Potassium Chloride 20meq ER Tablets
It is used to treat or prevent low potassium levels.
Drug Class
Electrolyte replacement
Pharmacologic Class
Mineral supplement
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Potassium chloride is a mineral supplement used to treat or prevent low levels of potassium in your blood (hypokalemia). Potassium is very important for your heart, muscles, and nerves to work properly.
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 to help with absorption.
Swallow your medication whole with a full glass of water.
Do not chew, break, or crush your medication, as this can affect its effectiveness.
Avoid sucking on your medication.
If you have difficulty swallowing, consult with your doctor for guidance.
Some medications can be broken in half or mixed with water. Check with your doctor to see if this is an option for your specific medication. If you can mix your medication with water:
Mix the entire tablet with 1/2 cup of water.
Drink the mixture immediately.
Rinse the cup with more water and drink again to ensure you get the full dose.
Repeat this process one more time to confirm all the medication has been taken.
Do not store the mixture for later use; take it right away.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature, away from direct light.
Keep it in a dry place, such as a closet or drawer.
Avoid storing your medication in the bathroom, as the humidity can affect its potency.
Keep all medications out of the reach of children and pets to prevent accidental ingestion.
Dispose of unused or expired medications properly.
Do not flush medications down the toilet or pour them down the drain unless instructed to do so by your pharmacist or healthcare provider.
Check with your pharmacist for guidance on the best way to dispose of your medication, and consider participating in local drug take-back programs.
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's 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 to help with absorption.
Swallow your medication whole with a full glass of water.
Do not chew, break, or crush your medication, as this can affect its effectiveness.
Avoid sucking on your medication.
If you have difficulty swallowing, consult with your doctor for guidance.
Some medications can be broken in half or mixed with water. Check with your doctor to see if this is an option for your specific medication. If you can mix your medication with water:
Mix the entire tablet with 1/2 cup of water.
Drink the mixture immediately.
Rinse the cup with more water and drink again to ensure you get the full dose.
Repeat this process one more time to confirm all the medication has been taken.
Do not store the mixture for later use; take it right away.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature, away from direct light.
Keep it in a dry place, such as a closet or drawer.
Avoid storing your medication in the bathroom, as the humidity can affect its potency.
Keep all medications out of the reach of children and pets to prevent accidental ingestion.
Dispose of unused or expired medications properly.
Do not flush medications down the toilet or pour them down the drain unless instructed to do so by your pharmacist or healthcare provider.
Check with your pharmacist for guidance on the best way to dispose of your medication, and consider participating in local drug take-back programs.
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's 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 with food or immediately after a meal to reduce stomach upset.
- Swallow the tablet whole; do not crush, chew, or suck on extended-release tablets, as this can cause a sudden release of potassium and lead to irritation or high potassium levels.
- Do not use salt substitutes that contain potassium unless advised by your doctor.
- Report any signs of high potassium (muscle weakness, slow or irregular heartbeat) or severe stomach upset immediately.
Available Forms & Alternatives
Available Strengths:
- Potassium Cl 2meq/ml Inj 30ml
- Kcl/d5w/nacl 0.15/0.9 Inj , 1000ml
- Kcl/d5w/nacl .15/.45% Inj, 1000ml
- Potassium Cl 2meq/ml Inj 20ml
- Potassium Cl 2meq/ml Inj 10ml
- Potassium Cl 2meq/ml Inj 20ml
- Pot Chl/nacl 0.15/.45% Inj, 1000ml
- Kcl/d5w/lr 0.15% Inj, 1000ml
- Pot Chloride 20meq Inj, 100ml
- Kcl/d5w/nacl 0.3/0.45 Inj, 1000ml
- Kcl/d5w/nacl .075/.45 Inj, 1000ml
- Kcl/d5w/nacl 0.15/0.2 Inj, 1000ml
- Pot Chl/dextrose 5%/nacl0.45% Inj
- Potassium Chloride ER 8meq Tablets
- Potassium Cl 10meq ER Tablets
- Potassium Chloride ER 8meq ER Tabs
- Potassium Cl 10meq ER Capsules
- Potassium Chlor 10% Liq(20meq/15ml)
- Potassium Chlor 20% Liq(40meq/15ml)
- Potassium Cl Micro 10meq ER Tabs
- Pot Chloride 8meq CR Capsules
- Potassium Chloride 20meq Powder Pkt
- Potassium Cl Micro 10meq ER Tabs
- Potassium Cit ER 1620mg (15meq) Tab
- Potassium Cl Micro 10meq ER Tabs
- Potassium Chl 40meq Inj, 100ml
- Potassium Chloride 10meq Inj, 50ml
- Potassium Chloride 20meq Inj, 50ml
- Potassium Chloride 10meq ER Tablets
- Kcl/d5w/lact 20meq/l Inj, 1000ml
- Potassium Chloride 20meq ER Tablets
- Potassium Cl 20meq ER Tablets
- Potassium Chloride 20meqpowder Pkt
- Potassium Cl 2meq/ml Inj 250ml
- Potassium Cl 2meq/ml Inj 50ml
- Potassium Chl 10meq Inj,100ml
- Pot Chl/nacl 40meq/l Inj, 1000ml
- Pot Chl/d5w 20meq/l Inj, 1000ml
- Pot Chl/d5w 10meq/l Inj, 1000ml
- Potassium Chlor/nacl 20meq/l Inj
- Potassium Chloride 15meq ER Tabs
Dosing & Administration
Adult Dosing
Standard Dose:
20 mEq once daily or in divided doses
Dose Range:
20 - 100 mg
Condition-Specific Dosing:
Hypokalemia (mild to moderate):
20-40 mEq/day in 1-2 divided doses. Max 100 mEq/day.
Prevention of hypokalemia:
20 mEq/day
Pediatric Dosing
Neonatal:
Not established (use liquid formulations with caution, specific dosing based on weight and serum levels)
Infant:
Not established (use liquid formulations with caution, specific dosing based on weight and serum levels)
Child:
Not established for ER tablets (liquid formulations typically 2-3 mEq/kg/day in divided doses, max 100 mEq/day)
Adolescent:
Similar to adult dosing, based on serum potassium levels and clinical need, typically 20-40 mEq/day
Dose Adjustments
Renal Impairment:
Mild:
Use with caution, monitor serum potassium
Moderate:
Reduce dose, monitor serum potassium closely; consider alternative forms if severe impairment
Severe:
Contraindicated (CrCl < 30 mL/min) due to high risk of hyperkalemia
Dialysis:
Contraindicated
Hepatic Impairment:
Mild:
No specific adjustment needed
Moderate:
No specific adjustment needed
Severe:
No specific adjustment needed
Pharmacology
Mechanism of Action
Potassium is the major intracellular cation and is essential for the maintenance of acid-base balance, isotonicity, and electrodynamic characteristics of the cell. It is involved in many enzymatic reactions and plays a vital role in physiological processes such as nerve impulse transmission, contraction of cardiac, skeletal, and smooth muscle, and maintenance of normal renal function. Potassium chloride extended-release tablets provide a controlled release of potassium ions to prevent high localized concentrations in the gastrointestinal tract.
Pharmacokinetics
Absorption:
Bioavailability:
Nearly 100%
Tmax:
Approximately 4-6 hours (for ER formulations)
FoodEffect:
Food can delay absorption but generally increases tolerability and reduces GI irritation; should be taken with food or immediately after meals.
Distribution:
Vd:
Approximately 0.5 L/kg (total body water)
ProteinBinding:
Not applicable (not protein bound)
CnssPenetration:
Limited
Elimination:
HalfLife:
Variable (homeostatically regulated; not a typical drug half-life)
Clearance:
Primarily renal excretion (90% of ingested potassium is excreted by the kidneys)
ExcretionRoute:
Renal (urine), small amounts in feces and sweat
Unchanged:
100%
Pharmacodynamics
OnsetOfAction:
Hours (for therapeutic effect in hypokalemia)
PeakEffect:
Variable, sustained release over 8-10 hours
DurationOfAction:
Approximately 12-24 hours (due to ER formulation and homeostatic regulation)
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 unusual symptoms, contact your doctor for advice:
Stomach pain or diarrhea
Upset stomach or vomiting
Gas
Note: Some potassium products have a wax matrix that may appear in your stool. This is a normal occurrence, indicating that the potassium has been absorbed by the body, while the wax has not.
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact 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 unusual symptoms, contact your doctor for advice:
Stomach pain or diarrhea
Upset stomach or vomiting
Gas
Note: Some potassium products have a wax matrix that may appear in your stool. This is a normal occurrence, indicating that the potassium has been absorbed by the body, while the wax has not.
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact 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:
- Muscle weakness or paralysis
- Numbness or tingling in hands or feet
- Slow, fast, or irregular heartbeat
- Severe stomach pain, nausea, vomiting, or diarrhea
- Black, tarry, or bloody stools (signs of GI bleeding)
- Confusion
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:
Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the symptoms you experienced.
If you have high potassium levels in your blood.
If you are currently taking any of the following medications: Amiloride, Eplerenone, Spironolactone, or Triamterene.
If you have any of the following health conditions:
+ A bowel block or obstruction
+ A slow-moving gastrointestinal (GI) tract
+ Slow stomach emptying or gastric clearance
+ Heart disease accompanied by esophageal problems
+ If you are taking other medications classified as anticholinergics, 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 list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. This will help ensure your safety while taking this medication. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm that it is safe to do so in conjunction with this drug and your specific health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the symptoms you experienced.
If you have high potassium levels in your blood.
If you are currently taking any of the following medications: Amiloride, Eplerenone, Spironolactone, or Triamterene.
If you have any of the following health conditions:
+ A bowel block or obstruction
+ A slow-moving gastrointestinal (GI) tract
+ Slow stomach emptying or gastric clearance
+ Heart disease accompanied by esophageal problems
+ If you are taking other medications classified as anticholinergics, 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 list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. This will help ensure your safety while taking this medication. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm that it is safe to do so in conjunction with this drug and your specific health conditions.
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, inform 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 both 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, inform 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 both you and your baby.
Overdose Information
Overdose Symptoms:
- Hyperkalemia (high potassium levels)
- Muscle weakness, flaccid paralysis
- Paresthesias (tingling, numbness)
- Bradycardia (slow heart rate)
- Hypotension (low blood pressure)
- Cardiac arrhythmias (e.g., peaked T waves, widened QRS, ventricular fibrillation, asystole)
- Cardiac arrest
What to Do:
Immediately discontinue potassium chloride. Administer intravenous calcium gluconate (to antagonize cardiac effects), insulin with glucose (to shift potassium intracellularly), sodium bicarbonate, and/or loop diuretics. Consider potassium-binding resins (e.g., sodium polystyrene sulfonate) or hemodialysis in severe cases. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Contraindicated Interactions
- Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride)
- Eplerenone
Major Interactions
- ACE inhibitors (e.g., lisinopril, enalapril)
- Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan)
- Non-steroidal anti-inflammatory drugs (NSAIDs) (especially in patients with renal impairment)
- Cyclosporine
- Tacrolimus
- Salt substitutes containing potassium
Moderate Interactions
- Digoxin (hypokalemia can potentiate digoxin toxicity, but hyperkalemia can antagonize it)
- Beta-blockers (may impair cellular potassium uptake)
- Heparin (may cause hypoaldosteronism)
Monitoring
Baseline Monitoring
Serum Potassium (K+)
Rationale: To establish baseline level and guide initial dosing for hypokalemia
Timing: Prior to initiation
Renal Function (BUN, Creatinine, eGFR)
Rationale: To assess kidney's ability to excrete potassium and determine risk of hyperkalemia
Timing: Prior to initiation
Electrocardiogram (ECG)
Rationale: To assess for cardiac manifestations of severe hypokalemia or hyperkalemia
Timing: Prior to initiation, especially if severe hypokalemia or cardiac risk factors
Routine Monitoring
Serum Potassium (K+)
Frequency: Initially daily or every few days until stable, then weekly to monthly depending on clinical status and concomitant medications
Target: 3.5-5.0 mEq/L
Action Threshold: < 3.5 mEq/L (increase dose or supplement), > 5.0 mEq/L (reduce dose or discontinue)
Renal Function (BUN, Creatinine)
Frequency: Periodically, especially with dose changes or concomitant nephrotoxic drugs
Target: Within normal limits for patient
Action Threshold: Significant decline in renal function (adjust dose or discontinue)
Electrocardiogram (ECG)
Frequency: As clinically indicated (e.g., symptoms of hyperkalemia or hypokalemia, significant changes in serum K+)
Target: Normal sinus rhythm, no signs of hyperkalemia (peaked T waves, prolonged PR, widened QRS)
Action Threshold: ECG changes suggestive of hyperkalemia (immediate intervention)
Symptom Monitoring
- Symptoms of hyperkalemia (e.g., muscle weakness, fatigue, paresthesia, bradycardia, irregular heartbeat)
- Symptoms of hypokalemia (e.g., muscle cramps, weakness, constipation, palpitations)
- Gastrointestinal symptoms (e.g., nausea, vomiting, abdominal pain, diarrhea, black/tarry stools, severe vomiting)
Special Patient Groups
Pregnancy
Potassium is an essential electrolyte. Supplementation is generally considered safe when indicated to correct or prevent hypokalemia during pregnancy, as long as serum levels are monitored to avoid hyperkalemia. Risk is low when used appropriately.
Trimester-Specific Risks:
First Trimester:
Low risk, if indicated and monitored.
Second Trimester:
Low risk, if indicated and monitored.
Third Trimester:
Low risk, if indicated and monitored.
Lactation
Potassium is a normal component of breast milk. Supplementation is generally considered safe during breastfeeding when indicated to correct or prevent maternal hypokalemia. Monitor infant for signs of hyperkalemia if maternal doses are very high, though unlikely.
Infant Risk:
Low risk
Pediatric Use
Use with caution. Extended-release tablets may pose a choking hazard or risk of localized GI irritation in young children. Liquid formulations are generally preferred for precise dosing and easier administration. Dosing must be carefully calculated based on weight and serum potassium levels. Risk of hyperkalemia is higher in neonates and infants due to immature renal function.
Geriatric Use
Increased risk of hyperkalemia due to age-related decline in renal function and potential for polypharmacy (e.g., concomitant use of 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 potassium chloride extended-release tablets with food or immediately after a meal to minimize gastrointestinal irritation and improve tolerability.
- Swallow the tablets whole; crushing, chewing, or sucking on them can lead to a rapid release of potassium, causing severe GI irritation or hyperkalemia.
- Regular monitoring of serum potassium and renal function is crucial, especially in patients with renal impairment or those on concomitant medications that affect potassium levels.
- Educate patients about the symptoms of hyperkalemia (muscle weakness, fatigue, irregular heartbeat) and instruct them to seek immediate medical attention if these occur.
- Avoid concomitant use of potassium-sparing diuretics or salt substitutes containing potassium unless specifically directed and closely monitored by a physician.
Alternative Therapies
- Potassium chloride liquid solution
- Potassium chloride powder for oral solution
- Potassium gluconate (less potassium per dose)
- Potassium bicarbonate (effervescent tablets)
- Dietary potassium intake (e.g., bananas, oranges, potatoes, leafy greens)
Cost & Coverage
Average Cost:
$10 - $50 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is 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 it is a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, do not hesitate to discuss them with 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, including the amount taken and the time it happened, to facilitate prompt and effective treatment.