Indications
Treatment of severe hypokalaemia (arrhythmia, marked muscular weakness and/or serum potassium level ≤ 2.5 mmol/litre)
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Drug reference
Treatment of severe hypokalaemia (arrhythmia, marked muscular weakness and/or serum potassium level ≤ 2.5 mmol/litre)
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Administer with caution to older adults. Administer with caution and reduce the dose in patients with renal impairment (increased risk of hyperkalaemia). May cause: pain at infusion site, venous irritation and phlebitis (use a large peripheral vein to reduce these risks); in the event of too rapid administration or overdose: hyperkalaemia, cardiac conduction and rhythm disorders, potentially fatal; in the event of extravasation: necrosis. Monitor closely: infusion rate; use an infusion pump or syringe pump if possible to prevent unintentional bolus; infusion site for redness and inflammation. Monitor electrolytes if possible to determine the need for further infusions and to avoid hyperkalaemia.
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Ampoule containing 15% potassium chloride hypertonic solution (150 mg/ml, 10 ml = 2 mmol/ml), i.e. 1.5 g of potassium chloride (KCl) per 10 ml ampoule Ionic composition: + potassium (K ): 20 mmol per 10 ml ampoule (20 mEq) – chloride (Cl ): 20 mmol per 10 ml ampoule (20 mEq) Check concentration before use: potassium chloride also comes in ampoules containing 7.5%, 10%, 11.2% and 20% solutions. Potassium chloride must always be administered by slow IV infusion, diluted in 0.9% sodium chloride. For dilution: The potassium concentration in the infusion fluid should not exceed 40 mmol/litre. Mix thoroughly the potassium and the 0.9% sodium chloride solution by inverting at least 5 times the infusion bottle or bag. NEVER USE BY DIRECT UNDILUTED IV OR IM OR SC INJECTION.
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Dosage depends on the severity of hypokalaemia and the patient’s underlying condition. For information: Child over one month: 0.2 mmol/kg/hour for 3 hours Each mmol of potassium is diluted in 25 ml of 0.9% sodium chloride. Examples: 0.2 (mmol) x 10 (kg) = 2 mmol/hour x 3 hours = 6 mmol 10 kg 6 mmol (= 3 ml of 15% KCl solution) diluted in 150 ml of NaCl 0.9% and administered over 3 hours 0.2 (mmol) x 15 (kg) = 3 mmol/hour x 3 hours = 9 mmol 15 kg 9 mmol (= 4.5 ml of 15% KCl solution) diluted in 225 ml of NaCl 0.9% and administered over 3 hours Adult: 40 mmol (= 2 ampoules of 10 ml of 15% KCl) in one litre of 0.9% sodium chloride, to be administered over 4 hours Do not exceed 10 mmol/hour. The infusion may be repeated if severe symptoms persist or if the serum potassium level remains < 3 mmol/litre.
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Higher dose or infusion rate requires continuous electrocardiogram monitoring. Potassium chloride is also used to prevent hypokalaemia in patients unable to meet their daily + requirements by oral route : daily K requirements are 2 to 3 mmol/kg daily in children and 1 to 2 mmol/kg daily in adults. + A 7.5% potassium solution contains 1 mmol of K /ml; a 10% solution contains 1.34 mmol/ml ; a + + 11.2% solution contains 1.5 mmol of K /ml; a 20% solution contains 2.68 mmol of K /ml.
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Below 25 °C
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40 mmol (= 2 ampoules of 10 ml of 15% KCl) in one litre of 0.9% sodium chloride, to be administered over 4 hours
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