Last updated: July 2021
- Treatment of severe hypokalaemia (arrhythmia, marked muscular weakness and/or serum potassium level ≤ 2.5 mmol/litre)
Forms and strengths, route of administration
- 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.
Dosage and duration
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.
0.2 (mmol) x 10 (kg) = 2 mmol/hour x 3 hours = 6 mmol
0.2 (mmol) x 15 (kg) = 3 mmol/hour x 3 hours = 9 mmol
- 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.
Contra-indications, adverse effects, precautions
- 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.
- 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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