Micro-K 10meq Exten Capsules
It is used to treat or prevent low potassium levels.
Drug Class
Electrolyte replacement; Mineral supplement
Pharmacologic Class
Mineral; Electrolyte
Pregnancy Category
C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Potassium chloride is a medicine used to treat or prevent low potassium levels in your body. Potassium is a very important mineral that helps your heart, muscles, and nerves work properly. This medicine is an extended-release capsule, meaning it releases the potassium slowly over time.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most benefit from your medication, follow these steps:
Take your medication exactly as directed by your doctor.
Read all the information provided with your medication and follow the instructions carefully.
Take your medication with or immediately after a meal.
Swallow your medication with a full glass of water.
Swallow the medication whole; do not chew, break, or crush it.
Do not suck on the medication.
If you have difficulty swallowing, consult your doctor for guidance.
If needed, you can sprinkle the contents of the capsule onto applesauce or another soft food. However, do not chew the mixture. Swallow it immediately and follow with a glass of water or juice.
Avoid mixing the medication with hot food.
After mixing the medication with food, take your dose right away. Do not store the mixture for later use.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication:
Store it at room temperature, protected from light.
Keep it in a dry place, away from the bathroom.
Store all medications in a secure location, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of your medication. Your area may have a drug take-back program.
What to Do If You Miss a Dose
If you miss a dose of your medication:
Take it as soon as you remember.
If it is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at the same time or take extra doses to make up for the missed one.
To ensure you get the most benefit from your medication, follow these steps:
Take your medication exactly as directed by your doctor.
Read all the information provided with your medication and follow the instructions carefully.
Take your medication with or immediately after a meal.
Swallow your medication with a full glass of water.
Swallow the medication whole; do not chew, break, or crush it.
Do not suck on the medication.
If you have difficulty swallowing, consult your doctor for guidance.
If needed, you can sprinkle the contents of the capsule onto applesauce or another soft food. However, do not chew the mixture. Swallow it immediately and follow with a glass of water or juice.
Avoid mixing the medication with hot food.
After mixing the medication with food, take your dose right away. Do not store the mixture for later use.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication:
Store it at room temperature, protected from light.
Keep it in a dry place, away from the bathroom.
Store all medications in a secure location, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of your medication. Your area may have a drug take-back program.
What to Do If You Miss a Dose
If you miss a dose of your medication:
Take it as soon as you remember.
If it is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Take this medicine with food or immediately after a meal to reduce stomach upset.
- Swallow the capsules whole; do not crush, chew, or suck on them, as this can cause a sudden release of potassium and lead to irritation or high potassium levels.
- If you have trouble swallowing the capsule, some brands allow sprinkling the contents on soft food (like applesauce) and swallowing immediately without chewing. Check your specific product's instructions.
- Maintain adequate hydration unless otherwise instructed by your doctor.
- Avoid salt substitutes that contain potassium unless advised by your doctor, as this can lead to dangerously high potassium levels.
- Inform your doctor about all other medications you are taking, especially blood pressure medicines (like ACE inhibitors or ARBs) or diuretics, as they can affect potassium levels.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Hypokalemia: 20-100 mEq/day in 1-5 divided doses. Prophylaxis: 20 mEq/day.
Dose Range:
20 - 100 mg
Condition-Specific Dosing:
Hypokalemia:
Initial dose typically 40-80 mEq/day, adjusted based on serum potassium levels and clinical response. Doses >100 mEq/day are rarely required and should be given with extreme caution.
Diuretic-induced hypokalemia prophylaxis:
20 mEq/day, adjusted as needed.
Pediatric Dosing
Neonatal:
Not established for routine use; consult specialist. IV route preferred for acute severe hypokalemia.
Infant:
Hypokalemia: 2-4 mEq/kg/day in divided doses, not to exceed 1 mEq/kg/dose or 40 mEq/day. Prophylaxis: 1-2 mEq/kg/day.
Child:
Hypokalemia: 2-4 mEq/kg/day in divided doses, not to exceed 1 mEq/kg/dose or 40 mEq/day. Prophylaxis: 1-2 mEq/kg/day.
Adolescent:
Hypokalemia: 20-100 mEq/day in 1-5 divided doses. Prophylaxis: 20 mEq/day.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor serum potassium and renal function closely.
Moderate:
Significant dose reduction required; monitor serum potassium and renal function frequently. Consider alternative therapies if hyperkalemia risk is high.
Severe:
Contraindicated in patients with severe renal impairment (e.g., GFR < 30 mL/min) due to high risk of hyperkalemia.
Dialysis:
Generally contraindicated in patients on dialysis unless specifically indicated for documented hypokalemia and under strict monitoring. Dialysis itself removes potassium.
Hepatic Impairment:
Mild:
No specific dose adjustment required.
Moderate:
No specific dose adjustment required.
Severe:
No specific dose adjustment required, but monitor for concomitant renal impairment which is common in severe liver disease.
Pharmacology
Mechanism of Action
Potassium is the principal intracellular cation and is essential for the maintenance of intracellular tonicity, nerve impulse transmission, muscle contraction (including cardiac muscle), and the maintenance of normal renal function. It plays a critical role in numerous enzymatic reactions and in the physiological processes of carbohydrate metabolism and protein synthesis. Potassium chloride provides a source of potassium ions to replenish depleted body stores.
Pharmacokinetics
Absorption:
Bioavailability:
Nearly 100% from the gastrointestinal tract for potassium ions, though the rate is slowed by extended-release formulations.
Tmax:
Approximately 4-6 hours for extended-release capsules.
FoodEffect:
Food can delay absorption but generally enhances tolerability and reduces gastrointestinal irritation. Should be taken with food or immediately after meals.
Distribution:
Vd:
Approximately 0.5 L/kg (reflects total body water distribution, as potassium is widely distributed).
ProteinBinding:
Not protein bound.
CnssPenetration:
Limited (tightly regulated by blood-brain barrier, but essential for neuronal function).
Elimination:
HalfLife:
Not applicable in the traditional sense for an ion; plasma levels are tightly regulated by renal excretion. The physiological half-life of potassium in the body is complex and depends on intake, excretion, and cellular shifts.
Clearance:
Primarily renal clearance, regulated by aldosterone and acid-base status.
ExcretionRoute:
Mainly renal (approximately 90%), with a small amount excreted in feces and sweat.
Unchanged:
100% (as it is an ion).
Pharmacodynamics
OnsetOfAction:
Gradual, over several hours due to extended-release formulation.
PeakEffect:
Corresponds to Tmax, approximately 4-6 hours.
DurationOfAction:
Approximately 8-12 hours due to extended-release properties, allowing for less frequent dosing.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high potassium levels, including:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Slow heartbeat
Chest pain or pressure
Signs of bowel problems, such as:
+ Black, tarry, or bloody stools
+ Fever
+ Mucus in the stools
+ Vomiting blood or coffee ground-like material
+ Severe stomach pain, constipation, or diarrhea
Abdominal swelling
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Stomach pain or diarrhea
Upset stomach or vomiting
* Gas
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high potassium levels, including:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Slow heartbeat
Chest pain or pressure
Signs of bowel problems, such as:
+ Black, tarry, or bloody stools
+ Fever
+ Mucus in the stools
+ Vomiting blood or coffee ground-like material
+ Severe stomach pain, constipation, or diarrhea
Abdominal swelling
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Stomach pain or diarrhea
Upset stomach or vomiting
* Gas
This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of high potassium (hyperkalemia): unusual tiredness, muscle weakness, tingling or numbness in hands/feet, slow or irregular heartbeat, shortness of breath.
- Severe stomach pain, black/tarry stools, or vomiting blood (signs of GI irritation/ulceration).
- Difficulty swallowing or feeling like the capsule is stuck in your throat.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction you experienced.
High potassium levels in your blood.
If you are taking any of the following medications: Amiloride, Eplerenone, Spironolactone, or Triamterene.
Certain health conditions, including:
+ A bowel block or obstruction.
+ A slow-moving gastrointestinal (GI) tract.
+ Slow stomach emptying.
+ Heart disease accompanied by esophageal problems.
+ Use of anticholinergic medications, such as Ipratropium or Oxybutynin. If you are unsure whether any of your medications fall into this category, consult your doctor.
Please note that this is not an exhaustive list of potential interactions. To guarantee your safety, it is crucial to discuss all of your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. Before starting, stopping, or adjusting the dosage of any medication, always consult with your doctor to confirm that it is safe to do so in conjunction with this medication.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction you experienced.
High potassium levels in your blood.
If you are taking any of the following medications: Amiloride, Eplerenone, Spironolactone, or Triamterene.
Certain health conditions, including:
+ A bowel block or obstruction.
+ A slow-moving gastrointestinal (GI) tract.
+ Slow stomach emptying.
+ Heart disease accompanied by esophageal problems.
+ Use of anticholinergic medications, such as Ipratropium or Oxybutynin. If you are unsure whether any of your medications fall into this category, consult your doctor.
Please note that this is not an exhaustive list of potential interactions. To guarantee your safety, it is crucial to discuss all of your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. Before starting, stopping, or adjusting the dosage of any medication, always consult with your doctor to confirm that it is safe to do so in conjunction with this medication.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor.
To minimize the risk of severe side effects, it is crucial to adhere to the prescribed dosage and not exceed the amount recommended by your doctor. If you follow a low-salt diet or use a salt substitute, consult with your doctor to discuss any potential interactions.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor immediately. You and your doctor will need to carefully weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
To minimize the risk of severe side effects, it is crucial to adhere to the prescribed dosage and not exceed the amount recommended by your doctor. If you follow a low-salt diet or use a salt substitute, consult with your doctor to discuss any potential interactions.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor immediately. You and your doctor will need to carefully weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Extreme muscle weakness or paralysis
- Tingling or numbness in extremities
- Slow, irregular, or absent pulse
- Severe fatigue
- Confusion
- Shortness of breath
- Cardiac arrhythmias (e.g., peaked T waves, widened QRS, ventricular fibrillation, asystole)
What to Do:
Seek immediate medical attention. Call 911 or your local emergency number. For poison control, call 1-800-222-1222. Management may include IV calcium (to stabilize cardiac membrane), IV insulin and glucose (to shift potassium intracellularly), sodium bicarbonate, diuretics, or dialysis in severe cases.
Drug Interactions
Contraindicated Interactions
- Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) in patients with impaired renal function or other conditions predisposing to hyperkalemia.
- Eplerenone (in patients with impaired renal function or other hyperkalemia risk factors).
Major Interactions
- ACE inhibitors (e.g., lisinopril, enalapril): Increased risk of hyperkalemia.
- Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan): Increased risk of hyperkalemia.
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (e.g., ibuprofen, naproxen): Can impair renal potassium excretion, increasing hyperkalemia risk.
- Cyclosporine: Increased risk of hyperkalemia.
- Tacrolimus: Increased risk of hyperkalemia.
- Trimethoprim (often in combination with sulfamethoxazole): Can cause hyperkalemia by blocking renal potassium excretion.
- Heparin: Can cause hyperkalemia by inhibiting aldosterone secretion.
- Digoxin: Hyperkalemia can antagonize the therapeutic effects of digoxin, while hypokalemia potentiates digoxin toxicity. Careful monitoring is essential.
Moderate Interactions
- Beta-blockers (non-selective): Can impair cellular uptake of potassium, potentially leading to mild hyperkalemia.
- Certain laxatives (e.g., sodium polystyrene sulfonate): Can bind potassium, potentially reducing its absorption or increasing its excretion (though this is more relevant for treating hyperkalemia).
Minor Interactions
- Licorice: Can cause hypokalemia, potentially counteracting potassium supplementation.
Monitoring
Baseline Monitoring
Serum Potassium (K+)
Rationale: To establish baseline potassium status and guide initial dosing.
Timing: Prior to initiation of therapy.
Renal Function (BUN, Serum Creatinine, GFR)
Rationale: Potassium is primarily renally excreted; impaired renal function significantly increases hyperkalemia risk.
Timing: Prior to initiation of therapy.
Electrocardiogram (ECG)
Rationale: To assess for pre-existing cardiac abnormalities and establish a baseline, especially in patients at risk for hyperkalemia or with pre-existing cardiac disease.
Timing: Prior to initiation, particularly for higher doses or high-risk patients.
Routine Monitoring
Serum Potassium (K+)
Frequency: Initially daily or every 2-3 days until stable, then weekly to monthly depending on patient stability, dose, and concomitant medications.
Target: 3.5-5.0 mEq/L
Action Threshold: Below 3.5 mEq/L (consider dose increase); Above 5.0 mEq/L (consider dose reduction/cessation); Above 5.5 mEq/L (urgent intervention for hyperkalemia).
Renal Function (BUN, Serum Creatinine)
Frequency: Periodically, especially when initiating therapy, changing dose, or adding interacting medications; at least every 3-6 months for stable patients.
Target: Within normal limits for age/sex.
Action Threshold: Significant increase in creatinine or decrease in GFR warrants immediate re-evaluation of potassium therapy.
Electrocardiogram (ECG)
Frequency: As clinically indicated, especially if serum potassium is outside target range or symptoms of hyperkalemia/hypokalemia develop.
Target: Normal sinus rhythm, no signs of hyperkalemia (peaked T waves, prolonged PR, widened QRS, absent P waves) or hypokalemia (U waves, flattened T waves, prolonged QT).
Action Threshold: Any ECG changes suggestive of hyperkalemia or hypokalemia require immediate intervention.
Symptom Monitoring
- Symptoms of hyperkalemia: muscle weakness, fatigue, paresthesias, bradycardia, irregular heartbeat, shortness of breath.
- Symptoms of hypokalemia (if inadequate dose): muscle weakness, cramps, fatigue, constipation, palpitations.
- Gastrointestinal upset: nausea, vomiting, abdominal pain, diarrhea (common side effects).
Special Patient Groups
Pregnancy
Potassium is an essential electrolyte. Use during pregnancy is generally considered acceptable if clinically indicated to treat or prevent hypokalemia. The benefits of maintaining normal potassium levels outweigh potential risks. Category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Trimester-Specific Risks:
First Trimester:
No specific increased risk identified beyond general electrolyte balance.
Second Trimester:
No specific increased risk identified beyond general electrolyte balance.
Third Trimester:
No specific increased risk identified beyond general electrolyte balance. Close monitoring of maternal potassium levels is important.
Lactation
Potassium is naturally present in breast milk. Supplementation is generally considered safe during breastfeeding when used at therapeutic doses to correct maternal hypokalemia. Monitor the infant for any signs of gastrointestinal upset or electrolyte imbalance, though this is unlikely with appropriate maternal dosing.
Infant Risk:
Low risk (L3 - Moderately safe).
Pediatric Use
Dosing must be carefully calculated based on weight and severity of hypokalemia. Children, especially infants, are more susceptible to electrolyte imbalances. Close monitoring of serum potassium and renal function is crucial. Extended-release formulations may not be suitable for very young children due to swallowing difficulties and risk of esophageal lodging.
Geriatric Use
Elderly patients are at increased risk for renal impairment, which can lead to hyperkalemia with potassium supplementation. They may also be on multiple medications that interact with potassium (e.g., ACE inhibitors, ARBs, NSAIDs). Close monitoring of serum potassium and renal function is essential. Start with lower doses and titrate carefully.
Clinical Information
Clinical Pearls
- Always take oral potassium chloride with food or immediately after meals to minimize gastrointestinal irritation and ulceration.
- Extended-release capsules must be swallowed whole; crushing or chewing can lead to a rapid release of potassium, causing hyperkalemia and severe GI irritation.
- Never administer potassium chloride intravenously as a bolus or undiluted; this can be fatal.
- Regular monitoring of serum potassium and renal function is critical, especially in patients with renal impairment, heart failure, or those on interacting medications.
- Symptoms of hyperkalemia can be subtle; educate patients on warning signs.
- Consider dietary sources of potassium before initiating or increasing supplementation, especially for mild hypokalemia or prophylaxis.
Alternative Therapies
- Other oral potassium salts (e.g., potassium gluconate, potassium citrate, potassium bicarbonate) - often used for different indications or patient preferences.
- Intravenous potassium chloride (for severe or symptomatic hypokalemia, or when oral route is not feasible).
- Dietary potassium intake (e.g., bananas, oranges, potatoes, leafy greens) for mild hypokalemia or prophylaxis.
Cost & Coverage
Average Cost:
$10 - $50 per 30 capsules (generic)
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (for generic formulations)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.