POTASSIUM CHLORIDE Concentrate for solution for infusion Ref.[7041] Active ingredients: Potassium chloride

Source: Medicines & Healthcare Products Regulatory Agency (GB)  Revision Year: 2019  Publisher: Mercury Pharmaceuticals Limited, Capital House, 85 King William Street, London EC4N 7BL, UK

Contraindications

  1. Sterile Potassium Chloride Concentrate should never be used undiluted.
  2. Hyperkalaemia (plasma-potassium concentration above 5 mmol/litre).
  3. Hyperchloraemia.
  4. Impaired renal function with oliguria, anuria or azotaemia.
  5. Addison’s disease.
  6. Acute dehydration.
  7. Heat cramps.

Special warnings and precautions for use

Administration (see also section 4.2):

  • Only use with specialist advice.
  • ECG should be used throughout and monitored continuously.
  • High concentrations of potassium cause serious cardiotoxicity, so the concentration of the solution should not exceed 3g (40mmol)/L and the diluted solution given slowly (maximal rate 20mmol/L).
  • Initially do not use with glucose infusions – glucose may further decrease potassium levels.

Other concurrent treatment (also see section 4.5):

  • Extreme caution in patients on potassium sparing diuretics and other drugs that may increase potassium.
  • Glucose infusion – see above Administration.

Monitoring:

  • Continuous ECG monitoring – see above Administration.
  • Regular potassium levels especially in patients with renal impairment (see section 4.3) Underlying conditions – see also section 4.3.
  • Dehydration must be corrected to ensure adequate urinary output (and potassium excretion).
  • Where renal excretion of potassium or cellular uptake deficient – life threatening hyperkalaemia can occur with standard doses.
  • Extreme caution with extensive tissue destruction (e.g. burns).
  • Extreme caution in cardiac disease.

Interaction with other medicinal products and other forms of interaction

Increased risk of severe hyperkalaemia with the following:

  • ACE-inhibitors.
  • Aliskerin.
  • Angiotensin-II receptor anatagonists.
  • Potassium sparing diuretics such as: amiloride, spironolactone and triamterene and aldosterone antagonists.
  • Ciclosporin.
  • Tacrolimus (not topical formulations).

Particularly close monitoring required with these (see section 4.4) and any other medicines or conditions that may increase potassium levels.

Further reductions in potassium occurs with glucose infusions – see also section 4.4.

Pregnancy and lactation

Potassium chloride should be used during pregnancy or lactation only under the supervision of the prescribing physician if considered essential by the physician.

Effects on ability to drive and use machines

Nil.

Undesirable effects

Excessive intake of potassium may cause hyperkalaemia, with paraesthesia, muscle weakness, paralysis, hypotension, cardiac arrhythmias and cardiac arrest.

Pain at the injection site and phlebitis may occur during IV administration of solutions containing 30 mmol potassium or more per litre.

Incompatibilities

Incompatibilities have been reported with dobutamine hydrochloride, amphotericin, amikacin sulphate and fixed oil emulsions.

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