Potassium Chloride

Indications

Potassium Chloride is indicated in-

  • Replacement of potassium deficit
  • Diuretic (Potassium losing)-induced hypokalaemia
  • Hypokalaemia from renal potassium wasting
  • Hypokalaemia from gastrointestinal losses
  • Hypochloraemic alkalosis associated with hypokalaemia

Pharmacology

Potassium Chloride is used for the treatment of hypokalaemia and of potassium deficiency states. Potassium ion is the principal intracellular cation of most body tissues. It participates in a number of essential physiological processes, including the maintenance of intracellular tonicity, the transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle and the maintenance of normal renal function.

Dosage And Administration

Oral dose: It should be taken with or after meals with plenty of fluid (water/fruit juice). Typical doses for the prevention of hypokalaemia may be upto 50 mmol (about 37.5 mL) daily by mouth. Oral treatment may be suitable in some cases of hypokalaemia and similar doses to those used for prevention may be adequate in mild potassium deficiency. However, higher doses may be needed in more severe deficiency.

Parenteral dose: Intravenous administration may be required in acute hypokalaemia. One ampoule (10 mL) i.e. 1.5 gm (20 mmol k+) may be added to 500 mL of sodium chloride or glucose intravenous infusion and given slowly over 2 to 3 hours with specialist advice and ECG monitoring in difficult cases. Repeated measurements of potassium are necessary to determine whether further infusions are required and to avoid the development of hyperkalaemia. This is especially liable to occur in renal impairment.

Interaction

Combined treatment with the following increase the risk of hyperkalaemia: Angiotensin-converting enzyme inhibitors, cyclosporin, NSAIDs, beta-blockers, heparin, digoxin, potassium-sparing diuretics.

Contraindications

Hypersensitivity to potassium administration e.g. hyperkalaemic periodic paralysis, congenital paramyotonia, marked renal failure (even when not yet associated with manifest hyperkalaemia), untreated Addison's disease, hyporeninaemic hypoaldosteronism, acute dehydration, hyperkalaemia and conditions involving extensive cell destruction (e.g. severe burns). In case of metabolic acidosis, the hypokalaemia should be treated not with potassium chloride.

Side Effects

Excessive administration of potassium leads to development of hyperkalaemia, the symptoms of which include paraesthesia of the extremitis, muscle weakness, paralysis, hypotension, cardiac arrhythmias, heart block and cardiac arrest. Pain or phlebitis may occur during I.V. administration of solutions containing about 30 mmol or more potassium per litre. Nausea, vomiting, diarrhoea and abdominal cramps may occur following oral administration.

Pregnancy And Lactation

As a general rule, no drugs should be taken during the first three months of pregnancy and the risks & benefits of taking drugs should be carefully considered throughout pregnancy. There are no contraindications to breastfeeding while taking potassium salts.

Precautions And Warnings

It should be administered with caution to patients with renal or adrenocortical insufficiency, cardiac disease, acute dehydration, heat cramps, extensive tissue destruction as occurs with severe burns, or to patients receiving potassium-sparing diuretics. Excessive use of potassium-containing salt substitutes or concurrent administration with potassium supplements may lead to accumulation of potasssium especially in patients with renal insufficiency. Attention should be paid to the concurrent use of other drugs that either contain potassium or have the potential for hyperkalaemia. Treatment should be discontinued if severe nausea, vomiting or abdominal distress develops.

Therapeutic Class

Electrolytes preparations, Oral electrolytes preparations.

Use in special populations

Use in children: No special precautions are required.

Storage Conditions

Store below 25°C in a dry place, away from light. Keep out of the reach of children.