electrolyte supplements may be added.
Certain potassium chloride extended-release tablets contain a wax matrix. This matrix is not absorbed and is excreted in the feces. In some instances the empty matrices may be noticeable in the stool.
Dose selection in the elderly should be cautious and should start at the lower end of the dosing range.
Potassium is rarely, if ever, given to a patient who is on dialysis. Hypokalemia in this case may indicate an inappropriately low predialysis potassium concentration or resolution of an acidotic state which has resulted in a rapid shift of extracellular potassium to the intracellular compartment. Adjustment of the dialysate potassium concentration that will result in a postdialysis serum potassium concentration of 4 mEq/L (4.5 to 5 mEq/L if this patient also has a high digoxin concentration) based on the fractional dialyzer urea clearance (Kt/V) required is recommended.
Hypokalemia may be present during the early stages of dialysis-dependent renal failure because of excessive potassium losses during the early stages in the pathogenesis of renal failure and/or the continued use of a low dialysate potassium in the presence of potassium depletion during this period.
Chronic potassium chloride therapy is not recommended for this patient with dialysis-dependent renal insufficiency because of the high risk of hyperkalemia.
Patients who are extremely potassium-depleted may require higher total daily doses of potassium chloride to replenish body stores. If large doses are required, administer potassium in equally divided doses 2 to 3 times a day.
Oral potassium chloride formulations:
Because of the high incidence of gastrointestinal irritation, administering potassium chloride with food and/or a full glass of water or similar beverage is recommended.
Potassium chloride tablets or capsules should not be crushed or chewed.
Dissolvable potassium chloride tablets, powder or concentrated solutions may be mixed with 3 to 8 ounces of a suitable beverage.
Parenteral potassium chloride formulations:
The maximum recommended concentration is 60 mEq potassium/L of intravenous fluid for infusion, although extreme emergencies may dictate greater concentrations. It is recommended that potassium chloride solutions be infused slowly (up to 20 mEq/hour) to avoid venous irritation and local pain. The rate of infusion will depend on the patient's clinical condition, the initial serum potassium concentration, the rate of change in the serum potassium concentration, peripheral or central intravenous port, and the patient's renal function. Monitoring the serum potassium concentration at appropriate intervals is recommended.
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