Potassium Chloride / Potassium Gluconate
Potassium chloride (KCl), Potassium gluconate
Also known as: Tumil-K · Renakare · Potassiject · Cal-Dextro K · K-G Elixir · Kaon · Kaylixir · Potasoral · Sopa-K · Ultra-K · KCl · cloreto de potassio · E508 · kalii chloridum · kalium chloratum · E577
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L) | 0.5-1 mEq/kg mixed in food once or twice daily | PO | q12-24h | — | 🌎 NA |
| Treatment of chronic mild hypokalemia (Tumil-K powder) | 1/4 teaspoonful (2 mEq) per 4.5 kg body weight in food twice daily; adjust as necessary | PO | q12h | — | 🌎 NA |
| Moderate to severe (<3.0 mEq/L) or acute hypokalemia | Rate should not exceed 0.5 mEq/kg/hour. Under dire circumstances (serum K < 2.0 mEq/L), rate can be increased to 1.5 mEq/kg/hour along with close EKG monitoring. | IV | Continuous | — | 🌎 NA |
| Subcutaneous fluid supplementation (<10 kg patients) | 150 mL SC every 12 hours of isotonic fluids containing 30-35 mEq/L KCl | SC | q12h | — | 🌎 NA |
| Intravenous replacement | Rate not to exceed 0.5 mEq/hour. Concentration of replacement fluid should exceed 60 mEq/L. | IV | Continuous | — | 🌎 NA |
| Oral maintenance supplementation | 2-44 mEq/day depending on body size | PO | Daily | — | 🌎 NA |
| Maintenance IV fluid supplementation | 0.05-0.1 mEq/kg/hour to 0.5 mEq/kg/hour | IV | Continuous | — | 🌎 NA |
| Sliding scale IV supplementation based on Serum K+ | Serum K+ <2 mEq/L = 60 mEq/1000 mL IV fluid; Serum K+ 2-2.5 mEq/L = 40 mEq/1000 mL IV fluid; Serum K+ 2.5-3 mEq/L = 30 mEq/1000 mL IV fluid; Serum K+ 3-3.5 mEq/L = 20 mEq/1000 mL IV fluid. Infusion rates should generally not exceed 0.5 mEq/kg/hour. | IV | Continuous | — | 🌎 NA |
- Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L): Can use commercially available oral supplement tablets and elixirs diluted in water.
- Moderate to severe (<3.0 mEq/L) or acute hypokalemia: Amounts exceeding >10 mEq/hour to a small animal (<10 kg) can be life-threatening via central line.
- Intravenous replacement: Begin oral supplementation as soon as possible.
- Oral maintenance supplementation: Using potassium gluconate.
- Sliding scale IV supplementation based on Serum K+: Higher rates up to 1.5 mEq/kg/hour require continuous ECG monitoring.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treatment of chronic mild hypokalemia (3.0-3.5 mEq/L) | 0.5-1 mEq/kg mixed in food once or twice daily | PO | q12-24h | — | 🌎 NA |
| Treatment of chronic mild hypokalemia (Tumil-K powder) | 1/4 teaspoonful (2 mEq) per 4.5 kg body weight in food twice daily; adjust as necessary | PO | q12h | — | 🌎 NA |
| Moderate to severe (<3.0 mEq/L) or acute hypokalemia | Rate should not exceed 0.5 mEq/kg/hour. Under dire circumstances (serum K < 2.0 mEq/L), rate can be increased to 1.5 mEq/kg/hour along with close EKG monitoring. | IV | Continuous | — | 🌎 NA |
| Subcutaneous fluid supplementation (<10 kg patients) | 150 mL SC every 12 hours of isotonic fluids containing 30-35 mEq/L KCl | SC | q12h | — | 🌎 NA |
| Oral maintenance supplementation | 2-4 mEq/day | PO | Daily | — | 🌎 NA |
| Sliding scale IV supplementation based on Serum K+ | Serum K+ <2 mEq/L = 60 mEq/1000 mL IV fluid; Serum K+ 2-2.5 mEq/L = 40 mEq/1000 mL IV fluid; Serum K+ 2.5-3 mEq/L = 30 mEq/1000 mL IV fluid; Serum K+ 3-3.5 mEq/L = 20 mEq/1000 mL IV fluid. Infusion rates should generally not exceed 0.5 mEq/kg/hour. | IV | Continuous | — | 🌎 NA |
- Oral maintenance supplementation: Using potassium gluconate.
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Counteract potassium depletion in a completely anorectic horse | IV fluids should be supplemented with KCL (at least 50 mEq/hour) | IV | Continuous | — | 🌎 NA |
| Hypokalemia with diarrhea | Hypertonic oral KCL pastes | PO | As needed | — | 🌎 NA |
Cattle
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Hypokalemia in 'downer' cows | 80 grams sodium chloride and 20 grams potassium chloride in 10 liters of water via stomach tube. Provide a bucket containing similar solution for cow to drink and another containing fresh water. | PO | Once | — | 🌎 NA |
| Hypokalemia maintenance/treatment | 50 grams PO daily; 1 mEq/kg/hour IV drip | PO/IV | Daily/Continuous | — | 🌎 NA |
| Severe hypokalemia (<2.3 mEq/L) with severe muscle weakness or recumbency | Isotonic potassium chloride (11.5 grams of potassium chloride per 1 liter of sterile water) at a rate of 4 mL/kg/hour. Combined with large doses of oral potassium salts (i.e., 200 grams of KCl per day). | IV/PO | Continuous/Daily | — | 🌎 NA |
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Potassium is a critical intracellular electrolyte essential for life. It plays a vital role in maintaining cellular resting membrane potentials, particularly in excitable tissues like the heart, skeletal muscle, and smooth muscle.
Clinical Pearls:
- Hypokalemia (low potassium) is a common complication of chronic kidney disease (especially in cats), aggressive diuresis, diabetic ketoacidosis (DKA), and severe gastrointestinal losses.
- Potassium Gluconate is typically preferred for oral supplementation as it is less irritating to the GI tract and provides a mild alkalinizing effect.
- Potassium Chloride (KCl) is the standard for intravenous supplementation but must always be diluted prior to administration to prevent fatal arrhythmias.
- Total body potassium depletion may be severe even if serum levels appear normal, especially in the presence of acid-base disturbances (acidosis shifts potassium extracellularly).
Mechanism of action
Potassium is the principal intracellular cation in the body. It works primarily via the Na+/K+ ATPase pump to maintain the electrochemical gradient across cell membranes.
- Maintains cellular tonicity and resting membrane potential → essential for nerve impulse transmission.
- Regulates smooth, skeletal, and cardiac muscle contraction.
- Acts as a crucial cofactor in carbohydrate utilization and protein synthesis.
- Essential for the maintenance of normal renal function.
Safety & warnings
Contraindications
- Hyperkalemia
- Renal failure or severe renal impairment
- Severe hemolytic reactions
- Untreated Addison's disease (hypoadrenocorticism)
- Acute dehydration
- GI motility impairment (for solid oral dosage forms)
Adverse effects
- Hyperkalemia (muscle weakness, cardiac conduction disturbances)
- Gastrointestinal distress (vomiting, diarrhea) with oral therapy
- Vein irritation and phlebitis with IV therapy
Precautions
CRITICAL WARNING: Intravenous potassium salts MUST be diluted before administering and given slowly. Rapid IV administration can cause fatal cardiac arrest.
- Maximum standard IV rate: Generally should not exceed 0.5 mEq/kg/hour. In dire circumstances (<2.0 mEq/L), rates up to 1.5 mEq/kg/hour may be used only with continuous ECG monitoring.
- Assess renal and cardiac function prior to therapy.
- Acid-base balance masks the actual potassium picture: acidosis causes a false elevation (shifts K+ out of cells), while alkalosis causes a falsely low serum value.
- Supplementation should generally occur over 3-5 days to allow equilibration between extracellular and intracellular fluids.
- Use cautiously in digitalized patients.
Drug interactions
Potassium retention may occur; increased risk for hyperkalemia.
In patients with severe or complete heart block receiving digitalis therapy, it is often recommended not to use potassium salts.
Oral potassium given with non-steroidal anti-inflammatory agents may increase the risk of gastrointestinal adverse effects.
Potassium retention may occur; increased risk for hyperkalemia.
Monitoring
- Serum potassium levels
- Other electrolytes (sodium, chloride, magnesium, calcium)
- Acid/base status
- Blood glucose
- ECG (especially during IV administration)
- CBC
- Urinalysis and renal function parameters
Pharmacokinetics
Absorption
Readily absorbed from the gastrointestinal tract when administered orally.
Distribution
Approximately 98% of total body potassium is found in the intracellular fluid space, while only 2% is in the extracellular fluid space. Plasma pH alters distribution: acidosis shifts potassium out of the intracellular space, and alkalosis shifts potassium into the intracellular space.
Metabolism
Potassium is an elemental ion and is not metabolized.
Elimination
Primarily (80-90%) excreted via the kidneys, with the majority of the remainder excreted in the feces. Very small amounts may be excreted in perspiration (in animals with sweat glands).
Overdose
Fatal hyperkalemia may develop if potassium salts are administered too rapidly IV or if potassium renal excretory mechanisms are impaired.
Clinical Signs of Hyperkalemia:
- Muscular weakness
- Gastrointestinal disturbances
- Severe cardiac conduction disturbances (bradycardia, atrial standstill, ventricular fibrillation, asystole)
Treatment of Hyperkalemia:
- Immediate discontinuation of the potassium supplement.
- Continuous ECG, acid/base, and electrolyte monitoring.
- Medical interventions: Glucose/insulin infusions (drives K+ into cells), sodium bicarbonate (alkalinization drives K+ into cells), calcium therapy (cardioprotective, antagonizes K+ effects on the heart), and polystyrene sulfonate resin (binds K+ in the GI tract).
Available products
Formulations
- Intravenous injection concentrate
- Oral tablets
- Oral powder
- Oral gel
- Oral liquid/elixir
Veterinary
- Potassium Chloride IV Solution: 2 mEq (149 mg) in 10 mL vials (Potassiject)
- Potassium Gluconate Tablets: 2 mEq (468 mg) (Tumil-K, Renakare)
- Potassium Gluconate Oral Powder: 2 mEq per 0.65 gram (1/4 tsp) (Tumil-K, Renakare)
- Potassium Gluconate Gel: 2 mEq per 2.34 grams (1/2 tsp) (Tumil-K Gel, Renakare)
Human-labeled
- Potassium Chloride for Injection Concentrate: 2 mEq/mL in various vial sizes (Must be diluted)
- Potassium Chloride Tablets, controlled/sustained release tablets and capsules
- Potassium Chloride effervescent tablets, liquids, and powders
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Potassium gluconate oral products and potassium chloride products should be stored in tight, light-resistant containers at room temperature (15-30°C). Protect potassium chloride solutions from freezing.
Client information
Important: Never give human potassium supplements to your pet without explicit veterinary approval, as dosing is highly specific and overdoses can be fatal.
- Administration: Mix oral powders, gels, or liquids thoroughly into your pet's food to prevent stomach upset and improve palatability.
- Refusal to Eat: If your pet refuses to eat the medicated food, contact your veterinarian. Do not force-feed or double the next dose.
- Monitoring: Watch for signs of muscle weakness, severe lethargy, vomiting, or diarrhea. Contact your vet immediately if these occur.
- Keep all potassium supplements out of reach of children and other pets.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.