Treatment for hypokalaemia

If patients have hypokalaemia due to chronic accumulation of digoxin, replace potassium aiming for the normal serum potassium concentration.

If the serum potassium concentration is low, but more than 3 mmol/L, and patients can tolerate and absorb oral potassium, use:

potassium chloride 14 to 16 mmol (child: 0.25 mmol/kg up to 16 mmol) orally, every 2 to 4 hours as required to achieve a normal serum potassium concentration¹. chronic digoxin accumulation

If the serum potassium concentration is less than 3 mmol/L or patients cannot tolerate or absorb oral potassium, use:

potassium chloride 10 to 20 mmol (child: 0.4 mmol/kg up to 20 mmol) intravenously over 1 to 2 hours, every 2 to 4 hours as required to achieve a normal serum potassium concentration. Use a premixed solution of the appropriate intravenous fluid².

¹ Effervescent immediate-release tablets of potassium contain 14 mmol of potassium per tablet, and modified-release tablets contain 8 mmol of potassium per tablet. The modified-release preparations of potassium are almost completely absorbed within 1 hour.Return

² Potassium chloride should only be given using premixed infusion bags. Extemporaneously adding ampoules of potassium chloride to intravenous fluids is not safe; inadequate mixing may result in potassium being delivered at a lethal concentration. Premixed infusion bags are available in varying concentrations and volumes; the most common is potassium chloride in 1000 mL of compatible fluid. Premixed potassium chloride is also available in a smaller volume at a high concentration (10 mmol/100 mL). Choice of preparation depends on the amount of potassium required and how much fluid the patient will tolerate.Return