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Potassium Cl 2meq/ml Inj 30ml

Manufacturer FRESENIUS KABI Active Ingredient Potassium Chloride Injection Solution(poe TASS ee um KLOR ide) Pronunciation Poe-TASS-ee-um KLOR-ide
It is used to treat or prevent low potassium levels.
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Drug Class
Electrolyte replacement; Mineral supplement
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Pharmacologic Class
Electrolyte; Potassium salt
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Pregnancy Category
Category C
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

Potassium chloride is a medicine used to treat or prevent low levels of potassium in your blood. Potassium is a very important mineral that your body needs to work properly, especially for your heart, muscles, and nerves. This medicine is given as an injection into a vein, usually when you cannot take potassium by mouth or when your potassium levels are very low and need to be corrected quickly.
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How to Use This Medicine

Taking Your Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the dosage instructions carefully. This medication is administered as an infusion into a vein over a specified period.

Storing and Disposing of Your Medication

If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.

Missing a Dose

If you miss a dose, contact your doctor immediately to receive guidance on what to do next.
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Lifestyle & Tips

  • Follow your doctor's instructions regarding diet, especially if you have kidney problems or are taking other medications that affect potassium levels.
  • Report any unusual symptoms such as muscle weakness, tingling, numbness, or a slow/fast/irregular heartbeat immediately.
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Available Forms & Alternatives

Available Strengths:

Dosing & Administration

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Adult Dosing

Standard Dose: Highly variable based on serum potassium level, clinical symptoms, and patient's acid-base status. For severe hypokalemia (K+ <2.5 mEq/L) with ECG changes or paralysis: 10-20 mEq/hour IV, maximum 40 mEq/hour. For moderate hypokalemia (K+ 2.5-3.5 mEq/L): 10 mEq/hour IV. For maintenance: 20-60 mEq/day IV or PO.

Condition-Specific Dosing:

hypokalemia_severe: 10-20 mEq/hour IV, max 40 mEq/hour (requires continuous ECG monitoring and central line for rates >10 mEq/hour)
hypokalemia_moderate: 10 mEq/hour IV
maintenance: 20-60 mEq/day IV or PO
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Pediatric Dosing

Neonatal: Not established for routine use; consult specialist. For severe hypokalemia: 0.5-1 mEq/kg/dose IV over 1-2 hours, max 1 mEq/kg/hour.
Infant: For severe hypokalemia: 0.5-1 mEq/kg/dose IV over 1-2 hours, max 1 mEq/kg/hour. Max 3 mEq/kg/day.
Child: For severe hypokalemia: 0.5-1 mEq/kg/dose IV over 1-2 hours, max 1 mEq/kg/hour. Max 3 mEq/kg/day. For maintenance: 2-3 mEq/kg/day IV or PO in divided doses.
Adolescent: Similar to adult dosing, but consider weight. For severe hypokalemia: 0.5-1 mEq/kg/dose IV over 1-2 hours, max 1 mEq/kg/hour. Max 3 mEq/kg/day. For maintenance: 2-3 mEq/kg/day IV or PO in divided doses.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor serum potassium closely.
Moderate: Reduce dose and/or frequency; monitor serum potassium and renal function frequently. Avoid if possible.
Severe: Contraindicated in severe renal impairment (e.g., anuria, oliguria, acute renal failure) due to high risk of hyperkalemia. If absolutely necessary, use extremely low doses with continuous ECG and potassium monitoring.
Dialysis: Generally contraindicated in patients on dialysis unless specifically indicated for severe hypokalemia and under strict monitoring. Dialysis itself removes potassium.

Hepatic Impairment:

Mild: No specific adjustment needed.
Moderate: No specific adjustment needed.
Severe: No specific adjustment needed, but monitor for concomitant renal impairment which is common in severe liver disease.

Pharmacology

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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, muscle contraction (especially cardiac muscle), and renal function.
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Pharmacokinetics

Absorption:

Bioavailability: 100% (IV administration)
Tmax: Rapid (IV administration)
FoodEffect: Not applicable for IV; oral forms may be affected by food.

Distribution:

Vd: Approximately 0.5 L/kg (reflects total body water)
ProteinBinding: Negligible
CnssPenetration: Limited

Elimination:

HalfLife: Not applicable for an electrolyte; plasma half-life is very short as it rapidly equilibrates between intra- and extracellular compartments. Renal excretion is the primary regulatory mechanism.
Clearance: Primarily renal clearance, regulated by aldosterone and acid-base status.
ExcretionRoute: Renal (approximately 90%), small amounts via feces and sweat.
Unchanged: 100%
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Pharmacodynamics

OnsetOfAction: Immediate (IV administration)
PeakEffect: Within minutes to hours, depending on dose and rate of administration.
DurationOfAction: Dependent on renal function and ongoing potassium losses; typically hours.

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when 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 low sodium levels, such as:
+ Headache
+ Difficulty focusing
+ Memory problems
+ Confusion
+ Weakness
+ Seizures
+ Changes in balance
 Shortness of breath, significant weight gain, or swelling in the arms or legs
* Tissue damage at the injection site, characterized by:
+ Redness
+ Burning
+ Pain
+ Swelling
+ Blisters
+ Skin sores
+ Leaking of fluid

If you experience any of these symptoms, notify your nurse immediately.

Other Possible Side Effects

Like all medications, this drug can cause side effects, although not everyone will experience them. If you have any side effects that bother you or persist, contact your doctor for guidance.

Please note that this list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor.

To report side effects, you can contact the FDA at 1-800-332-1088 or visit their website at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Muscle weakness or paralysis
  • Tingling or numbness in hands or feet
  • Fatigue
  • Slow or irregular heartbeat (palpitations)
  • Shortness of breath
  • Confusion
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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, such as foods or drugs. 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.

Please note that this is not an exhaustive list of all potential interactions. To ensure your safety, it is crucial to disclose all of your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you may have. Your doctor and pharmacist need this information to assess the safety of taking this medication in conjunction with your other treatments. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
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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 follow the dosage instructions provided by your doctor, as taking more than the recommended amount can increase the risk of severe side effects. If you follow a low-sodium diet or use a salt substitute, consult with your doctor to discuss any potential interactions. Certain formulations of this medication are not suitable for children, so it is crucial to consult with your doctor if you have any questions or concerns. Additionally, if you are pregnant, planning to become pregnant, or breastfeeding, you should discuss the potential benefits and risks of this medication with your doctor to make an informed decision about your treatment.
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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 complex, ventricular fibrillation, asystole)
  • Cardiac arrest

What to Do:

Immediate medical attention is required. Management includes: stopping potassium infusion, administering calcium gluconate (to stabilize cardiac membrane), insulin and glucose (to shift potassium intracellularly), sodium bicarbonate (for acidosis), beta-2 agonists (e.g., albuterol), and loop diuretics. In severe cases, hemodialysis may be necessary. Call 911 or 1-800-222-1222 (Poison Control).

Drug Interactions

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Contraindicated Interactions

  • Potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene) in patients with hyperkalemia or significant renal impairment.
  • Eplerenone (in patients with hyperkalemia or significant renal impairment).
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Major Interactions

  • ACE inhibitors (e.g., lisinopril, enalapril): Increased risk of hyperkalemia.
  • Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan): Increased risk of hyperkalemia.
  • NSAIDs (e.g., ibuprofen, naproxen): May reduce renal potassium excretion, increasing hyperkalemia risk.
  • Cyclosporine, Tacrolimus: Increased risk of hyperkalemia.
  • Digoxin: Hyperkalemia can antagonize the effects of digoxin, while hypokalemia can potentiate digoxin toxicity.
  • Beta-blockers (non-selective): May impair cellular uptake of potassium, increasing serum levels.
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Moderate Interactions

  • Heparin: May cause hypoaldosteronism, leading to hyperkalemia.
  • Trimethoprim: Can cause hyperkalemia, especially in high doses or with renal impairment.
  • Succinylcholine: May cause a transient increase in serum potassium, especially in patients with pre-existing hyperkalemia or conditions predisposing to it (e.g., burns, trauma).

Monitoring

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Baseline Monitoring

Serum Potassium (K+)

Rationale: To determine baseline potassium status and guide initial dosing.

Timing: Prior to initiation of therapy.

Renal Function (BUN, Creatinine, GFR)

Rationale: Potassium is primarily renally excreted; impaired renal function increases risk of hyperkalemia.

Timing: Prior to initiation of therapy.

Electrocardiogram (ECG)

Rationale: To assess for cardiac manifestations of hypokalemia (e.g., U waves, flattened T waves, ST depression) or hyperkalemia (e.g., peaked T waves, widened QRS, prolonged PR interval).

Timing: Prior to initiation, especially in severe hypokalemia or with rapid infusion.

Other Electrolytes (Magnesium, Calcium, Phosphate)

Rationale: Hypomagnesemia can impair potassium repletion; other electrolyte imbalances may coexist.

Timing: Prior to initiation of therapy.

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Routine Monitoring

Serum Potassium (K+)

Frequency: Every 2-4 hours during rapid repletion; daily during maintenance; more frequently if renal function is impaired or patient is critically ill.

Target: 3.5-5.0 mEq/L

Action Threshold: If K+ >5.0 mEq/L, hold infusion and assess for hyperkalemia. If K+ <3.5 mEq/L, continue or adjust dose as needed.

Electrocardiogram (ECG)

Frequency: Continuous monitoring during rapid IV infusion (>10 mEq/hour) or in severe hypokalemia/hyperkalemia. Intermittent monitoring otherwise.

Target: Normal sinus rhythm, absence of hyperkalemia/hypokalemia signs.

Action Threshold: Any signs of hyperkalemia (peaked T waves, widened QRS) or persistent hypokalemia (U waves, arrhythmias) require immediate intervention.

Renal Function (BUN, Creatinine)

Frequency: Daily or every other day, especially in patients with pre-existing renal impairment or those receiving high doses.

Target: Stable, within patient's baseline.

Action Threshold: Significant decline in renal function warrants dose reduction or discontinuation.

Fluid Balance (I&O)

Frequency: Daily

Target: Appropriate for patient's clinical status.

Action Threshold: Significant fluid retention or dehydration may impact electrolyte balance.

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Symptom Monitoring

  • Symptoms of hyperkalemia: muscle weakness, paresthesias, fatigue, flaccid paralysis, bradycardia, hypotension, cardiac arrhythmias (palpitations, irregular heartbeat).
  • Symptoms of hypokalemia: muscle weakness, cramps, fatigue, constipation, ileus, polyuria, cardiac arrhythmias (palpitations, irregular heartbeat).

Special Patient Groups

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Pregnancy

Potassium is an essential electrolyte. While there are no adequate and well-controlled studies of potassium chloride in pregnant women, it is generally considered safe when used to correct or prevent hypokalemia. Use only if clearly needed and the benefit outweighs the potential risk.

Trimester-Specific Risks:

First Trimester: No specific risks identified beyond general electrolyte balance.
Second Trimester: No specific risks identified beyond general electrolyte balance.
Third Trimester: No specific risks identified beyond general electrolyte balance.
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Lactation

Potassium is a normal component of breast milk. Exogenous potassium chloride is generally considered compatible with breastfeeding when administered in appropriate therapeutic doses to correct maternal hypokalemia. Monitor infant for any signs of electrolyte imbalance, though unlikely.

Infant Risk: Low risk; unlikely to cause adverse effects in a breastfed infant at therapeutic maternal doses.
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Pediatric Use

Dosing must be carefully calculated based on weight, age, and severity of hypokalemia. Infusion rates should be slower than in adults, and continuous ECG monitoring is often recommended, especially for higher concentrations or faster rates. Renal function must be closely monitored.

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Geriatric Use

Elderly patients are at increased risk for renal impairment, which can lead to potassium accumulation and hyperkalemia. They may also be on medications that affect potassium levels (e.g., ACE inhibitors, ARBs, diuretics). Close monitoring of serum potassium and renal function is essential. Start with lower doses and titrate carefully.

Clinical Information

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Clinical Pearls

  • ALWAYS dilute potassium chloride injection before intravenous administration. Never administer undiluted or by IV push, as this can be fatal.
  • Maximum recommended concentration for peripheral IV infusion is typically 20-40 mEq/L. Higher concentrations (e.g., 60-80 mEq/L) should be administered via a central venous line with continuous ECG monitoring.
  • Maximum infusion rate for peripheral IV is generally 10 mEq/hour. Higher rates (up to 20-40 mEq/hour) are reserved for severe, life-threatening hypokalemia and require central line access and continuous ECG monitoring.
  • Rapid correction of hypokalemia can lead to hyperkalemia, especially in patients with impaired renal function. Frequent monitoring of serum potassium and ECG is crucial.
  • Hypomagnesemia often coexists with hypokalemia and can make potassium repletion refractory. Magnesium should be repleted concurrently if deficient.
  • Patients receiving potassium chloride should have adequate urine output before administration to prevent accumulation and hyperkalemia.
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Alternative Therapies

  • Oral potassium supplements (e.g., potassium chloride tablets, solutions, powders) for mild to moderate hypokalemia or maintenance.
  • Dietary potassium intake (e.g., bananas, oranges, potatoes, leafy greens) for prevention or mild cases.
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Cost & Coverage

Average Cost: Highly variable, typically low cost per 30ml vial (2meq/ml)
Generic Available: Yes
Insurance Coverage: Tier 1 (Generic)
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General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the quantity, and the time of ingestion.