Medically reviewed on Nov 15, 2018
(poe TASS ee um KLOR ide)
- Dextrose, Potassium Chloride, and Sodium Chloride
- Dextrose, Sodium Chloride, and Potassium Chloride
- KCl and NaCl
- KCl, NaCl, and D5W
- NaCl and KCl
- NaCl, KCl, and D5W
- Potassium Chloride and Sodium Chloride
- Potassium Chloride, Sodium Chloride, and Dextrose
- Sodium Chloride and Potassium Chloride
- Sodium Chloride, Potassium Chloride, and Dextrose
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule Extended Release, Oral:
Klor-Con Sprinkle: 8 mEq [contains brilliant blue fcf (fd&c blue #1)]
Klor-Con Sprinkle: 10 mEq [contains fd&c red #40, fd&c yellow #10 (quinoline yellow)]
Micro-K: 8 mEq, 10 mEq
Generic: 8 mEq, 10 mEq
Klor-Con: 20 mEq (1 ea, 30 ea, 100 ea) [contains fd&c yellow #6 (sunset yellow); orange flavor]
Klor-Con: 20 mEq (30 ea [DSC], 100 ea [DSC]) [sugar free; contains fd&c yellow #6 (sunset yellow)]
Klor-Con: 20 mEq (1 ea [DSC], 30 ea [DSC], 100 ea [DSC]) [sugar free; contains fd&c yellow #6 (sunset yellow); fruit flavor]
Klor-Con: 25 mEq (30 ea [DSC], 100 ea [DSC]) [sugar free; contains fd&c yellow #6 (sunset yellow)]
Klor-Con: 25 mEq (30 ea [DSC], 100 ea [DSC]) [sugar free; contains fd&c yellow #6 (sunset yellow); fruit flavor]
Generic: 20 mEq (1 ea, 30 ea, 100 ea)
Potassium Chloride PROAMP: 2 mEq/mL (10 mL)
Generic: 20 mEq (1000 mL); 40 mEq (1000 mL); 0.4 mEq/mL (50 mL); 10 mEq/100 mL (100 mL); 10 mEq/50 mL (50 mL); 20 mEq/100 mL (100 mL); 20 mEq/50 mL (50 mL); 40 mEq/100 mL (100 mL); 2 mEq/mL (5 mL, 10 mL, 20 mL, 30 mL, 250 mL); 20 mEq/L (1000 mL); 40 mEq/L (1000 mL); Potassium 10 mEq/L, dextrose 5%, and sodium chloride 0.45% (1000 mL); Potassium 20 mEq/L and sodium chloride 0.45% (1000 mL); Potassium 20 mEq/L and sodium chloride 0.9% (1000 mL); Potassium 20 mEq/L, dextrose 5%, and sodium chloride 0.2% (250 mL [DSC], 500 mL, 1000 mL); Potassium 20 mEq/L, dextrose 5%, and sodium chloride 0.225% (500 mL, 1000 mL); Potassium 20 mEq/L, dextrose 5%, and sodium chloride 0.33% (500 mL, 1000 mL); Potassium 20 mEq/L, dextrose 5%, and sodium chloride 0.45% (500 mL, 1000 mL); Potassium 20 mEq/L, dextrose 5%, and sodium chloride 0.9% (1000 mL); Potassium 30 mEq/L, dextrose 5%, and sodium chloride 0.45% (1000 mL); Potassium 40 mEq/L and sodium chloride 0.9% (1000 mL); Potassium 40 mEq/L, dextrose 5%, and sodium chloride 0.45% (1000 mL); Potassium 40 mEq/L, dextrose 5%, and sodium chloride 0.9% (1000 mL)
K-Sol: 20 mEq/15 mL (10%) (473 mL [DSC]) [alcohol free, dye free, sugar free; contains methylparaben, propylene glycol, propylparaben, saccharin sodium]
K-Sol: 40 mEq/15 mL (20%) (473 mL [DSC]) [alcohol free, sugar free; contains fd&c red #40, saccharin sodium, sodium benzoate]
Generic: 20 mEq/15 mL (10%) (15 mL, 30 mL, 473 mL, 3800 mL); 40 MEQ/15ML (20%) (473 mL); 40 mEq/15 mL (20%) (473 mL)
Tablet Extended Release, Oral:
K-Tab: 8 mEq, 10 mEq [contains fd&c yellow #10 (quinoline yellow)]
K-Tab: 20 mEq
Klor-Con: 8 mEq [contains fd&c blue #1 aluminum lake, fd&c blue #2 aluminum lake]
Klor-Con 10: 10 mEq [contains fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake]
Klor-Con M10: 10 mEq
Klor-Con M15: 15 mEq [scored]
Klor-Con M20: 20 mEq [scored]
Generic: 8 mEq, 10 mEq, 20 mEq
Brand Names: U.S.
- K-Sol [DSC]
- Klor-Con 10
- Klor-Con M10
- Klor-Con M15
- Klor-Con M20
- Klor-Con Sprinkle
- Potassium Chloride PROAMP
- Electrolyte Supplement, Oral
- Electrolyte Supplement, Parenteral
Potassium is the major cation of intracellular fluid and is essential for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism, and gastric secretion
Well absorbed from upper GI tract
Enters cells via active transport from extracellular fluid
Primarily urine; skin and feces (small amounts); most intestinal potassium reabsorbed
Use: Labeled Indications
Hypokalemia: Treatment or prevention of hypokalemia.
Hypersensitivity to potassium chloride or any component of the formulation; hyperkalemia, renal failure, and conditions in which potassium retention is present; structural, pathological, and/or pharmacologic cause for delay or arrest in passage through the GI tract (solid oral dosage forms only).
Note: When maintaining normal daily requirements, IV doses should be incorporated into the patient's maintenance IV fluids. Intermittent IV potassium administration should be reserved for more severe depletion situations in patients undergoing ECG monitoring. Doses expressed as mEq of potassium.
Normal daily requirements: Oral, IV: 40 to 80 mEq/day
Prevention of hypokalemia: Oral: 20 to 40 mEq/day in 1 to 2 divided doses
Treatment of hypokalemia:
Mild to moderate hypokalemia: Note: If deficits are severe or ongoing losses are great, IV route should be considered.
Capsules, tablets, oral solution: Usual dose: 40 to 100 mEq daily in divided doses; limit single doses to 20 to 25 mEq/dose to avoid GI discomfort.
Powder for oral solution (Klor-Con): Usual dose: 40 to 100 mEq daily in 2 to 5 divided doses; limit single doses to 40 mEq/dose; maximum: 200 mEq/24 hours.
Alternate dosing: Some clinicians initiate treatment with 10 to 20 mEq given 2 to 4 times per day (20 to 80 mEq/day), depending upon the severity of the hypokalemia. Total daily doses up to 120 mEq may be necessary as determined by laboratory assessment, patient symptoms and/or ongoing losses (Brophy 2014).
Severe hypokalemia: Some clinicians initiate treatment with 40 mEq given 3 to 4 times per day; may also administer 20 mEq every 2 to 3 hours in conjunction with IV potassium administration with careful monitoring. Administration of dose >40 mEq orally per dose are typically not well tolerated, resulting in GI irritation and nausea.
IV intermittent infusion: Peripheral or central line: ≤10 mEq/hour; repeat as needed based on frequently obtained lab values; central line infusion and continuous ECG monitoring highly recommended for infusions >10 mEq/hour.
Potassium dosage/rate of infusion general guidelines (per product labeling): Note: High variability exists in dosing/infusion rate recommendations; therapy guided by patient condition and specific institutional guidelines. As an estimate, 10 mEq of potassium chloride will roughly increase serum levels by 0.1 mEq/L. Patients with more severe forms of hypokalemia (eg, serum potassium levels <3.5 mEq/L) may require increased amounts due to total body potassium deficit (Flurie 2017).
Serum potassium >2.5 to 3.5 mEq/L: Maximum infusion rate: 10 mEq/hour; maximum concentration: 40 mEq/L; maximum 24-hour dose: 200 mEq
Serum potassium <2.5 mEq/L or symptomatic hypokalemia (excluding emergency treatment of cardiac arrest): Maximum infusion rate (central line only): 40 mEq/hour in presence of continuous ECG monitoring and frequent lab monitoring; in selected situations, patients may require up to 400 mEq/24 hours.
Refer to adult dosing. Use with caution, starting at the low end of the dosage range.
Note: Maintenance potassium IV doses should be incorporated into the patient's maintenance IV fluids; intermittent IV potassium administration should be reserved for severe depletion situations; continuous ECG monitoring should be used for intermittent IV doses >0.5 mEq/kg/hour. Oral solutions are available in two concentrations: 20 mEq/15 mL (1.33 mEq/mL) and 40 mEq/15 mL (2.67 mEq/mL); use extra precaution; verify product formulation for dosage calculation.
Hypokalemia, prevention for ongoing drug losses (eg, concurrent diuretic therapy): Limited data available: Infants, Children, and Adolescents: Oral: 1 to 2 mEq/kg/day in 1 to 2 divided doses; usual single dose should not exceed usual adult single dose: 20 mEq/dose; although some patients may require a single dose up to 40 mEq/dose (Moffett 2011); some patients may require higher individual daily doses based on lab values and ongoing losses
Hypokalemia, treatment; mild to moderate: Limited data available: Infants, Children, and Adolescents: Oral: 2 to 5 mEq/kg/day in divided doses; not to exceed 1 to 2 mEq/kg as a single dose or 20 mEq (whichever is less) (Corkins 2015; Moffett 2011); if deficits are severe or ongoing losses are great, IV potassium route should be considered as preferred route of administration
Hypokalemia, treatment; severe: Infants, Children, and Adolescents: Intermittent IV infusion: 0.5 to 1 mEq/kg/dose; maximum dose: 40 mEq/dose; infuse at a rate ≤0.5 mEq/kg/hour (Corkins 2015; Fuhrman 2017; Kliegman 2016); serum concentrations should be evaluated 1 to 2 hours after completion of infusion; may repeat as needed based on lab values; severe depletion or ongoing losses may require >200% of normal daily maintenance (Knudson 2013)
Dosing: Renal Impairment
There are no specific dosage adjustments provided in the manufacturer's labeling. Reduce initial dose by at least 50% in patients with renal impairment (Kraft 2005). Contraindicated in patients with renal failure.
Dosing: Hepatic Impairment
There are no specific dosage adjustments provided in the manufacturer's labeling; use oral formulations with caution in patients with cirrhosis and start at the low end of dosage range.
Parenteral: Potassium must be diluted prior to parenteral administration. The concentration of infusion may be dependent on patient condition and specific institution policy. Some clinicians recommend that the maximum concentration for peripheral infusion is 10 mEq/100 mL and 20-40 mEq/100 mL for central infusions.
Parenteral: Potassium must be diluted prior to parenteral administration. For IV infusion; do not administer IV push. In general, the rate of administration may be dependent on patient condition and specific institution policy.
Pediatric: Noncritical care settings: Usual range: 0.2 to 0.5 mEq/kg/hour up to 10 mEq to 20 mEq/hour have been used. Critical care settings/situations: Higher rates may be used; maximum rate: 1 mEq/kg/hour up to 40 mEq/hour; continuous cardiac monitoring recommended for rates >0.5 mEq/kg/hour (Fuhrman 2017; Hamill 1991; Klaus 1989; Kliegman 2016; Kruse 1990; Lafraniere 2006; Schaber 1985)
Adults: Some clinicians recommend that the maximum concentration for peripheral infusion is 10 mEq/100 mL and maximum rate of administration for peripheral infusion is 10 mEq/hour (Kraft 2005). ECG monitoring is recommended for peripheral or central infusions >10 mEq/hour in adults (Kraft 2005). With central line administration, higher concentrations and more rapid rates of infusion may be used; concentrations of 20 to 40 mEq/100 mL at a maximum rate of 40 mEq/hour via central line have been safely administered (Hamill 1991; Kruse 1990).
Vesicant/irritant (at concentrations >0.1 mEq/mL); ensure proper needle or catheter placement prior to and during IV infusion. Avoid extravasation.
Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave needle/cannula in place); gently aspirate extravasated solution (do NOT flush the line); initiate hyaluronidase antidote; remove needle/cannula; apply dry cold compresses (Hurst 2004; Reynolds 2014); elevate extremity.
Hyaluronidase: Intradermal or SubQ: Inject a total of 1 to 1.7 mL (15 units/mL) as five separate 0.2 to 0.3 mL injections (using a 25-gauge needle) into area of extravasation at the leading edge in a clockwise manner (MacCara 1983; Reynolds 2014; Zenk 1981).
Oral: Oral dosage forms should be taken with meals (or immediately after eating) and a full glass of water or other liquid to minimize the risk of GI irritation. Prescribing information for the various oral preparations recommend that no more than 20 mEq to 40 mEq should be given as single dose.
Capsule: MicroK: Swallow whole, do not chew. Capsules may also be opened and contents sprinkled on a spoonful of applesauce or pudding and should be swallowed immediately without chewing.
Powder for oral solution: Klor-Con: Dissolve one packet in at least 120 mL of cold water or other beverage prior to administration. If GI irritation occurs, increase dilution.
K-Tab, Kaon-Cl, Klor-Con: Swallow tablets whole; do not crush, chew, or suck on tablet.
Klor-Con M: Swallow tablets whole; do not crush, chew, or suck on tablet. Tablet may also be broken in half and each half swallowed separately; the whole tablet may be dissolved in ~4 ounces of water (allow ~2 minutes to dissolve, stir well and drink immediately)
Administer with plenty of fluid to decrease stomach irritation and discomfort. Some dietary sources of potassium include leafy green vegetables (eg, spinach, cabbage), tomatoes, cucumbers, zucchini, fruits (eg, apples, oranges, and bananas), root vegetables (eg, carrots, radishes), beans, and peas.
Capsule, tablet: Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from light and moisture.
Powder for oral solution: Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). Protect from light.
Solution for injection: Store at 25°C (77°F); do not freeze; avoid excessive heat. Use only clear solutions. Potassium chloride is compatible when admixed in most common infusion solutions. Refer to institution-specific policies and procedures for stability information.
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
Angiotensin-Converting Enzyme Inhibitors: Potassium Salts may enhance the hyperkalemic effect of Angiotensin-Converting Enzyme Inhibitors. 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
Heparins (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 occurred with potassium chloride injection unless otherwise specified.
Frequency not defined:
Cardiovascular: Asystole (with rapid administration or hyperkalemia), bradycardia, chest pain, thrombosis (infusion site), ventricular fibrillation (with rapid administration or hyperkalemia)
Dermatologic: Skin rash (oral and injection)
Endocrine & metabolic: Hyperkalemia (oral and injection)
Gastrointestinal: Abdominal cramps (oral), abdominal distress (oral), abdominal pain (oral), diarrhea (oral), flatulence (oral), gastrointestinal hemorrhage (oral), gastrointestinal irritation (oral), gastrointestinal obstruction (oral), gastrointestinal perforation (oral), gastrointestinal ulcer (oral), nausea (oral), vomiting (oral)
Hypersensitivity: Angioedema, hypersensitivity reaction
Local: Burning sensation at injection site, erythema at injection site, injection site phlebitis, irritation at injection site, swelling at injection site
Concerns related to adverse effects:
• Extravasation: Vesicant/irritant (at concentrations >0.1 mEq/mL); ensure proper catheter or needle position prior to and during infusion. Avoid extravasation.
• Hyperkalemia: May occur with IV or oral use. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic. Use with caution or avoid use in patients with predisposing conditions for hyperkalemia (eg, chronic or severe renal impairment, extensive burns or tissue injury, heart failure, acute dehydration, systemic acidosis, adrenal insufficiency, or the administration of potassium-sparing diuretics). Monitor serum potassium closely.
• Hypersensitivity/infusion reactions: Hypersensitivity/infusion reactions, including anaphylaxis and chills, may occur with parenteral administration of potassium containing solutions. Discontinue immediately if signs/symptoms of hypersensitivity/infusion reactions develop.
• Acid/base disorders: Use with caution in patients with acid/base alterations or acid/base correction; hyperosmolality or acidosis (or correction of alkalosis) is associated with hyperkalemia (shift of intracellular potassium to extracellular space); monitor serum potassium closely.
• Cardiovascular disease: Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias, atrioventricular [AV] block); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.
• Hepatic impairment: Use with caution in patients with cirrhosis; monitor serum potassium more frequently.
• Renal impairment: Use with caution in patients with renal impairment; monitor serum potassium closely. Contraindicated in patients with renal failure.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
Dosage form specific issues:
• Oral formulations: May cause GI upset and irritation (eg, nausea, vomiting, diarrhea, abdominal pain, discomfort) and lead to GI ulceration, bleeding, perforation, and/or obstruction. Oral liquid preparations (not solid) should be used in patients with esophageal compression or delayed gastric emptying. Extended-release formulations of potassium chloride may result in a “ghost tablet” in the stool.
• Parenteral administration: Use extreme caution with parenteral administration and monitor serum potassium concentrations closely. Evaluate renal function, cardiac and fluid status, and any factors contributing to altered potassium concentrations (eg, acidosis, alkalosis) prior to therapy. Do NOT administer undiluted or IV push; inappropriate parenteral administration may be fatal. Always administer potassium further diluted; refer to appropriate dilution and administration rate recommendations. Pain and phlebitis may occur during parenteral infusion requiring a decrease in infusion rate or potassium concentration.
Electrolytes (including serum potassium, calcium, chloride, magnesium, phosphate, sodium), acid/base balance; renal function; cardiac monitor (if intermittent infusion or potassium infusion rates 0.5 mEq/kg/hour in children or >10 mEq/hour in adults); to assess adequate replacement, repeat serum potassium level 2 to 4 hours after dose; monitor potassium levels daily for treatment and monthly to biannually for prophylaxis. Monitor IV infusion site.
Potassium requirements are the same in pregnant and nonpregnant women. Adverse events have not been observed following use of potassium supplements in healthy women with normal pregnancies. Use caution in pregnant women with other medical conditions (eg, preeclampsia; may be more likely to develop hyperkalemia) (IOM 2004). Potassium supplementation (that does not cause maternal hyperkalemia) would not be expected to cause adverse fetal events.
• 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 abdominal pain, diarrhea, flatulence, or tablet wax in stool. Have patient report immediately to prescriber signs of high potassium (abnormal heartbeat, confusion, dizziness, passing out, weakness, shortness of breath, or numbness or tingling feeling), bradycardia, angina, signs of bowel problems (black, tarry, or bloody stools; fever; mucus in stools; vomiting; vomiting blood; severe abdominal pain; constipation; or diarrhea), severe nausea, severe vomiting, abdominal edema, shortness of breath, excessive weight gain, swelling of arms or legs, or severe injection site pain, edema, or irritation (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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