potassium chloride: clinical use

Prescribing considerations

• Confirm hypokalaemia or clinically relevant depletion and identify the underlying cause.
• Account for renal function, gastrointestinal disease, cardiac disease, digitalis therapy, acid-base disturbance and medicines that increase potassium.
• Use extra caution in older people and patients with renal or hepatic dysfunction.
• The syrup contains sorbitol and is unsuitable in hereditary fructose intolerance. Its benzoate and propylene-glycol content requires particular consideration in neonates.

Contraindications and cautions

• Hypersensitivity to potassium chloride or an excipient
• Hyperkalaemia
• Advanced severe renal failure or renal impairment with oliguria
• Inadequately treated Addison's disease
• Acute dehydration
• Extensive cell destruction, including severe burns
• Crush injury

Monitoring

• Serum potassium and other relevant electrolytes
• Renal function and urine output
• Clinical response and ongoing potassium losses
• ECG where clinically indicated, particularly with cardiac disease, digitalis treatment or significant electrolyte disturbance
• Acid-base status in patients with acidosis
• Gastrointestinal symptoms suggesting irritation, ulceration or obstruction

Clinical pharmacology

Oral potassium chloride dissociates into potassium and chloride. Potassium is absorbed from the gastrointestinal tract, enters intracellular fluid and contributes to membrane potential, neuromuscular excitability, enzyme activity and renal electrolyte homeostasis. Excess potassium is eliminated mainly by the kidneys.

Formulation and product differences

• The selected product is an oral, sorbitol-containing syrup; its concentration and excipients must be checked when switching from another liquid.
• Oral potassium products are not interchangeable volume-for-volume without checking their potassium content.
• Intravenous potassium products have distinct safety requirements and should be administered in hospital with appropriate controls and monitoring.

Syrup

Route: Oral

Strengths: 7.5% w/v