Related Terms

• KCl, KH oxalate, KNO3, monobasic potassium phosphate, potassium acid tartrate, potassium bicarbonate (Effervescent® Potassium, K+Care ET®, K-Effervescent®, K-vescent®), potassium benzoate, potassium bisulfate, potassium bromate, potassium caprate, potassium caprylate, potassium carbonate, potassium caseinate, potassium chloride (Kaon-CL®, Kay Ciel®, K-Dur®, K-Lor®, Klor-Con®, Klotrix®, K-Tab®, Micro-K®), potassium citrate (Cytra-K®, Cytra-K Crystals®, Polycitra-K®, Polycitra-K Crystals®), potassium gluconate (Kaon®), potassium glycerophosphate, potassium hydroxide, potassium hypophosphate, potassium iodate, potassium iodide (Pima®, SSKI®, ThyroShield®), potassium lactate, potassium metabisulfite, potassium myristate, potassium nitrate, potassium oleate, potassium palmitate, potassium permanganate, potassium phosphate (Neutra-Phos®-K), potassium pyrophosphate, potassium salts of fatty acids, potassium sorbate, potassium stearate, potassium sulfate, potassium triphosphate, potassium tripolyphosphate, tribasic potassium phosphate.

Background

• Potassium is the most abundant electrolyte found in the body. Electrolytes are electrically charged ions that the body needs to function properly. Potassium in present in all cells in the body. The 2004 guidelines of the Institute of Medicine specify a recommended daily allowance (RDA) of 4.7 grams of potassium for adults. Fruits and vegetables are dietary sources of potassium. Salt substitutes also contain high levels of potassium.

• Hypokalemia (low levels of potassium in the blood serum) may cause muscle cramps and pain, weakness, and cardiovascular abnormalities. Hypokalemia may be caused by decreased potassium intake, vomiting, burns, dialysis, sweating, various medications orsupplements, and low levels of magnesium. Potassium supplementation is approved by the U.S. Food and Drug Administration (FDA) for the treatment of hypokalemia.

• Hyperkalemia (too much potassium in the blood serum) may cause potentially severe problems to the brain and the neural and cardiovascular systems. Hyperkalemia may be caused by increased potassium intake, decreased potassium excretion, or redistribution of potassium caused by medications or supplements.

• There is evidence from human studies that potassium is an effective treatment for hypertension (high blood pressure). There is limited or conflicting evidence for the use of potassium in cardiovascular disease or osteoporosis prevention, heart protection during surgery, or the treatment of alcohol withdrawal, critical illness, dehydration in elderly patients, dentin (teeth) hypersensitivity, diarrhea, edema (swelling), kidney stones, kwashiorkor (malnutrition), myocardial infarction (heart attack), pre-eclampsia (hypertension and other problems during pregnancy), thallium poisoning, rheumatoid arthritis, and stroke. Large-scale, high-quality human trials are needed in these areas.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Acne, allergies, antivenom (scorpion), constipation, diabetes, headaches, infantile colic, insulin potentiation, Ménière's disease, menopause.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• The 2004 guidelines of the Institute of Medicine specify an recommended daily allowance (RDA) of 4.7 grams of potassium for adults. Initial dosages may be adjusted to specific patient needs based on steady-state serum potassium concentrations.

• Oral potassium chloride should be taken with food and/or a full glass of water to prevent gastrointestinal irritation. Dissolvable potassium chloride tablets, powder, or concentrated solutions may be mixed with 3-8 ounces of water.

• For hypertension, 17-200 millimoles of potassium supplements (potassium chloride, potassium citrate, potassium bicarbonate, etc.) or dietary potassium daily has been used for five days to 28 weeks.

• For treatment of hypokalemia, 40-100 milliequivalents have been taken by mouth once daily, using formulations that include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution, or powder for dissolution mixed with an appropriate volume of water or juice. 40-100 milliequivalents of potassium chloride for injection diluted in an appropriate amount and type of solution have been infused in the vein once at a rate not exceeding 10-40 milliequivalents per hour.

• For prevention of hypokalemia, 10-20 milliequivalents have been taken by mouth once daily in equally divided doses, using formulations that include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution, or powder for dissolution mixed with an appropriate volume of water or juice. 10-40 milliequivalents of potassium chloride for injection diluted in an appropriate amount and type of solution have been infused in the vein once at a rate not exceeding 40 milliequivalents per hour.

• For rheumatoid arthritis, 6,000 milligrams of potassium chloride dissolved in grape juice and taken by mouth for 28 consecutive days with normal medications has been used.

• For dentin hypersensitivity, toothpastes, solutions, gels, and mouth rinses that have been used have included 1-15% KNO3 and/or 30% potassium oxalate solution.

• For infusions, the maximum recommended concentration is 60 milliequivalents of potassium per liter of intravenous (infused in the vein) fluid. Potassium chloride solutions should be infused slowly (up to 20 milliequivalents per hour) to avoid venous irritation and pain. Monitoring the serum potassium concentration is recommended.

• For dehydration, 34 millimoles per liter of potassium chloride, at an infusion rate of 250-333 milliliters per hour, has been used.

Children (under 18 years old)

• Potassium chloride by mouth should be taken with food and/or a full glass of water to prevent gastrointestinal irritation. Dissolvable potassium chloride tablets, powder, or concentrated solutions may be mixed with 3-8 ounces of water.

• For treatment of hypokalemia, 2-5 milliequivalents taken by mouth in equally divided doses, using age-appropriate oral dosage formulations, have been used. 0.5-1 milliequivalents per kilogram per dose (with a maximum dose of 30 milliequivalents) of potassium chloride for injection diluted in an appropriate amount and type of solution to has been infused in the vein once at a rate not exceeding 0.3-0.5 milliequivalents per kilogram per hour. Monitoring the serum potassium concentration is recommended.

• For prevention of hypokalemia, 1-2 milliequivalents have been taken by mouth in equally divided doses, using age-appropriate oral dosage formulations.

• For kwashiorkor, 4.7-7.7 millimoles of potassium per kilogram of body weight has been taken by mouth.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid potassium products in patients with known allergy or hypersensitivity to ingredients in potassium-containing products.

Side Effects and Warnings

• Side effects of potassium supplementation may include high blood levels of potassium, increased blood pressure, stinging or irritation from application, and gastrointestinal side effects (pain, burping, nausea, vomiting, diarrhea, stool color change, and gas). High levels of potassium in the serum, or hyperkalemia (serum potassium greater than five milliequivalents per liter), may be caused by increased potassium intake, decreased potassium excretion, or redistribution of potassium caused by medications or supplements. Signs and symptoms of hyperkalemia include cardiac (heart) and neuromuscular effects, although patients may not show symptoms. Hyperkalemia may cause skin numbness, generalized weakness, paralysis, listlessness, dizziness, confusion, low blood pressure, blood in the stool, abnormal heart rhythms, and death.

• Potassium may cause low blood pressure. Caution is advised in patients with low blood pressure or heart conditions, and in those taking drugs that lower blood pressure.

• Potassium supplementation should be used cautiously in combination with the following agents: acetazolamide, aldosterone antagonists, aminoglycosides, aminosalicylic acid, amphotericin B, angiotensin-converting enzyme (ACE) inhibitors, antineoplastons, beta-agonists (salbutamol and albuterol), blood sugar-lowering agents, calcium, carbenicillin, cardiovascular agents, cisplatin, fluconazole, gentamicin, glucocorticoids, glucose, gossypol, horsetail, insulin, intravenous (infused in the vein) solutions, ion exchange resins, laxatives, levodopa, licorice, methylxanthines, mineralocorticoids, nonsteroidal anti-inflammatory drugs (NSAIDs), penicillin G, phenothiazines, potassium-rich salt substitutes, salicylates, sodium bicarbonate, sodium polystyrene sulfonate (Kayexalate®), succinylcholine, tetracyclines, vitamin B12, and vitamin D.

• Use cautiously in patients with gastrointestinal conditions, due to the risk of abdominal pain, belching, vomiting, diarrhea, red stool discoloration, and flatulence.

• Use cautiously at higher than normal dietary levels in pregnant and lactating women, due to lack of sufficient data.

• Avoid in patients with kidney dysfunction, hyperkalemia, potassium retention, oliguria, azotemia, anuria, crush syndrome, severe hemolytic reactions, adrenocortical insufficiency (including untreated Addison's disease), adynamical episodica hereditaria, acute dehydration, heat cramps, or early postoperative oliguria (except during gastrointestinal drainage), and in patients on dialysis (instead adjust dialysate potassium levels).

• Avoid in patients taking potassium-sparing diuretics (such as triamterene, amiloride, or spironolactone), drugs with anticholinergic properties, sodium polystyrene sulfonate (Kayexalate®), antimuscarinics, or opioid analgesics.

• Avoid solid dosage forms of potassium supplements in patients at risk for arrest or delay in tablet passage throughout the gastrointestinal (GI) tract. Avoid lying down after administration, to prevent delayed passage through the GI tract.

• Avoid wax matrix potassium chloride preparations in heart patients with esophageal compression due to an enlarged left atrium.

• Avoid tartrazine-containing potassium chloride preparations in patients with tartrazine sensitivity.

• Avoid potassium-rich salt substitutes during potassium chloride therapy.

• Avoid with known allergy or hypersensitivity to potassium.

• Oral potassium chloride should be taken with food and/or a full glass of water to prevent gastrointestinal irritation.

• Fluid balance, electrolyte concentrations, and acid-base balance should be monitored regularly in patients on potassium therapy to prevent abnormally high or low levels of potassium and other electrolytes. Hyperkalemia has occurred in human trials utilizing potassium supplementation. Hypoglycemia has occurred in human trials utilizing glucose-insulin-potassium (GIK). Postoperative potassium estimations should be calculated frequently during postoperative potassium supplementation to prevent life-threatening complications due to potassium imbalances.

• Pseudohyperkalemia is a rise in the amount of potassium that occurs due to excessive leakage of potassium from cells, during or after blood is drawn, that is caused by hemolysis during venipuncture. It has been found to be a laboratory artifact that is not uncommon in patients with cancer or increased white cell counts.

Pregnancy and Breastfeeding

• Potassium supplementation at higher than normal dietary levels in pregnant and lactating women is not recommended, due to a lack of sufficient data. Infant formulas contain potassium.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Potassium may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.

• Potassium may also interact with acetazolamide, aldosterone antagonists, aminoglycosides, aminosalicylic acid, amphotericin B, angiotensin-converting enzyme (ACE) inhibitors, anticholinergics, antimuscarinics, antineoplastons, beta-agonists (salbutamol and albuterol), blood sugar-lowering agents, carbenicillin, cardiovascular agents, cisplatin, diuretics (potassium-sparing, such as triamterene, amiloride, or spironolactone; loop; and thiazide), fluconazole, gentamicin, glucocorticoids, glucose, insulin, intravenous (infused in the vein) solutions, ion exchange resins, laxatives, levodopa, methylxanthines, mineralocorticoids, nonsteroidal anti-inflammatory drugs (NSAIDs), opioid pain killers (opiates), penicillin G, phenothiazines, potassium-rich salt substitutes, salicylates, sodium bicarbonate, sodium polystyrene sulfonate (Kayexalate®), succinylcholine, and tetracyclines.

Interactions with Herbs and Dietary Supplements

• Potassium may cause low blood pressure. Caution is advised in patients taking herbs and supplements that lower blood pressure.

• Potassium may also interact with anticholinergics, antimuscarinics, anti-inflammatory herbs and supplements, antineoplastons, blood sugar-lowering herbs and supplements, cardiovascular agents, calcium, diuretics, gossypol, herbs or supplements which may increase serum potassium levels, horsetail, laxatives, licorice, opioid pain killers (opiates), salicylates, salt substitutes, vitamin B12, and vitamin D.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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