Potassium chloride oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations containing potassium chloride.
Drugs List
Therapeutic Indications
Uses
Potassium depletion
Dosage
The dosage should be adapted for individual requirements depending on cause, degree, and duration of hypokalaemia.
Response to treatment should be monitored by repeat plasma potassium analysis until hypokalaemia has been corrected.
Adults
Syrup
10ml to 50ml of potassium chloride 7.5% liquid per day in divided doses after food.
At higher doses and particularly in patients with more severe hypokalaemic conditions, the dose should be determined by the patients response as determined by serum electrolyte levels and acid-base studies.
Tablets
One tablet every 12 hours.
The following alternative dosing schedule may be suitable:
2g to 4g daily in divided doses.
Children
Syrup
Children 1 to 12 years
0.5ml/kg to 1.0ml/kg bodyweight of potassium chloride 7.5% liquid per day in divided doses after food. The dose should be administered using a graduated dropper.
Children under 1 year
0.5ml/kg to 0.75ml/kg bodyweight of potassium chloride 7.5% liquid per day in divided doses after food. The dose should be administered using a graduated dropper.
Tablets
Children aged 12 to 18 years: (See Dosage; Adult)
Contraindications
Baseline serum potassium above 5 mmol/L
Dehydration
Gastrointestinal haemorrhage
Hereditary fructose intolerance
Hyperchloraemia
Hyperkalaemia
Hyporeninaemic hypoaldosteronism
Metabolic acidosis
Renal impairment - glomerular filtration rate below 20ml/minute
Severe burn
Uncontrolled Addison's disease
Precautions and Warnings
Children under 18 years
Elderly
Cardiac impairment
Decreased gastrointestinal motility
Gastrointestinal obstruction
Gastrointestinal stenosis
Glucose-galactose malabsorption syndrome
Hepatic impairment
Hiatus hernia
History of peptic ulcer
Pregnancy
Renal impairment - glomerular filtration rate 20-60ml/minute
Not all available brands are licensed for all age groups
Oral liquid contains propylene glycol
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some formulations contain sucrose
Discontinue if signs of gastro-intestinal bleeding occur
Monitor renal function regularly
Monitor serum electrolytes in patients with cardiac impairment
Monitor serum electrolytes in patients with renal impairment
Monitor serum potassium in patients with renal impairment
Monitor serum potassium periodically
Discontinue if signs of gastro-intestinal ulceration occur
Discontinue if early signs of stricture occur
Interrupt or reduce dose if significant gastrointestinal disturbances occur
Modified release preparations of potassium chloride should be avoided unless effervescent tablets or liquid preparations are inappropriate.
Hypomagnesaemia which is diuretic induced can prevent restoration of intracellular deficits of potassium; hypomagnesaemia should be corrected at the same time as hypokalaemia.
All solid forms of potassium medication are contraindicated in the presence of obstructions in the digestive tract (e.g. resulting from compression of the oesophagus due to dilation of the left atrium or from stenosis of the gut).
Pregnancy and Lactation
Pregnancy
Potassium chloride can be used during pregnancy.
Briggs (2015) suggests that potassium chloride is safe for use during pregnancy by women who are or could become hypokalaemic. Potassium chloride is a constituent of human tissue and fluid and a good balance needs to be maintained, as both high or low levels can be detrimental to maternal and foetal cardiac function. Due to the gastro-intestinal hypomotility associated with pregnancy, modified release formulations should be avoided and an alternative dosage form may be more appropriate if potassium supplementation is required.
Lactation
Potassium chloride can be used during breastfeeding.
It is expected that this preparation would have little or no effect on breast milk providing normal plasma potassium concentrations are not exceeded. Potassium chloride is found naturally in high concentrations in breast milk, and freely passes in and out. Supplementing the mother is unlikely to have any adverse effect on milk composition and the nursing infant.
Counselling
Advise patients to swallow the tablets whole, during meals, with plenty of fluid, while sitting in an upright position or standing.
Side Effects
Abdominal cramps
Abdominal pain
Diarrhoea
Gastro-intestinal perforation
Gastro-intestinal ulceration
Gastrointestinal bleeding
Hyperkalaemia
Intestinal obstruction
Irregular pulse
Limpness
Muscle weakness
Nausea
Numbness
Pruritus
Rash
Tingling in extremities
Urticaria
Vomiting
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: October 2016
Reference Sources
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. Accessed on 11 October 2016.
Paediatric Formulary Committee. BNF for Children (online) London: BMJ Group, Pharmaceutical Press, and RCPCH Publications. Accessed on 11 October 2016.
Summary of Product Characteristics: Kay-Cee-L Syrup. Geistlich Sons Ltd. Revised July 2015.
Summary of Product Characteristics: PotaChlor 600mg MR Oral Tablets. TriOn Pharma UK. Revised September 2021.
Summary of Product Characteristics: Slow-K Tablets 600mg. Alliance Pharmaceuticals Ltd. Revised May 2015.
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