Medication | Initial dosage | Effectiveness | Comments |
---|---|---|---|
Potassium chloride | Oral: 10 to 40 mEq two to four times per day Intravenous*: Up to 10 mEq per hour (peripheral line) Up to 20 mEq per hour (central line) Emergent treatment: 5 to 10 mEq intravenously over 15 to 20 minutes | Expect increase in serum potassium by 0.1 mEq for every 10 mEq administered; may be less if the patient is experiencing ongoing losses | Most effective formulation; up to 40% improved absorption compared with other formulations Intravenous treatment should be reserved for patients with electrocardiography changes, paralysis, respiratory failure, rhabdomyolysis, or inability to take treatment orally Continuous cardiac monitoring is recommended for rates of 10 mEq per hour and greater |
Potassium bicarbonate (potassium citrate, acetate, gluconate)† | Oral: Bicarbonate 20 to 40 mEq per day in one to two divided doses (prevention) 40 to 100 mEq per day in two to four divided doses (treatment) Citrate 10 to 20 mEq two to four times per day Gluconate 10 to 20 mEq two to four times per day Intravenous: Acetate Up to 10 mEq per hour (peripheral line) Up to 40 mEq per hour (central line) | Intravenous treatment should increase serum potassium levels by 0.1 mEq per L for every 10 mEq administered | Preferred for patients with metabolic acidosis Potassium gluconate is commonly found in over-the-counter formulations Continuous cardiac monitoring recommended for intravenous infusions |
Potassium phosphate | Primarily used for the treatment of hypophosphatemia For every 1 mmol of phosphate, there is 1.5 mEq of potassium | Not established | Typically found in dietary potassium Reserve for patients with hypokalemia and hypophosphatemia (e.g., refeeding syndrome, type 2 renal tubular acidosis, Fanconi syndrome) Avoid oral supplementation due to phosphate-induced diarrhea |