Comparison of Potassium Salts

POTASSIUM CHLORIDE: 750 mg of potassium chloride is equivalent to 10 mEq (mmol) of potassium.

Wax-matrix tablet,

slow-release

Generics: 8 mEq, 10 mEq (US), 20 mEq (US)

K-Tab (US): 20 mEq

Klor-Con (US): 8 mEq, 10 mEq

Choice for most patients due to effectiveness for most common causes of potassium loss (i.e., diuretic- and diarrhea-induced).³

Potassium chloride has better GI absorption compared to other potassium salts.⁴

Microencapsulated forms may cause less GI irritation/bleeding compared to wax-matrix tabs.^3,5

Oral liquid formulations act quickly and are usually inexpensive; however, they must be diluted and have poor adherence due to a strong unpleasant/bitter taste.^3,5

Microencapsulated tablets can be dispersed in
120 mL water, let sit two minutes, stir 30 seconds, then drink. Rinse cup with 30 mL of water and drink, then repeat with 30 mL more.⁴

Microencapsulated capsules can be opened and sprinkled onto a small amount of soft food (e.g., applesauce, pudding).⁴ Food should be swallowed immediately, without chewing, and followed by a full glass of water.⁴

Some wax-matrix formulations produce a “ghost” tab in the stool.⁴

Concentrated injectable solution is considered a high-alert medication by ISMP.⁶

Microencapsulated tablet, sustained-release

Generics: 10 mEq (US), 20 mEq

Klor-Con M10 (US): 10 mEq

Klor-Con M15 (US): 15 mEq

Klor-Con M20 (US): 20 mEq

Microencapsulated capsule, sustained-release

Generics: 8 mEq, 10 mEq (US)

Klor-Con Sprinkle (US): 8 mEq, 10 mEq

Powder packets for oral solution (US only)

Generics: 10 mEq, 20 mEq

Klor-Con: 20 mEq

Oral liquid

Generics: 20 mEq/15 mL (10%),
40 mEq/15 mL (20%) (US)

Injectable solution

Generics (must be diluted): 2 mEq/mL vials

Premixed intravenous bags are also available with various diluents, in several concentrations and sizes.

POTASSIUM PHOSPHATE: 1,350 mg of monobasic potassium phosphate is equivalent to 10 mEq (mmol) of potassium.

Tablet (US only)

K-Phos, generic: 500 mg (to be dissolved in liquid)

Choice when phosphate deficit accompanies potassium depletion (e.g., diabetic ketoacidosis).³

Also used for the prevention and treatment of hypophosphatemia.⁴

Injectable solution is considered a high-alert medication by ISMP (US).⁶

Injectable solution

Generics (must be diluted): 3 mmol/mL (US),
1.29 mmol/mL (Canada)

POTASSIUM BICARBONATE: 1,000 mg of potassium bicarbonate is equivalent to 10 mEq (mmol) of potassium.

Capsule (US only)

K-Bicarb (OTC): 99 mg

Generics (OTC): 300 mg, 500 mg, 1,020 mg, 2,100 mg

Can be considered in patients with hypokalemia and metabolic acidosis due to its alkalinizing effect.^3,4

Effervescent tablet
(US only)

Effer-K: 10 mEq, 20 mEq, 25 mEq

Klor-Con EF: 25 mEq

POTASSIUM GLUCONATE: 2,350 mg of potassium gluconate is equivalent to 10 mEq (mmol) of potassium.

Tablet/caplet/capsule

Generics (US, OTC): 90 mg, 99 mg

Generics (Canada): 50 mg, 99 mg

Considered a dietary supplement to prevent hypokalemia.⁴

Gluconate metabolizes to bicarbonate, so can be considered in patients with hypokalemia and metabolic acidosis.⁷

Extended-release tablet/caplet

Generics (US, OTC): 99 mg, 100 mg, 195 mg

Generics (Canada): 100 mg, 195 mg

POTASSIUM ACETATE: 975 mg of potassium acetate is equivalent to 10 mEq (mmol) of potassium.

Injectable solution

Generics (must be diluted): 2 mEq/mL (US),
4 mEq/mL (Canada)

Consider for treatment and prevention of hypokalemia if acidemia is also present, when oral therapy is not an option.⁴

Alternative to potassium chloride when you want to avoid administering chloride.

POTASSIUM CITRATE: 1,075 mg of potassium citrate is equivalent to 10 mEq (mmol) of potassium.

Extended-release tablet

Urocit-K: 5 mEq, 10 mEq, 15 mEq (US)

Generics: 5 mEq, 10 mEq, 15 mEq (additional strengths available OTC in Canada)

K-Citra (Canada): 10 mEq

Generally used for the management of renal tubular acidosis with calcium stones, uric acid kidney stones, or calcium kidney stones in patients with hypocitruria (low urinary citrate levels).⁸

K-Citra is recommended for treatment or prophylaxis of hypokalemia and to help reduce the formation of kidney stones.⁹

Can be considered in patients with distal renal tubular acidosis plus hypokalemia, high blood and urine calcium levels, or calcium kidney stones.¹⁰

Some formulations (slow-release wax matrix; e.g., Urocit-K) produce a “ghost” tab in the stool.¹¹

Oral solution

K-Citra: 10 mEq/5 mL

Capsules (Canada only)

Generics: 99 mg (~0.9 mEq), 316 mg (~3 mEq), others