Hypokalaemia
Borders Intranet - Electrolyte Deficiency
Treatment of hypokalaemia
Potassium bicarbonate + Potassium chloride
Sando-K effervescent tablets
Two tablets three times daily, dispersed in water. Dose may be altered according to serum levels.
Prescribing Notes:
- Potassium-sparing diuretics are recommended instead of potassium supplements for prevention of hypokalaemia due to diuretics such as furosemide or thiazides when these are given to eliminate oedema. Long term use of potassium supplements is not generally recommended but if clinically indicated then serum potassium levels should be checked regularly.
- Refer to local board hospital guidance and/or NPSA alert Discontinuation of Kay-Cee-L (potassium chloride 375mg/5ml) (potassium chloride 5mmol/5ml) syrup for further guidance on enteral product choices when Sando-K is not considered appropriate.
- Potassium chloride 600mg (potassium 8mmol) modified-release tablets are not preferred for potassium supplementation but may be considered in patients in whom effervescent tablets are considered inappropriate.
- Consider parenteral replacement in severe potassium deficiency or in patients with ECG changes.
- For information on potassium replacement in IV fluids refer to local secondary care IV fluid management guidelines.
- Only premixed potassium chloride IV infusion bags should be used as per local guidelines. Awareness of the National Patient Safety Alert is also helpful - see ‘Potassium chloride concentrate solution - Patient Safety Alert’.
History Notes
26/11/2024
Kay-Cee-L syrup discontinued, prescribing information updated, ERWG Nov 2024.
20/04/2023
East Region Formulary content agreed.
Treatment of hypokalaemia
Potassium bicarbonate + Potassium chloride
Sando-K effervescent tablets
For dose, refer to BNF for children.
Potassium chloride 375mg/5ml (potassium chloride 5mmol/5ml) oral solution unlicensed medicine, see prescribing notes for further details on product choice.
Potassium chloride
Potassium chloride 375mg/5ml oral solution
For dose, refer to BNF for children.
Prescribing Notes:
- Potassium-sparing diuretics are recommended instead of potassium supplements for prevention of hypokalaemia due to diuretics. See ‘Treatment of oedema’ pathway.
- Part-dosing of Sando-K effervescent tablets (off-label) is an option. Clinical teams should ensure that patients and/or carers are trained on how to administer the correct dose and can demonstrate safe administration of part-doses. Please refer to the NPPG Position Statement on enteral calcium, phosphate and potassium supplementation in Neonates and Children Updated August 2024 for further information.
- When Sando K is not considered suitable for an individual due to intolerance the preferred potassium chloride 375mg/5ml (potassium chloride 5mmol/5ml) oral solution (manufactured special) will be specified in patient correspondence. Clinical teams should ensure that patients and/or carers are trained on the correct volume of liquid to be taken and are provided instructions on storage requirements.
- Refer to local board hospital guidance and/or NPSA alert Discontinuation of Kay-Cee-L (potassium chloride 375mg/5ml) (potassium chloride 5mmol/5ml) syrup for further guidance on product choices.
- Consider parenteral replacement in severe potassium deficiency or in patients with ECG changes.
- For information on potassium replacement in IV fluids refer to local children’s service secondary care IV fluid management guidelines.
History Notes
26/11/2024
Kay-Cee-L syrup discontinued, prescribing information updated, ERWG Nov 2024.
10/06/2020
Content migrated from LJF website.