Special Warning : אזהרת שימוש

4.4   Special warnings and precautions for use

Potassium Chloride 14.9% should only be administered with caution in the presence of: ●     cardiac disorders
●     disorders associated with potassium retention, such as impaired renal function, Addison's disease, sickle cell anaemia. When treating patients with severe renal impairment and patients on dialysis, a nephrologist must be consulted
●     concomitant treatment with potassium-sparing diuretics, angiotensin II receptor antagonists, ACE inhibitors or potentially nephrotoxic medicinal products (non-steroidal anti-inflammatory drugs, etc.), see also section 4.5
●     shock
●     extensive tissue damage (e.g. burns)
●     familial hyperkalaemic periodic paralysis

Sudden discontinuation of potassium administration may be followed by marked hypokalaemia, which may lead to increased toxicity of cardiac glycosides taken concomitantly.

Initial potassium replacement therapy must not include glucose infusions, because glucose may cause a further decrease in the plasma-potassium concentration.

ECG monitoring should be available
In the event of abnormal changes in the potassium level (hypokalaemia or hyperkalaemia), typical changes are found in the ECG. However, there is no linear relationship between ECG changes and the blood potassium concentration.

Refeeding syndrome
Refeeding severely undernourished patients may result in the refeeding syndrome. This manifests as hypophosphataemia, which is often accompanied by hypokalaemia, hypomagnesaemia, fluid retention and hyperglycaemia. Thiamine deficiency and fluid retention may also develop. Careful monitoring and slowly increasing nutrient intakes while avoiding overfeeding can prevent these complications.

Clinical monitoring should include checks of serum electrolyte levels and acid-base balance.

Special attention should be paid to strictly intravenous administration, as paravenous administration can lead to tissue necrosis.
Elderly patients
Elderly patients who are more likely to suffer from cardiac insufficiency and renal impairment should be closely monitored during treatment, and the dosage should be carefully adjusted.

Effects on Driving

4.7    Effects on ability to drive and use machines

Potassium Chloride 14.9% has no or negligible influence on the ability to drive and use machines.