Potassium Chloride

Common Side Effects of Potassium Chloride

You should tell your doctor if any of the following side effects are severe or do not go away:

• Vomiting
• Upset stomach
• Diarrhea

On occasion, an empty tablet or capsule shell may appear in your stool. This effect is harmless because your body has absorbed the medication.

Serious Side Effects of Potassium Chloride

You should contact your doctor immediately if you experience any of the following serious side effects:

• Mental confusion
• Tingling, prickling, burning, tight, or pulling sensation of arms, hands, legs, or feet
• Stomach pain
• Lethargy
• Heaviness or weakness of legs
• Cold, pale, or gray skin
• Unusual stomach bulging
• Black stools

You should tell your doctor about all prescription, non-prescription, illegal, and recreational drugs; herbal remedies; nutritional or dietary supplements you're taking, especially:

• Angiotensin-converting enzyme (ACE) inhibitors, such as captopril (Capoten), enalapril (Vasotec), and lisinopril (Prinivil, Zestril)
• Angiotensin-receptor blockers (ARB), such as losartan (Cozaar), diovan (Valsartan), or irbesartan (Avapro)
• Diuretic drugs (often called "water pills")
• Vitamins
• Salt substitutes, such as "Mrs. Dash"

You should not take potassium if you are taking the following:

• Amiloride (Midamor)
• Spironolactone (Aldactone)
• Triamterene (Dyrenium)

Natural fruit-flavored K-LOR (potassium chloride for oral solution, USP) is an oral potassium supplement offered in individual packets as a powder for reconstitution. Each packet of K-LOR (potassium chloride) 20 mEq powder contains potassium 20 mEq and chloride 20 mEq provided by potassium chloride 1.5 g.

K-LOR (potassium chloride) powder is an electrolyte replenisher. The chemical name is potassium chloride, and the structural formula is KCl. Potassium chloride, USP, occurs as a white, granular powder or as colorless crystals. It is odorless and has a saline taste. Its solutions are neutral to litmus. It is freely soluble in water and insoluble in alcohol.

Inactive Ingredients

FD&C Yellow No. 6, maltodextrin (contains corn derivative), malic acid, saccharin, silica gel and natural flavoring.

You should not use this medication if you are allergic to it, or if you have certain conditions. Be sure your doctor knows if you have:

• high levels of potassium in your blood (hyperkalemia);
• kidney failure;
• Addison's disease (an adrenal gland disorder);
• a large tissue injury such as a severe burn;
• if you are severely dehydrated; or
• if you are taking a "potassium-sparing" diuretic (water pill) such as amiloride (Midamor, Moduretic), spironolactone (Aldactone, Aldactazide), triamterene (Dyrenium, Dyazide, Maxzide).

To make sure you can safely take potassium chloride, tell your doctor if you have any of these other conditions:

• kidney disease;
• heart disease or high blood pressure;
• a blockage in your stomach or intestines; or
• chronic diarrhea (such as ulcerative colitis, Crohn's disease).

FDA pregnancy category C. It is not known whether potassium chloride will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether potassium chloride passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Take potassium chloride exactly as prescribed.

• This medication comes in tablet and capsule forms and may be taken multiple times a day with food and water.
• Swallow capsules and tablets whole. Do not chew or crush contents of either the tablet or capsule.
• This medication is also available in an injectable form to be given directly into a vein by a healthcare professional.
• The liquid for injection form is to be used by your hospital physician.
• For patients who have difficulty swallowing tablets whole, the tablet may be broken in half.
• For patients who have difficulty swallowing capsules whole, its contents may be sprinkled into soft food followed by a glass of water or other liquid.
• If one cannot swallow a tablet, a capsule, or half a tablet, try the following alternate methods of administration:
  • Prepare an aqueous (water) suspension as follows:
    1. Place the whole tablet or pour the capsule's contents in approximately one-half glass of water (4 fluid ounces).
    2. Allow approximately 2 minutes for the contents to dissolve.
    3. Stir for about half a minute after the contents have dissolved.
    4. Swirl the suspension and consume the entire suspension immediately by drinking or by the use of a straw.
    5. Add another one fluid ounce of water, swirl, and consume immediately.
    6. Then, add an additional one fluid ounce of water, swirl, and consume immediately.
  •  If not taken immediately, it should be discarded. The use of other liquids besides water for dissolving tablets or capsule contents is not recommended.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of potassium chloride at the same time.

• Store potassium chloride at room temperature.
• Keep this and all medicines out of the reach of children.

If you are taking a dietary supplement without a prescription, carefully read and follow any precautions on the label. For these supplements, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Although there is no specific information comparing use of potassium supplements in children with use in other age groups, they are not expected to cause different side effects or problems in children than they do in adults.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of potassium supplements in the elderly with use in other age groups, they are not expected to cause different side effects or problems in older people than they do in younger adults.

Older adults may be at a greater risk of developing high blood levels of potassium (hyperkalemia).

Pregnancy

Potassium supplements have not been shown to cause problems in humans.

Breast Feeding

Potassium supplements pass into breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these dietary supplements, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using dietary supplements in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with dietary supplements in this class or change some of the other medicines you take.

• Amantadine
• Amifampridine
• Amisulpride
• Atropine
• Belladonna
• Belladonna Alkaloids
• Benztropine
• Bepridil
• Biperiden
• Cisapride
• Clidinium
• Darifenacin
• Dicyclomine
• Dronedarone
• Eplerenone
• Fesoterodine
• Glycopyrrolate
• Hyoscyamine
• Mesoridazine
• Methscopolamine
• Oxybutynin
• Pimozide
• Piperaquine
• Procyclidine
• Saquinavir
• Scopolamine
• Solifenacin
• Sparfloxacin
• Terfenadine
• Thioridazine
• Tolterodine
• Trihexyphenidyl
• Trospium
• Ziprasidone

Using dietary supplements in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alacepril
• Alfuzosin
• Amiloride
• Amiodarone
• Amitriptyline
• Amoxapine
• Anagrelide
• Apomorphine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Asenapine
• Astemizole
• Azithromycin
• Bedaquiline
• Benazepril
• Buserelin
• Canrenoate
• Captopril
• Chloroquine
• Chlorpromazine
• Cilazapril
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clomipramine
• Clozapine
• Crizotinib
• Cyclobenzaprine
• Dabrafenib
• Dasatinib
• Degarelix
• Delamanid
• Delapril
• Desipramine
• Deslorelin
• Deutetrabenazine
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Droperidol
• Efavirenz
• Enalaprilat
• Enalapril Maleate
• Erythromycin
• Escitalopram
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Foscarnet
• Fosinopril
• Gatifloxacin
• Gemifloxacin
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Histrelin
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Imidapril
• Imipramine
• Indomethacin
• Ivabradine
• Ketoconazole
• Lapatinib
• Leuprolide
• Levofloxacin
• Lisinopril
• Lopinavir
• Lumefantrine
• Mefloquine
• Methadone
• Metronidazole
• Mifepristone
• Moexipril
• Moxifloxacin
• Nafarelin
• Nilotinib
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Ondansetron
• Paliperidone
• Panobinostat
• Pasireotide
• Pazopanib
• Pentopril
• Perindopril
• Pimavanserin
• Pitolisant
• Posaconazole
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinapril
• Quinidine
• Quinine
• Ramipril
• Ranolazine
• Ribociclib
• Salmeterol
• Sevoflurane
• Solifenacin
• Sorafenib
• Sotalol
• Spirapril
• Spironolactone
• Sulpiride
• Sunitinib
• Tacrolimus
• Telavancin
• Telithromycin
• Temocapril
• Tetrabenazine
• Tizanidine
• Toremifene
• Trandolapril
• Trazodone
• Triamterene
• Trifluoperazine
• Trimipramine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Vinflunine
• Voriconazole
• Zofenopril
• Zuclopenthixol

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of dietary supplements in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Addison's disease (underactive adrenal glands) or
• Dehydration (excessive loss of body water, continuing or severe)
• Type 2 diabetes mellitus or
• Kidney disease—Potassium supplements may increase the risk of hyperkalemia (high blood levels of potassium), which may worsen or cause heart problems in patients with these conditions.

• Diarrhea (continuing or severe)—The loss of fluid in combination with potassium supplements may cause kidney problems, which may increase the risk of hyperkalemia (high blood levels of potassium).

• Heart disease—Potassium supplements may make this condition worse.

• Intestinal or esophageal blockage—Potassium supplements may damage the intestines.

• Stomach ulcer—Potassium supplements may make this condition worse.

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 bear in mind 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 to within 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:

To take each dose with meals and with a full glass of water or other liquid.

To take this medicine following the frequency and amount prescribed by the physician. This is especially important if the patient is also taking diuretics and/or digitalis preparations.

To check with the physician if there is trouble swallowing tablets or if the tablets seem to stick in the throat.

To check with the physician at once if tarry stools or other evidence of gastrointestinal bleeding is noticed.

To take each dose without crushing, chewing or sucking the tablets.

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.

Drug Interactions

Potassium-sparing diuretics, angiotensin converting enzyme inhibitors (see WARNINGS).

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenicity, mutagenicity and fertility studies in animals have not been performed. Potassium is a normal dietary constituent.

Pregnancy Category C

Animal reproduction studies have not been conducted with Potassium Chloride extended-release tablets. 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, as 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 children have not been established.

Geriatric Use

Clinical Studies of Potassium Chloride extended-release tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. 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.

One of the most severe adverse effects is hyperkalemia (see CONTRAINDICATIONS, WARNINGS, and OVERDOSAGE). There also have been reports of upper and lower gastrointestinal conditions including obstruction, bleeding, ulceration, and perforation (see CONTRAINDICATIONS and WARNINGS).

The most common adverse reactions to oral potassium salts are nausea, vomiting, flatulence, abdominal pain/discomfort, and diarrhea. 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.

Skin rash has been reported rarely.

• Dextrose, Potassium Chloride, and Sodium Chloride
• Dextrose, Sodium Chloride, and Potassium Chloride
• KCl
• KCl and NaCl
• KCl, NaCl, and D5W
• Kdur
• NaCl and KCl
• NaCl, KCl, and D5W
• Potassium Chloride and Sodium Chloride
• Potassium Chloride, Sodium Chloride, and Dextrose
• Sodium Chloride and Potassium Chloride
• Sodium Chloride, Potassium Chloride, and Dextrose

Refer to adult dosing.

Parenteral: Potassium must be diluted prior to parenteral administration. For IV infusion; do not administer IV push. In general, the rate of administration may be dependent on patient condition and specific institution policy.

Adults: Some clinicians recommend that the maximum concentration for peripheral infusion is 10 mEq/100 mL and maximum rate of administration for peripheral infusion is 10 mEq/hour (Kraft 2005). ECG monitoring is recommended for peripheral or central infusions >10 mEq/hour in adults (Kraft 2005). Concentrations and rates of infusion may be greater with central line administration. Concentrations of 20 to 40 mEq/100 mL at a maximum rate of 40 mEq/hour via central line have been safely administered (Hamill 1991; Kruse 1990)

Vesicant/irritant (at concentrations >0.1 mEq/mL); ensure proper needle or catheter placement prior to and during IV infusion. Avoid extravasation.

Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave needle/cannula in place); gently aspirate extravasated solution (do NOT flush the line); initiate hyaluronidase antidote; remove needle/cannula; apply dry cold compresses (Hurst 2004; Reynolds 2014); elevate extremity.

Hyaluronidase: Intradermal or SubQ: Inject a total of 1 to 1.7 mL (15 to 25 units/mL) as five separate 0.2 to 0.3 mL injections (using a 25-gauge needle) into area of extravasation at the leading edge in a clockwise manner (MacCara 1983; Reynolds 2014; Zenk 1981).

Oral: Oral dosage forms should be taken with meals and a full glass of water or other liquid to minimize the risk of GI irritation. Prescribing information for the various oral preparations recommend that no more than 20 mEq or 25 mEq should be given as single dose.

Capsule: MicroK: Swallow whole, do not chew. Capsules may also be opened and contents sprinkled on a spoonful of applesauce or pudding and should be swallowed immediately without chewing.

Powder: Klor-Con: Dissolve one packet in 4 to 5 ounces of water or other beverage prior to administration.

Tablet:

K-Tab, Kaon-Cl, Klor-Con: Swallow tablets whole; do not crush, chew, or suck on tablet.

Klor-Con M: Swallow tablets whole; do not crush, chew, or suck on tablet. Tablet may also be broken in half and each half swallowed separately; the whole tablet may be dissolved in ~4 ounces of water (allow ~2 minutes to dissolve, stir well and drink immediately)