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Potassium Bicarbonate and Potassium Chloride

Pronunciation

(poe TASS ee um bye KAR bun ate & poe TASS ee um KLOR ide)

Index Terms

  • K-Lyte/Cl
  • Potassium Bicarb/Pot Chloride
  • Potassium Bicarbonate and Potassium Chloride (Effervescent)

Dosage Forms

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]

Pharmacologic Category

  • Electrolyte Supplement, Oral

Use: Labeled Indications

Treatment or prevention of hypokalemia

Contraindications

Hypersensitivity to any component of the formulation; hyperkalemia

Dosing: Adult

Hypokalemia: Oral:

Prevention: 16-24 mEq/day in 2-4 divided doses

Treatment: 40-100 mEq/day in 2-4 divided doses

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

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.

Reconstitution

Tablet for oral solution: 25 mEq: Dissolve in 3-4 ounces of cold water.

Administration

Administer with meals; solution should be sipped slowly, over 5-10 minutes

Dietary Considerations

Should be taken with meals.

Storage

Store below 30°C (86°F).

Drug Interactions

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

Adverse Reactions

Frequency not defined: Gastrointestinal: Abdominal discomfort, diarrhea, nausea, vomiting

Warnings/Precautions

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).

Disease-related concerns:

• 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).

Monitoring Parameters

Serum potassium, magnesium (to facilitate potassium repletion), chloride, and bicarbonate

Pregnancy Risk Factor

C

Pregnancy Considerations

Animal reproduction studies have not been conducted with this combination. Refer to individual agents.

Patient Education

• 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.

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