Potassium Bicarbonate and Potassium Chloride
(poe TASS ee um bye KAR bun ate & poe TASS ee um KLOR ide)
- Potassium Bicarb/Pot Chloride
- Potassium Bicarbonate and Potassium Chloride (Effervescent)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet for solution, oral [effervescent]: Potassium chloride 25 mEq [potassium bicarbonate 0.5 g and potassium chloride 1.5 g]
- Electrolyte Supplement, Oral
Use: Labeled Indications
Treatment or prevention of hypokalemia
Hypersensitivity to any component of the formulation; hyperkalemia
Prevention: 16-24 mEq/day in 2-4 divided doses
Treatment: 40-100 mEq/day in 2-4 divided doses
Refer to adult dosing.
Oral: 1-4 mEq/kg/24 hours in divided doses as required to maintain normal serum potassium
Dosing: Renal Impairment
No dosage adjustment provided in manufacturer’s labeling. However, patients with chronic renal failure require serum potassium monitoring and appropriate dosage adjustment.
Dosing: Hepatic Impairment
No dosage adjustment provided in manufacturer’s labeling.
Tablet for oral solution: 25 mEq: Dissolve in 3-4 ounces of cold water.
Administer with meals; solution should be sipped slowly, over 5-10 minutes
Should be taken with meals.
Store below 30°C (86°F).
ACE Inhibitors: Potassium Salts may enhance the hyperkalemic effect of ACE Inhibitors. Monitor therapy
Aliskiren: Potassium Salts may enhance the hyperkalemic effect of Aliskiren. Monitor therapy
Angiotensin II Receptor Blockers: Potassium Salts may enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Monitor therapy
Anticholinergic Agents: May enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Eplerenone: May enhance the hyperkalemic effect of Potassium Salts. Management: This combination is contraindicated in patients receiving eplerenone for treatment of hypertension. Consider therapy modification
Glycopyrrolate (Systemic): May enhance the adverse/toxic effect of Potassium Chloride. This is specific to solid oral dosage forms of potassium chloride. Avoid combination
Heparin: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Heparin (Low Molecular Weight): May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Nicorandil: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Potassium-Sparing Diuretics: Potassium Salts may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Consider therapy modification
Frequency not defined: Gastrointestinal: Abdominal distress, diarrhea, nausea, vomiting
Concerns related to adverse effects:
• GI effects: May cause GI upset (eg, nausea, vomiting, diarrhea, abdominal pain, discomfort) and lead to GI ulceration, bleeding, perforation and/or obstruction.
• Hyperkalemia: Close monitoring of serum potassium concentrations is needed to avoid hyperkalemia; severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (eg, heart block, ventricular arrhythmias, asystole).
• Acid/base disorders: Use with caution in patients with acid/base alterations; changes in serum potassium concentrations can occur during acid/base correction, monitor closely.
• Cardiovascular disease: Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.
• Potassium-altering conditions/disorders: Use with caution in patients with disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (eg, untreated Addison's disease, heat cramps, severe tissue breakdown from trauma or burns).
• Renal impairment: Use with caution in patients with renal impairment; monitor serum potassium concentrations closely with severe impairment.
Concurrent drug therapy issues:
• Digitalis: Use with caution in digitalized patients; may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations.
• Potassium-altering therapies: Use with caution in patients receiving concomitant medications or therapies that increase potassium (eg, ACEI, potassium-sparing diuretics, potassium containing salt substitutes).
Serum potassium, magnesium (to facilitate potassium repletion), chloride, and bicarbonate
Pregnancy Risk Factor
Animal reproduction studies have not been conducted with this combination. Refer to individual agents.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience diarrhea. Have patient report immediately to prescriber signs of high potassium (abnormal heartbeat, confusion, dizziness, passing out, weakness, shortness of breath, numbness or tingling feeling), severe nausea, severe vomiting, abdominal edema, black, tarry, or bloody stools, vomiting blood, or severe abdominal pain (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.