▶Child: 1 – 2 mmol/kg daily, dose dependent on deficit or
the daily maintenance requirements
Potassium depletion
▶BY MOUTH
▶Neonate: 0. 5 – 1 mmol/kg twice daily, total daily dose
may alternatively be given in 3 divided doses, dose to be
adjusted according to plasma-potassium concentration.▶Child: 0. 5 – 1 mmol/kg twice daily, total daily dose may
alternatively be given in 3 divided doses, dose to be
adjusted according to plasma-potassium concentrationIMPORTANT SAFETY INFORMATION
SAFE PRACTICE
Potassium overdose can be fatal. Ready-mixed infusion
solutions containing potassium should be used.
Exceptionally, if potassium chloride concentrate is used
for preparing an infusion, the infusion solution should
bethoroughly mixed. Local policies on avoiding
inadvertent use of potassium chloride concentrate
should be followed.lCONTRA-INDICATIONSPlasma-potassium concentration
above 5 mmol/litre
lCAUTIONS
▶With intravenous useseek specialist advice in very severe
potassium depletion or difficult cases
▶With oral useCardiac disease.hiatus hernia (with modified-
release preparations).history of peptic ulcer (with modified-
release preparations).intestinal stricture (with modified-
release preparations)
lINTERACTIONS→Appendix 1 : potassium chloride
lSIDE-EFFECTS
GENERAL SIDE-EFFECTSHyperkalaemia
SPECIFIC SIDE-EFFECTS
▶With oral useAbdominal cramps.diarrhoea.
gastrointestinal disorders.nausea.vomiting
lRENAL IMPAIRMENTAvoid in severe impairment.
Dose adjustmentsSmaller doses must be used in the
prevention of hypokalaemia, to reduce the risk of
hyperkalaemia.
MonitoringClose monitoring required in renal
impairment—high risk of hyperkalaemia.
lMONITORING REQUIREMENTS
▶Regular monitoring of plasma-potassium concentration is
essential in those taking potassium supplements.
▶With intravenous useECG monitoring should be performed
in difficult cases.
lDIRECTIONS FOR ADMINISTRATION
▶With oral use in neonatesPotassium chloride solutions
suitable for use by mouth in neonates are available from
‘special order’manufacturers or specialist importing
companies; they should be used with care because they are
hypertonic and can damage the gastric mucosa.
▶With oral usePotassium salts are preferably given as a
liquid (or effervescent) preparation, rather than modified-
release tablets; they should be given as the chloride (the
use of effervescent potassium tablets BPC 1968 should be
restricted tohyperchloraemicstates).
▶With intravenous usePotassium chloride concentrate must
be diluted withnot lessthan 50 times its volume of
sodium chloride intravenous infusion 0. 9 % or other
suitable diluent andmixed well.
Ready-mixed infusion solutions should be used when
possible. Forperipheral intravenous infusion,the
concentration of potassium should not usually exceed
40 mmol/L. Potassium infusions should be given slowly
over at least 2 – 3 hours and at a rate not exceeding
0. 2 mmol/kg/hour with specialist advice and ECG
monitoring in difficult cases. Higher concentrations ofpotassium chloride or faster infusion rates may be given in
very severe depletion, but require specialist advice.
lPRESCRIBING AND DISPENSING INFORMATIONKay-Cee-L®
contains 1 mmol/mL each of K+and Cl-.
Potassium TabletsDo not confuse Effervescent Potassium
Tablets BPC 1968 with effervescent potassium chloride
tablets. Effervescent Potassium Tablets BPC 1968 do not
contain chloride ions and their use should be restricted to
hyperchloraemic states.
lPATIENT AND CARER ADVICE
Patient or carers should be given advice on how to
administer potassium chloride modified-release tablets.
Salt substitutesA number of salt substitutes which contain
significant amounts of potassium chloride are readily
available as health food products (e.g.LoSalt®and
Ruthmol®). These should not be used by patients with
renal failure as potassium intoxication may result.
lLESS SUITABLE FOR PRESCRIBINGModified-release tablets
are less suitable for prescribing. Modified-release
preparations should be avoided unless effervescent tablets
or liquid preparations inappropriate.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: modified-release tablet, oral solution,
solution for injection, infusion, solution for infusion
Modified-release tablet
CAUTIONARY AND ADVISORY LABELS25, 27
▶Potassium chloride (Non-proprietary)
Potassium chloride 600 mgKaleorid LP 600 mg tablets|
30 tabletPs
Duro-K 600 mg tablets| 100 tabletPs
Solution for infusion
▶Potassium chloride (Non-proprietary)
Potassium chloride 150 mg per 1 mlPotassium chloride 15 %
(potassium 20 mmol/ 10 ml) solution for infusion 10 ml ampoules|
10 ampouleP£ 5. 00 | 20 ampouleP£ 6. 50 – £ 10. 70
Potassium chloride 15 % (potassium 20 mmol/ 10 ml) solution for
infusion 10 ml Mini-Plasco ampoules| 20 ampouleP£ 10. 70
Potassium chloride 200 mg per 1 mlPotassium chloride 20 %
(potassium 13. 3 mmol/ 5 ml) solution for infusion 5 ml ampoules|
10 ampouleP£ 3. 84 – £ 4. 00
Potassium chloride 20 % (potassium 27 mmol/ 10 ml) solution for
infusion 10 ml ampoules| 10 ampouleP£ 121. 25
Oral solution
CAUTIONARY AND ADVISORY LABELS 21
▶Kay-Cee-L(Geistlich Sons Ltd)
Potassium chloride 75 mg per 1 mlKay-Cee-L syrup sugar-free|
500 mlp£ 8. 433 Metabolic disorders
Metabolic disorders
Use of medicines in metabolic disorders
Metabolic disorders should be managed under the guidance
of a specialist. As many preparations are unlicensed and may
be difficult to obtain, arrangements for continued
prescribing and supply should be made in primary care.
General advice on the use of medicines in metabolic
disorders can be obtained from:
Alder Hey Children’s Hospital, Medicines Information
Centre
( 0151 )252 5381
and
Great Ormond Street Hospital for Children, pharmacy
( 020 )7405 9200602 Metabolic disorders BNFC 2018 – 2019
Blood and nutrition9