Drugs List

Therapeutic Indications

Uses

Potassium depletion

Prophylaxis and treatment of hypokalaemia associated with:

Use of drugs which can induce potassium depletion e.g. furosemide, thiazide diuretics, corticosteroids, carbenoxolone and cardiac glycosides, especially in combination with diuretics.

Potassium loss resulting from severe diarrhoea, vomiting or fistulas.

Acid-base disturbances e.g. alkalosis, renal tubular acidosis, states in which there is aldosterone excess, Cushing syndrome.

Decreased intake of potassium e.g. malnutrition, alcoholism, some elderly patients with deficient diets.

Hypochloraemic alkalosis.

Contraindications

Crush injuries
Dehydration
Hereditary fructose intolerance
Hyperkalaemia
Severe burn
Severe renal impairment
Uncontrolled Addison's disease

Precautions and Warnings

Elderly
Cardiac disorder
Glucose-galactose malabsorption syndrome
Hypertension
Myotonia congenita
Renal impairment
Severe haemolysis

Preparation contains sucrose
Monitor acid-base balance
Monitor cardiac function by ECG
Monitor serum electrolytes

Pregnancy and Lactation

Pregnancy

Potassium chloride is a natural constituent of human tissues and fluids. Because high or low levels are detrimental to maternal and fetal cardiac function serum levels must be monitored frequently and dose adjusted accordingly.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Breast milk is naturally high in potassium with levels that are 3 to 4 times those in plasma. Potassium freely passes into and out of milk, the use of potassium chloride by a lactating woman with normal plasma potassium levels would have no adverse effect on a nursing infant.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal discomfort
Diarrhoea
Gastric irritation
Hyperkalaemia
Nausea
Vomiting

Presentation

Oral formulations of potassium bicarbonate and potassium chloride.

Drugs List

Therapeutic Indications

Uses

Potassium depletion

Prophylaxis and treatment of hypokalaemia associated with:

Use of drugs which can induce potassium depletion e.g. furosemide, thiazide diuretics, corticosteroids, carbenoxolone and cardiac glycosides, especially in combination with diuretics.

Potassium loss resulting from severe diarrhoea, vomiting or fistulas.

Acid-base disturbances e.g. alkalosis, renal tubular acidosis, states in which there is aldosterone excess, Cushing syndrome.

Decreased intake of potassium e.g. malnutrition, alcoholism, some elderly patients with deficient diets.

Hypochloraemic alkalosis.

Dosage

Effervescent tablets containing potassium bicarbonate 400mg and potassium chloride 600mg. This is equivalent to potassium 470mg (12mmol potassium(K+)) and chloride 285mg (8mmol chloride (Cl-)).

Dosage depends on cause, severity and duration of potassium depletion and should be adjusted accordingly.

Adults

Children

Contraindications

Crush injuries
Dehydration
Hereditary fructose intolerance
Hyperkalaemia
Severe burn
Severe renal impairment
Uncontrolled Addison's disease

Precautions and Warnings

Elderly
Cardiac disorder
Glucose-galactose malabsorption syndrome
Hypertension
Myotonia congenita
Renal impairment
Severe haemolysis

Preparation contains sucrose
Monitor acid-base balance
Monitor cardiac function by ECG
Monitor serum electrolytes

Pregnancy and Lactation

Pregnancy

Potassium chloride is a natural constituent of human tissues and fluids. Because high or low levels are detrimental to maternal and fetal cardiac function serum levels must be monitored frequently and dose adjusted accordingly.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Breast milk is naturally high in potassium with levels that are 3 to 4 times those in plasma. Potassium freely passes into and out of milk, the use of potassium chloride by a lactating woman with normal plasma potassium levels would have no adverse effect on a nursing infant.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal discomfort
Diarrhoea
Gastric irritation
Hyperkalaemia
Nausea
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: January 2019

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.

Summary of Product Characteristics: Sando-K Effervescent Tablets. HK Pharma Limited. Revised November 2015.