If potassium depletion associated with metabolic alkalosis cannot be managed by correcting the fundamental cause of the deficiency, e. In rare circumstances e. In such patients potassium replacement should be accomplished with potassium salts other than the chloride, such as potassium bicarbonate, potassium citrate, potassium acetate or potassium gluconate.
The wax matrix is not absorbed and is excreted in the feces; in some instances the empty matrices may be noticeable in the stool. The use of potassium salts in patients receiving diuretics for uncomplicated essential hypertension is often unnecessary when such patients have a normal dietary pattern and when low doses of the diuretic are used.
Serum potassium should be checked periodically, however, and if hypokalemia occurs, dietary supplementation with potassium-containing foods may be adequate to control milder cases. In more severe cases, and if dose adjustment of the diuretic is ineffective or unwarranted, supplementation with potassium salts may be indicated. Potassium supplements are contraindicated in patients with hyperkalemia since a further increase in serum potassium concentration in such patients can produce cardiac arrest.
Hyperkalemia may complicate any of the following conditions: chronic renal failure, systemic acidosis such as diabetic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal insufficiency or the administration of a potassium-sparing diuretic e. Extended-release formulations of potassium chloride have produced esophageal ulceration in certain cardiac patients with esophageal compression due to an enlarged left atrium.
Potassium supplementation, when indicated in such patients, should be given as a liquid preparation. All solid oral dosage forms of potassium chloride are contraindicated in any patient in whom there is structural, pathological e. This occurs most commonly in patients given potassium by the intravenous route but may also occur in patients given potassium orally. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic. The use of potassium salts in patients with chronic renal disease, or any other condition which impairs potassium excretion, requires particularly careful monitoring of the serum potassium concentration and appropriate dosage adjustment.
Interaction with Potassium-sparing Diuretics: Hypokalemia should not be treated by the concomitant administration of potassium salts and a potassium-sparing diuretic e. Potassium supplements should be given to patients receiving ACE inhibitors only with close monitoring. Based on spontaneous adverse reaction reports, enteric-coated preparations of potassium chloride are associated with an increased frequency of small bowel lesions per , patient years compared to extended-release wax matrix formulations less than one per , patient years.
Because of the lack of extensive marketing experience with microencapsulated products, a comparison between such products and wax matrix or enteric-coated products is not available.
Prospective trials have been conducted in normal human volunteers in which the upper gastrointestinal tract was evaluated by endoscopic inspection before and after one week of solid oral potassium chloride therapy. The ability of this model to predict events occurring in usual clinical practice is unknown. Trials which approximated usual clinical practice did not reveal any clear differences between the wax matrix and microencapsulated dosage forms.
In contrast, there was a higher incidence of gastric and duodenal lesions in subjects receiving a high dose of a wax matrix extended-release formulation under conditions which did not resemble usual or recommended clinical practice i.
The upper gastrointestinal lesions observed by endoscopy were asymptomatic and were not accompanied by evidence of bleeding hemoccult testing. The relevance of these findings to the usual conditions i. Metabolic Acidosis: Hypokalemia in patients with metabolic acidosis should be treated with an alkalinizing potassium salt such as potassium bicarbonate, potassium citrate, potassium acetate or potassium gluconate.
General: The diagnosis of potassium depletion is ordinarily made by demonstrating hypokalemia in a patient with a clinical history suggesting some cause for potassium depletion. In interpreting the serum potassium level, the physician should be aware that acute alkalosis per se can produce hypokalemia in the absence of a deficit in total body potassium while acute acidosis per se can increase the serum potassium concentration into the normal range even in the presence of a reduced total body potassium.
The treatment of potassium depletion, particularly in the presence of cardiac disease, renal disease or acidosis requires careful attention to acid-base balance and appropriate monitoring of serum electrolytes, the electrocardiogram and the clinical status of the patient. Information for Patients: Physicians should consider reminding the patient of the following:.
Laboratory Tests: When blood is drawn for analysis of plasma potassium it is important to recognize that artifactual elevations can occur after improper venipuncture technique or as a result of in vitro hemolysis of the sample.
Carcinogenesis, Mutagenesis, Impairment of Fertility: Carcinogenicity, mutagenicity and fertility studies in animals have not been performed. Potassium is a normal dietary constituent. Pregnancy: Pregnancy Category C. It is unlikely that potassium supplementation that does not lead to hyperkalemia would have an adverse effect on the fetus or would affect reproductive capacity. Nursing Mothers: The normal potassium ion content of human milk is about 13 mEq per liter.
Since oral potassium becomes part of the body potassium pool, so long as body potassium is not excessive, the contribution of potassium chloride supplementation should have little or no effect on the level in human milk. Pediatric Use: Safety and effectiveness in the pediatric population have not been established. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
These symptoms are due to irritation of the gastrointestinal tract and are best managed by taking the dose with meals or reducing the amount taken at one time. The administration of oral potassium salts to persons with normal excretory mechanisms for potassium rarely causes serious hyperkalemia. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum potassium concentration 6.
In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the serum potassium concentration can produce digitalis toxicity. The extended release feature means that absorption and toxic effects may be delayed for hours.
Consider standard measures to remove any unabsorbed drug. The usual dietary potassium intake by the average adult is 50 to mEq per day. You should not use this medicine if you have high levels of potassium in your blood hyperkalemia , or if you also take a "potassium-sparing" diuretic.
Potassium is a mineral that is needed for several functions of your body, especially the beating of your heart. Potassium chloride is used to prevent or to treat low blood levels of potassium hypokalemia. Potassium levels can be low as a result of a disease or from taking certain medicines, or after a prolonged illness with diarrhea or vomiting.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Potassium chloride oral is taken by mouth. Potassium chloride injection is given as a slow infusion into a vein.
A healthcare provider will give you this medicine by injection if you have severely low potassium levels. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when potassium chloride is injected. Do not crush, chew, or suck on a potassium tablet or capsule. Sucking on the pill could irritate your mouth or throat.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device not a kitchen spoon. Mix the oral solution with least 4 ounces of water before taking it. You may need to follow a special diet while using potassium chloride. Follow all instructions of your doctor or dietitian.
Learn about the foods to eat or avoid to help control your condition. Call your doctor if you have trouble swallowing a potassium chloride capsule or tablet. You may be able to dissolve the tablet in water, or mix the medicine from a capsule with soft food.
Carefully follow your doctor's instructions. You may need frequent medical tests. Even if you have no symptoms, tests can help your doctor determine if this medicine is effective. Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective. Store at room temperature away from moisture, heat, and light. Keep the medication in a closed container. Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose.
Do not take two doses at one time. Overdose symptoms may include stomach pain, vomiting, irregular heartbeats, chest pain, muscle weakness, loss of movement, numbness or tingling, or feeling light-headed.
Do not use potassium supplements or other products that contain potassium, unless your doctor has told you to. Salt substitutes or low-salt foods often contain potassium.
Read the label of any food or medicine to see if it contains potassium. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
This list is not complete.
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