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|Potassium Bicarbonate and Potassium Citrate

POTASSIUM SUPPLEMENTS (Systemic)

Some commonly used brand names are:

In the U.S.—

• Cena-K ⁵
• Effer-K ⁴
• Gen-K ⁵
• Glu-K ⁶
• K-8 ⁵
• K+ 10 ⁵
• Kaochlor 10% ⁵
• Kaochlor S-F 10% ⁵
• Kaon ⁶
• Kaon-Cl ⁵
• Kaon-Cl-10 ⁵
• Kaon-Cl 20% Liquid ⁵
• Kato ⁵
• Kay Ciel ⁵
• Kaylixir ⁶
• K+ Care ⁵
• K+ Care ET ²
• K-Dur ⁵
• K-Electrolyte ²
• K-G Elixir ⁶
• K-Ide ³
• K-Lease ⁵
• K-Lor ⁵
• Klor-Con 8 ⁵
• Klor-Con 10 ⁵
• Klor-Con/EF ²
• Klor-Con Powder ⁵
• Klor-Con/25 Powder ⁵
• Klorvess ³
• Klorvess Effervescent Granules ³
• Klorvess 10% Liquid ⁵
• Klotrix ⁵
• K-Lyte ²
• K-Lyte/Cl ³
• K-Lyte/Cl 50 ³
• K-Lyte/Cl Powder ⁵
• K-Lyte DS ⁴
• K-Norm ⁵
• Kolyum ⁷
• K-Sol ⁵
• K-Tab ⁵
• K-Vescent ²
• Micro-K ⁵
• Micro-K 10 ⁵
• Micro-K LS ⁵
• Potasalan ⁵
• Rum-K ⁵
• Slow-K ⁵
• Ten-K ⁵
• Tri-K ⁹
• Twin-K ⁸

In Canada—

• Apo-K ⁵
• K-10 ⁵
• Kalium Durules ⁵
• Kaochlor-10 ⁵
• Kaochlor-20 ⁵
• Kaon ⁶
• KCL 5% ⁵
• K-Dur ⁵
• K-Long ⁵
• K-Lor ⁵
• K-Lyte ²
• K-Lyte/Cl ⁵
• K-Med 900 ⁵
• Micro-K ⁵
• Micro-K 10 ⁵
• Neo-K ³
• Potassium-Rougier ⁶
• Potassium-Sandoz ³
• Roychlor-10% ⁵
• Slow-K ⁵

Another commonly used name for trikates is potassium triplex .

Category

• Antihypokalemic—Potassium Acetate; Potassium Bicarbonate; Potassium Bicarbonate and Potassium Chloride; Potassium Bicarbonate and Potassium Citrate; Potassium Chloride; Potassium Gluconate; Potassium Gluconate and Potassium Chloride; Potassium Gluconate and Potassium Citrate; Trikates
• Electrolyte replenisher—Potassium Acetate; Potassium Bicarbonate; Potassium Bicarbonate and Potassium Chloride; Potassium Bicarbonate and Potassium Citrate; Potassium Chloride; Potassium Gluconate; Potassium Gluconate and Potassium Chloride; Potassium Gluconate and Potassium Citrate; Trikates

Description

Potassium is needed to maintain good health. Although a balanced diet usually supplies all the potassium a person needs, potassium supplements may be needed by patients who do not have enough potassium in their regular diet or have lost too much potassium because of illness or treatment with certain medicines.

There is no evidence that potassium supplements are useful in the treatment of high blood pressure.

Lack of potassium may cause muscle weakness, irregular heartbeat, mood changes, or nausea and vomiting.

Injectable potassium is administered only by or under the supervision of your doctor. Some forms of oral potassium may be available in stores without a prescription. Since too much potassium may cause health problems, you should take potassium supplements only if directed by your doctor. Potassium supplements are available with your doctor"s prescription in the following dosage forms:

• Oral
• Potassium Bicarbonate
  • Tablets for solution (U.S. and Canada)
• Potassium Bicarbonate and Potassium Chloride
  • Powder for solution (U.S. and Canada)
  • Tablets for solution (U.S. and Canada)
• Potassium Bicarbonate and Potassium Citrate
  • Tablets for solution (U.S.)
• Potassium Chloride
  • Extended-release capsules (U.S. and Canada)
  • Solution (U.S. and Canada)
  • Powder for solution (U.S. and Canada)
  • Powder for suspension (U.S.)
  • Extended-release tablets (U.S. and Canada)
• Potassium Gluconate
  • Elixir (U.S. and Canada)
  • Tablets (U.S.)
• Potassium Gluconate and Potassium Chloride
  • Solution (U.S.)
  • Powder for solution (U.S.)
• Potassium Gluconate and Potassium Citrate
  • Solution (U.S.)
• Trikates
  • Solution (U.S.)

• Parenteral
• Potassium Acetate
  • Injection (U.S.)
• Potassium Chloride
  • Concentrate for injection (U.S. and Canada)

Importance of Diet

The following table includes some potassium-rich foods.

• For U.S.—
• Recommended Dietary Allowances (RDAs) are the amount of vitamins and minerals needed to provide for adequate nutrition in most healthy persons. RDAs for a given nutrient may vary depending on a person"s age, sex, and physical condition (e.g., pregnancy).
• Daily Values (DVs) are used on food and dietary supplement labels to indicate the percent of the recommended daily amount of each nutrient that a serving provides. DV replaces the previous designation of United States Recommended Daily Allowances (USRDAs).

• For Canada—
• Recommended Nutrient Intakes (RNIs) are used to determine the amounts of vitamins, minerals, and protein needed to provide adequate nutrition and lessen the risk of chronic disease.

Because lack of potassium is rare, there is no RDA or RNI for this mineral. However, it is thought that 1600 to 2000 mg (40 to 50 milliequivalents [mEq]) per day for adults is adequate.

Remember:

• The total amount of potassium that you get every day includes what you get from food and what you may take as a supplement. Read the labels of processed foods. Many foods now have added potassium.
• Your total intake of potassium should not be greater than the recommended amounts, unless ordered by your doctor. In some cases, too much potassium may cause muscle weakness, confusion, irregular heartbeat, or difficult breathing.

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For potassium supplements, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to potassium preparations. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

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.

Children—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.

Older adults—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).

Other 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 potassium supplements, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Amantadine (e.g., Symmetrel) or
• Anticholinergics (medicine for abdominal or stomach spasms or cramps) or
• Antidepressants (medicine for depression) or
• Antidyskinetics (medicine for Parkinson"s disease or other conditions affecting control of muscles) or
• Antihistamines or
• Antipsychotic medicine (medicine for mental illness) or
• Buclizine (e.g., Bucladin) or
• Carbamazepine (e.g., Tegretol) or
• Cyclizine (e.g., Marezine) or
• Cyclobenzaprine (e.g., Flexeril) or
• Disopyramide (e.g., Norpace) or
• Flavoxate (e.g., Urispas) or
• Ipratropium (e.g., Atrovent) or
• Meclizine (e.g., Antivert) or
• Methylphenidate (e.g., Ritalin) or
• Orphenadrine (e.g., Norflex) or
• Oxybutynin (e.g., Ditropan) or
• Procainamide (e.g., Pronestyl) or
• Promethazine (e.g., Phenergan) or
• Quinidine (e.g., Quinidex) or
• Trimeprazine (e.g., Temaril)—Use with potassium supplements may cause or worsen certain stomach or intestine problems

• Angiotensin-converting enzyme (ACE) inhibitors (benazepril [e.g., Lotensin], captopril [e.g., Capoten], enalapril [e.g., Vasotec], fosinopril [e.g., Monotril], lisinopril [e.g., Prinivil, Zestril], quinapril [e.g., Accupril], ramipril [e.g., Altace]) or
• Amiloride (e.g., Midamor) or
• Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren]) or
• Heparin (e.g., Panheprin) or
• Inflammation or pain medicine (except narcotics) or
• Potassium-containing medicines (other) or
• Salt substitutes, low-salt foods, or milk or
• Spironolactone (e.g., Aldactone) or
• Triamterene (e.g., Dyrenium)—Use with potassium supplements may further increase potassium blood levels, which may cause or worsen heart problems

• Digitalis glycosides (heart medicine)—Use with potassium supplements may make heart problems worse

• Thiazide diuretics (water pills)—If you have been taking a potassium supplement and a thiazide diuretic together, stopping the thiazide diuretic may cause hyperkalemia (high blood levels of potassium)

Other medical problems—The presence of other medical problems may affect the use of potassium supplements. 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

Proper Use of This Medicine

For patients taking the liquid form of this medicine:

• This medicine must be diluted in at least one-half glass (4 ounces) of cold water or juice to reduce its possible stomach-irritating or laxative effect.
• If you are on a salt (sodium)-restricted diet, check with your doctor before using tomato juice to dilute your medicine. Tomato juice has a high salt content.

For patients taking the soluble granule, soluble powder, or soluble tablet form of this medicine:

• This medicine must be completely dissolved in at least one-half glass (4 ounces) of cold water or juice to reduce its possible stomach-irritating or laxative effect.
• Allow any "fizzing" to stop before taking the dissolved medicine.
• If you are on a salt (sodium)-restricted diet, check with your doctor before using tomato juice to dilute your medicine. Tomato juice has a high salt content.

For patients taking the extended-release tablet form of this medicine:

• Swallow the tablets whole with a full (8-ounce) glass of water. Do not chew or suck on the tablet.
• Some tablets may be broken or crushed and sprinkled on applesauce or other soft food. However, check with your doctor or pharmacist first, since this should not be done for most tablets.
• If you have trouble swallowing tablets or if they seem to stick in your throat, check with your doctor. When this medicine is not properly released, it can cause irritation that may lead to ulcers.

For patients taking the extended-release capsule form of this medicine:

• Do not crush or chew the capsule. Swallow the capsule whole with a full (8-ounce) glass of water.
• Some capsules may be opened and the contents sprinkled on applesauce or other soft food. However, check with your doctor or pharmacist first, since this should not be done for most capsules.

Take this medicine immediately after meals or with food to lessen possible stomach upset or laxative action .

Take this medicine only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. This is especially important if you are also taking both diuretics (water pills) and digitalis medicines for your heart .

Dosing—The dose of these single or combination medicines will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average dose of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of ounces of solution that you drink, or the number of tablets or capsules you take, depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking the single or combination medicine .

• For potassium bicarbonate
• For oral dosage form (tablets for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—25 to 50 milliequivalents (mEq) dissolved in one-half to one glass of cold water, taken one or two times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.

• For potassium bicarbonate and potassium chloride
• For oral dosage form (granules for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 milliequivalents (mEq) dissolved in one-half to one glass of cold water, taken one or two times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.
• For oral dosage form (tablets for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20, 25, or 50 mEq dissolved in one-half to one glass of cold water, taken one or two times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.

• For potassium bicarbonate and potassium citrate
• For oral dosage form (tablets for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—25 or 50 milliequivalents (mEq) dissolved in one-half to one glass of cold water, taken one or two times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.

• For potassium chloride
• For oral dosage form (extended-release capsules):
  • To replace potassium lost by the body:
    • Adults and teenagers—40 to 100 milliequivalents (mEq) a day, divided into two or three smaller doses during the day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
  • To prevent potassium loss:
    • Adults and teenagers—16 to 24 mEq a day, divided into two or three smaller doses during the day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.
• For oral dosage form (liquid for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 mEq mixed into one-half glass of cold water or juice, taken one to four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 1 to 3 mEq of potassium per kilogram (kg) (0.45 to 1.36 mEq per pound) of body weight taken in smaller doses during the day. The solution should be well mixed in water or juice.
• For oral dosage form (powder for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—15 to 25 mEq dissolved in four to six ounces of cold water, taken two or four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 1 to 3 mEq per kg (0.45 to 1.36 mEq per pound) of body weight taken in smaller doses during the day. The solution should be mixed into water or juice.
• For oral dosage form (powder for suspension):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 mEq dissolved in two to six ounces of cold water, taken one to five times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.
• For oral dosage form (extended-release tablets):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—6.7 to 20 mEq taken three times a day. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.

• For potassium gluconate
• For oral dosage form (liquid for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 milliequivalents (mEq) mixed into one-half glass of cold water or juice, taken two to four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 2 to 3 mEq per kilogram (kg) (0.9 to 1.36 mEq per pound) of body weight a day, taken in smaller doses during the day. The solution should be completely mixed into water or juice.
• For oral dosage form (tablets):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—5 to 10 mEq taken two to four times a day. However, most people will not take more than 100 mEq a day.
    • Children—Dose must be determined by your doctor.

• For potassium gluconate and potassium chloride
• For oral dosage form (liquid for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 milliequivalents (mEq) diluted in 2 tablespoonfuls or more of cold water or juice, taken two to four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 2 to 3 mEq per kilogram (kg) (0.9 to 1.36 mEq per pound) of body weight taken in smaller doses during the day. The solution should be well mixed into water or juice.
• For oral dosage form (powder for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 mEq mixed in 2 tablespoonfuls or more of cold water or juice taken two to four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is base on body weight and must be determined by your doctor. The usual dose is 2 to 3 mEq per kg (0.9 to 1.36 mEq per pound) of body weight taken in smaller doses during the day. The solution should be well mixed into water or juice.

• For potassium gluconate and potassium citrate
• For oral dosage form (liquid for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—20 milliequivalents (mEq) mixed into one-half glass of cold water or juice, taken two to four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 2 to 3 mEq per kg (0.9 to 1.36 mEq per pound) of body weight taken in smaller doses during the day. The solution should be well mixed into water or juice.

• For trikates
• For oral dosage form (liquid for solution):
  • To prevent potassium loss or replace potassium lost by the body:
    • Adults and teenagers—15 milliequivalents (mEq) mixed into one-half glass of cold water or juice, taken three or four times a day. Your doctor may change the dose if needed. However, most people will not take more than 100 mEq a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 2 to 3 mEq per kilogram (kg) (0.9 to 1.36 mEq per pound) of body weight taken in smaller doses during the day. The solution should be well mixed into water or juice.

Missed dose—If you miss a dose of this medicine and remember within 2 hours, take the missed dose right away with food or liquids. Then go back to your regular dosing schedule. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Your doctor should check your progress at regular visits to make sure the medicine is working properly and that possible side effects are avoided. Laboratory tests may be necessary.

Do not use salt substitutes, eat low-sodium foods, especially some breads and canned foods, or drink low-sodium milk unless you are told to do so by your doctor, since these products may contain potassium. It is important to read the labels carefully on all low-sodium food products .

Check with your doctor before starting any physical exercise program, especially if you are out of condition and are taking any other medicine. Exercise and certain medicines may increase the amount of potassium in the blood.

Check with your doctor at once if you notice blackish stools or other signs of stomach or intestinal bleeding . This medicine may cause such a condition to become worse, especially when taken in tablet form.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Sometimes you may see what appears to be a whole tablet in the stool after taking certain extended-release potassium chloride tablets. This is to be expected. Your body has absorbed the potassium from the tablet and the shell is then expelled.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 07/11/1995

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