Usual Adult Dose for Hypokalemia

Oral:
40 to 100 mEq per day, orally, in 2 to 5 divided doses
Maximum single dose: 20 mEq per dose
Maximum daily dose: 200 mEq

Parenteral (must be diluted prior to administration):
Dose and rate of administration are dependent on patient condition

• If serum potassium is 2.5 mEq/L or higher, rate should not exceed 10 mEq/hour, and manufacturers recommend that concentration not exceed 40 mEq/L

Maximum daily dose: 200 mEq

• If treatment is urgent (serum potassium less than 2 mEq/L and electrocardiographic changes and/or muscle paralysis), infuse cautiously at up to 40 mEq/hour with continuous cardiac monitoring

Maximum daily dose: 400 mEq

• In critical situations, may administer in saline rather than dextrose (dextrose may lower serum potassium)

Comments:

• Never give injectable potassium chloride undiluted.
• The usual adult dietary intake is 50 to 100 mEq potassium per day.
• Potassium depletion sufficient to cause hypokalemia usually requires the loss of 200 mEq or more of the total body stores of potassium.

Usual Adult Dose for Prevention of Hypokalemia

Oral:
Typical dose: 20 mEq, orally, daily

• Individualize dose based on serum potassium levels
• Divide dose if more than 20 mEq per day is used

Parenteral (must be diluted prior to administration):
Dose and rate of administration are dependent on patient condition

• If serum potassium is 2.5 mEq/L or higher, rate should not exceed 10 mEq/hour, and manufacturers recommend that concentration not exceed 40 mEq/L

Maximum daily dose: 200 mEq

Comments:

• Never give injectable potassium chloride undiluted
• The usual adult dietary intake is 50 to 100 mEq potassium per day.

Usual Pediatric Dose for Hypokalemia

Birth to 16 years:
Oral solution:
Initial dose: 2 to 4 mEq/kg/day, orally, in divided doses

• Limit to 1 mEq/kg or 40 mEq per dose, whichever is lower

Maximum daily dose: 100 mEq

Parenteral (must be diluted prior to administration):
Dose and rate of administration are dependent on patient condition

• If serum potassium is 2.5 mEq/L or higher, rate should not exceed 10 mEq/hour, and manufacturers recommend that concentration not exceed 40 mEq/L

Maximum daily dose: 200 mEq

• If treatment is urgent (serum potassium less than 2 mEq/L and electrocardiographic changes and/or muscle paralysis), infuse cautiously at up to 40 mEq/hour with continuous cardiac monitoring

Maximum daily dose: 400 mEq

• In critical situations, may administer in saline rather than dextrose (dextrose may lower serum potassium)

Comments:

• Never give injectable potassium chloride undiluted

Usual Pediatric Dose for Prevention of Hypokalemia

Birth to 16 years:
Oral solution:
Initial dose: 1 mEq/kg/day, orally
Maximum daily dose: 3 mEq/kg/day

Intravenous (must be diluted prior to administration):
Dose and rate of administration are dependent on patient condition

• If serum potassium is 2.5 mEq/L or higher, rate should not exceed 10 mEq/hour, and manufacturers recommend that concentration not exceed 40 mEq/L

Maximum daily dose: 200 mEq

Comments:

• Never give injectable potassium chloride undiluted

Renal Dose Adjustments

Contraindicated in renal failure.

• May cause potassium intoxication and life-threatening hyperkalemia in patients with renal insufficiency due to reduced urinary excretion.
• Start mildly renally impaired patients, particularly if a concomitant renin-angiotensin-aldosterone inhibitor is used, on the low end of the dose range and monitor serum potassium frequently.
• Assess renal function periodically.
• Use of the dextrose containing injection may cause hyperkalemia, hyponatremia, and/or fluid overload in renally impaired patients; monitor for these reactions.

Liver Dose Adjustments

Use with caution.

• Published literature shows cirrhotic patients had baseline corrected serum potassium concentrations (measured 3 hours after oral administration) about twice that of normal subjects.
• It is recommended to start cirrhotic patients on the low end of the dose range and monitor serum potassium periodically.

Dose Adjustments

Initial dosages may be adjusted to specific patient needs based on steady state serum potassium concentrations.

Geriatrics:

• Clinical studies did not have sufficient numbers of patients 65 and older to determine if they respond differently than younger subjects, nor has reported clinical experience identified differences.
• In general, use caution, starting on the low end of the dose range, due to the likelihood of decreased hepatic, renal, or cardiac function; monitor serum potassium periodically.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to any of the ingredients
• Clinically significant hyperkalemia
• Clinically significant hyperglycemia (potassium chloride in dextrose injection)
• Concomitant potassium sparing diuretics (oral formulations)

Safety and efficacy of oral formulations have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Potassium chloride is dialyzable; however, no dose adjustment guidelines have been reported.

• Dialysis may be used for treatment of overdosage.

Other Comments

Administration advice:

• Never give injectable potassium chloride undiluted.
• Do not infuse rapidly.
• Administer oral potassium with or after food to minimize gastric irritation.

Patient advice:

• Take oral potassium with meals and a full glass of water or other liquids.
• Take this medication as prescribed.
• Check with your physician at once if tarry stools or other signs of gastrointestinal bleeding are noticed.

Frequently asked questions

• Can you eat bananas when taking losartan?