Label: POTASSIUM CHLORIDE injection, solution, concentrate

  • NDC Code(s): 63323-965-01, 63323-965-02, 63323-965-03, 63323-965-05, view more
    63323-965-10, 63323-965-20, 63323-967-01, 63323-967-30
  • Packager: Fresenius Kabi USA, LLC
  • Category: HUMAN PRESCRIPTION DRUG LABEL
  • DEA Schedule: None
  • Marketing Status: Abbreviated New Drug Application

Drug Label Information

Updated October 23, 2018

If you are a consumer or patient please visit this version.

  • SPL UNCLASSIFIED SECTION

    Concentrate Must Be
    Diluted Before Use

    FOR INTRAVENOUS INFUSION ONLY

    MUST BE DILUTED PRIOR TO INJECTION


  • DESCRIPTION:

    Potassium Chloride for Injection Concentrate, USP is a sterile, nonpyrogenic concentrated solution of Potassium Chloride, USP in Water for Injection to be administered by intravenous infusion only after dilution in a larger volume of fluid.

    Each mL of Potassium Chloride for Injection Concentrate contains 2 mEq of K+ and Cl equivalent to 149 mg of potassium chloride and has an osmolarity of 4000 mOsmol/L (calc).  A more concentrated Potassium Chloride for Injection Concentrate is also available. Each mL of this injection contains 3 mEq of K+ and Cl equivalent to 224 mg of potassium chloride and has an osmolarity of 6000 mOsmol/L(calc).

    pH (4.0-8.0) may have been adjusted with hydrochloric acid and if necessary, potassium hydroxide.

    Some packages are intended for multiple dose use and contain preservatives (0.05% methylparaben and 0.005% propylparaben).  A summary of the available products is presented in the HOW SUPPLIED section.

    Potassium Chloride for Injection Concentrate (appropriately diluted) is a parenteral fluid and electrolyte replenisher.

  • CLINICAL PHARMACOLOGY:

    Potassium is the chief cation of body cells (160 mEq/L of intracellular water) and is concerned with the maintenance of body fluid composition and electrolyte balance. Potassium participates in carbohydrate utilization and protein synthesis, and is critical in the regulation of nerve conduction and muscle contraction, particularly in the heart. Chloride, the major extracellular anion, closely follows the metabolism of sodium, and changes in the acid-base balance of the body are reflected by changes in the chloride concentration.

    Normally about 80 to 90% of the potassium intake is excreted in the urine, the remainder in the stools and to a small extent, in the perspiration.  The kidney does not conserve potassium well, so that during fasting, or in patients on a potassium-free diet, potassium loss from the body continues resulting in potassium depletion. A deficiency of either potassium or chloride will lead to a deficit of the other.

  • INDICATIONS AND USAGE:

    Potassium Chloride for Injection Concentrate, USP is indicated in the treatment of potassium deficiency states when oral replacement is not feasible.

  • CONTRAINDICATIONS:

    Potassium Chloride for Injection Concentrate is contraindicated in diseases where high potassium levels may be encountered, and in patients with hyperkalemia, renal failure and in conditions in which potassium retention is present.

  • WARNINGS:

    WARNING: This product contains aluminum that may be toxic.  Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

    Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity.  Tissue loading may occur at even lower rates of administration.

    To avoid potassium intoxication, do not infuse these solutions rapidly.  In patients with renal insufficiency, administration of potassium chloride may cause potassium intoxication and life-threatening hyperkalemia.

    The administration of intravenous solutions can cause fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema.  The risk of dilutional states is inversely proportional to the electrolyte concentration.  The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentration.

  • PRECAUTIONS:

    General

    Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation.  Significant deviations from normal concentrations may require the use of additional electrolyte supplements, or the use of electrolyte-free dextrose solutions to which individualized electrolyte supplements may be added.

    Potassium therapy should be guided primarily by serial electrocardiograms, especially in patients receiving digitalis.  Serum potassium levels are not necessarily indicative of tissue potassium levels.  Solutions containing potassium should be used with caution in the presence of cardiac disease, particularly in the presence of renal disease, and in such instances, cardiac monitoring is recommended.

    Solutions containing dextrose should be used with caution in patients with overt or known subclinical diabetes mellitus, or carbohydrate intolerance for any reason.

    If the administration is controlled by a pumping device, care must be taken to discontinue pumping action before the container runs dry or air embolism may result.

    Pregnancy

    Teratogenic Effects: Pregnancy Category C — Animal reproduction studies have not been conducted with potassium chloride.  It is also not known whether potassium chloride can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.  Potassium chloride should be given to a pregnant woman only if clearly needed.

  • ADVERSE REACTIONS:

    Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, hypervolemia, and hyperkalemia.

    Too rapid infusion of hypertonic solutions may cause local pain and, rarely, vein irritation.  Rate of administration should be adjusted according to tolerance.

    Reactions reported with the use of potassium-containing solutions include nausea, vomiting, abdominal pain and diarrhea. The signs and symptoms of potassium intoxication include paresthesias of the extremities, areflexia, muscular or respiratory paralysis, mental confusion, weakness, hypotension, cardiac arrhythmias, heart block, electrocardiographic abnormalities and cardiac arrest.  Potassium deficits result in disruption of neuromuscular function, and intestinal ileus and dilatation.

    If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.

  • OVERDOSAGE:

    In the event of fluid overload during parenteral therapy, reevaluate the patient's condition, and institute appropriate corrective treatment.

    In the event of overdosage with potassium-containing solutions, discontinue the infusion immediately and institute corrective therapy to reduce serum potassium levels. 

    Treatment of hyperkalemia includes the following:

    1. Dextrose Injection, USP, 10% or 25%, containing 10 units of crystalline insulin per 20 grams of dextrose administered intravenously, 300 to 500 mL/hour.
    2. Absorption and exchange of potassium using sodium or ammonium cycle cation exchange resin, orally and as retention enema.
    3. Hemodialysis and peritoneal dialysis. The use of potassium-containing foods or medications must be eliminated. However, in cases of digitalization, too rapid a lowering of plasma potassium concentration can cause digitalis toxicity.
  • DOSAGE AND ADMINISTRATION:

    Potassium Chloride for Injection Concentrate must be diluted before administration.  Care must be taken to ensure there is complete mixing of the potassium chloride with the large volume fluid, particularly if soft or bag type containers are used.

    The dose and rate of administration are dependent upon the specific condition of each patient.

    If the serum potassium level is greater than 2.5 mEq/L, potassium can be given at a rate not to exceed 10 mEq/hour and in a concentration of up to 40 mEq/L. The 24 hour total dose should not exceed 200 mEq.

    If urgent treatment is indicated (serum potassium level less than 2 mEq/L and electrocardiographic changes and/or muscle paralysis), potassium chloride may be infused very cautiously at a rate of up to 40 mEq/hour.  In such cases, continuous cardiac monitoring is essential.  As much as 400 mEq may be administered in a 24 hour period. In critical conditions, potassium chloride may be administered in saline (unless contraindicated) rather than in dextrose containing fluids, as dextrose may lower serum potassium levels.

    Prior to entering a vial, cleanse the rubber closure with a suitable antiseptic agent.

    Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.

  • HOW SUPPLIED:

    The following are packaged in plastic vials.


    Product
    Code
    Unit of Sale
     
     



    Total Potassium
    Ion


    Potassium Chloride
    per mL
     



     

    Each
    96505
    NDC 63323-965-05
    Unit of 25 
    10 mEq
    (0.39 g) 
    149 mg
    NDC 63323-965-01
    5 mL in a  10 mL
    Single Dose Vial 
    96510
    NDC 63323-965-10
    Unit of 25
    20 mEq
    (0.78 g)
    149 mg
    NDC 63323-965-03
    10 mL Single Dose Vial
    96520
    NDC 63323-965-20
    Unit of 25
    40 mEq
    (1.56 g)
    149 mg
    NDC 63323-965-02
    20 mL Single Dose Vial


    These are Single Dose Vials, no preservative added, packaged 25 vials per tray.  Unused portion of vial should be discarded.


    Product
    Code
    Unit of Sale




    Total

    Potassium
    Ion

     


    Potassium Chloride
    per mL
     



     

    Each
    96730
    NDC 63323-967-30
    Unit of 25 
    60 mEq
    (2.35 g) 
    149 mg
    NDC 63323-967-01
    30 mL Multiple Dose Vial


    This is a Multiple Dose Vial, preserved with 0.05% methylparaben and 0.005% propylparaben, packaged 25 vials per tray.


    Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].


    Use only if solution is clear, seal intact and undamaged.


    Vial stoppers do not contain natural rubber latex.


  • SPL UNCLASSIFIED SECTION


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    www.fresenius-kabi.com/us
    45767G

    Revised: September 2018

  • PRINCIPAL DISPLAY PANEL

    PACKAGE LABEL - PRINCIPAL DISPLAY - Potassium Chloride 5 mL Single Dose Vial Label

    NDC 63323-965-01    96505

    POTASSIUM CHLORIDE
    For Injection Concentrate, USP
    Concentrate Must Be Diluted Before Use
    10 mEq per 5 mL (2 mEq per mL)
    5 mL Single Dose Vial   Rx only

    5mlvial 


    PACKAGE LABEL - PRINCIPAL DISPLAY - Potassium Chloride 5 mL Single Dose Vial Tray Label

    NDC 63323-965-05   96505

    POTASSIUM CHLORIDE
    For Injection Concentrate, USP 
    Concentrate Must Be Diluted Before Use

    10 mEq per 5 mL(2 mEq per mL)
     Rx only

    25 x 5 mL Single Dose Vials
    5mltray


    PACKAGE LABEL - PRINCIPAL DISPLAY - Potassium Chloride 30 mL Multiple Dose Vial Label

    NDC 63323-967-01   96730

    POTASSIUM CHLORIDE
    For Injection Concentrate, USP
    Concentrate Must Be Diluted Before Use

    60 mEq per 30 mL(2 mEq per mL)

    30 mL Multiple Dose Vial  Rx only
    30mlvial


    PACKAGE LABEL - PRINCIPAL DISPLAY - Potassium Chloride 30 mL Multiple Dose Vial Tray Label

    NDC 63323-967-30   96730

    POTASSIUM CHLORIDE
    For Injection Concentrate, USP 
    Concentrate Must Be Diluted Before Use

    60 mEq per 30 mL (2 mEq per mL)
    Rx only
    25 x 30 mL Multiple Dose Vials

    30mltray


  • INGREDIENTS AND APPEARANCE
    POTASSIUM CHLORIDE 
    potassium chloride injection, solution, concentrate
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:63323-965
    Route of AdministrationINTRAVENOUS
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    POTASSIUM CHLORIDE (UNII: 660YQ98I10) (POTASSIUM CATION - UNII:295O53K152) POTASSIUM CATION2 meq  in 1 mL
    Inactive Ingredients
    Ingredient NameStrength
    HYDROCHLORIC ACID (UNII: QTT17582CB)  
    POTASSIUM HYDROXIDE (UNII: WZH3C48M4T)  
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC:63323-965-0525 in 1 TRAY09/27/1999
    1NDC:63323-965-015 mL in 1 VIAL, SINGLE-DOSE; Type 0: Not a Combination Product
    2NDC:63323-965-1025 in 1 TRAY09/27/1999
    2NDC:63323-965-0310 mL in 1 VIAL, SINGLE-DOSE; Type 0: Not a Combination Product
    3NDC:63323-965-2025 in 1 TRAY09/27/1999
    3NDC:63323-965-0220 mL in 1 VIAL, SINGLE-DOSE; Type 0: Not a Combination Product
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    ANDAANDA08890109/27/1999
    POTASSIUM CHLORIDE 
    potassium chloride injection, solution, concentrate
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:63323-967
    Route of AdministrationINTRAVENOUS
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    POTASSIUM CHLORIDE (UNII: 660YQ98I10) (POTASSIUM CATION - UNII:295O53K152) POTASSIUM CATION2 meq  in 1 mL
    Inactive Ingredients
    Ingredient NameStrength
    METHYLPARABEN (UNII: A2I8C7HI9T)  
    PROPYLPARABEN (UNII: Z8IX2SC1OH)  
    HYDROCHLORIC ACID (UNII: QTT17582CB)  
    POTASSIUM HYDROXIDE (UNII: WZH3C48M4T)  
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC:63323-967-3025 in 1 TRAY09/05/2000
    1NDC:63323-967-0130 mL in 1 VIAL, MULTI-DOSE; Type 0: Not a Combination Product
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    ANDAANDA08890809/05/2000
    Labeler - Fresenius Kabi USA, LLC (608775388)
    Establishment
    NameAddressID/FEIBusiness Operations
    Fresenius Kabi USA, LLC840771732MANUFACTURE(63323-965, 63323-967)