Addens-Kaliumklorid B. Braun (Potassium Chloride)
Concentrated electrolyte solution for intravenous infusion — treatment of potassium deficiency
Quick Facts: Addens-Kaliumklorid B. Braun
Key Takeaways
- Never administer undiluted: Addens-Kaliumklorid B. Braun is a concentrated solution that must be diluted with a suitable infusion fluid before intravenous use
- Treats potassium deficiency: Used primarily for hypokalemia, particularly when accompanied by hypochloraemic alkalosis
- Requires monitoring: Serum electrolytes, acid-base balance and ECG should be monitored during treatment
- Multiple drug interactions: Potassium-sparing diuretics, ACE inhibitors, ARBs and immunosuppressants can all increase hyperkalemia risk
- Infusion pump recommended: When correcting potassium levels, an infusion pump should be used to ensure accurate dosing and prevent rapid administration
What Is Addens-Kaliumklorid B. Braun and What Is It Used For?
Addens-Kaliumklorid B. Braun is a concentrated sterile solution of potassium chloride designed for intravenous administration after dilution. It is used to treat or prevent potassium deficiency (hypokalemia), particularly when accompanied by excess base (alkalosis) and abnormally low chloride levels in the blood (hypochloraemic alkalosis). It is also used as a component of parenteral nutrition for patients who cannot eat normally.
Potassium is the most abundant intracellular cation in the human body and is essential for numerous physiological processes. The body maintains a narrow range of serum potassium concentration, normally between 3.5 and 5.0 mmol/L, through a carefully regulated balance of intake, cellular distribution and renal excretion. Even small deviations outside this range can have significant clinical consequences, particularly affecting cardiac function.
Hypokalemia — defined as a serum potassium concentration below 3.5 mmol/L — is one of the most commonly encountered electrolyte disturbances in clinical practice. It occurs in approximately 20% of hospitalised patients and can result from a variety of causes, including excessive losses through the gastrointestinal tract (vomiting, diarrhoea), increased renal excretion (often due to diuretic therapy), inadequate dietary intake, or redistribution of potassium from the extracellular to the intracellular compartment.
When oral potassium replacement is insufficient, not feasible (for example, due to nausea, vomiting, bowel obstruction or critical illness), or when the deficit is severe, intravenous potassium chloride replacement becomes necessary. Addens-Kaliumklorid B. Braun provides potassium and chloride ions in a concentrated form that can be added to standard intravenous infusion fluids, allowing controlled correction of the electrolyte imbalance under medical supervision.
The chloride component is particularly important because hypokalemia frequently coexists with metabolic alkalosis and hypochloraemia. In this setting, chloride replacement is essential for the kidneys to appropriately retain potassium and correct the alkalosis. This is why potassium chloride is generally preferred over other potassium salts (such as potassium phosphate or potassium bicarbonate) for the treatment of most cases of hypokalemia.
Indications
- Hypokalemia: Treatment and prevention of low potassium levels, especially when accompanied by hypochloraemic alkalosis
- Parenteral nutrition: As a potassium supplement in patients receiving intravenous feeding who cannot eat by mouth
- Perioperative care: Maintenance and correction of potassium levels in surgical patients
- Diuretic-induced hypokalemia: Replacement of potassium losses caused by loop or thiazide diuretic therapy
Potassium chloride concentrate is classified as a high-risk medication by the Institute for Safe Medication Practices (ISMP) and the World Health Organization. Concentrated potassium chloride solutions have been involved in serious medication errors and fatalities. This is why they should only be handled, prepared and administered by trained healthcare professionals in an appropriate clinical setting.
What Should You Know Before Receiving Addens-Kaliumklorid B. Braun?
Addens-Kaliumklorid B. Braun must not be used if you have abnormally high levels of potassium (hyperkalemia) or chloride (hyperchloraemia) in the blood. Special caution is required in patients with heart problems, kidney impairment, Addison's disease or conditions associated with reduced potassium excretion. Your healthcare team will monitor your electrolyte levels and may perform ECG monitoring during treatment.
Contraindications
Addens-Kaliumklorid B. Braun must not be administered if you have:
- Hyperkalemia: Abnormally high potassium levels in the blood (serum potassium above 5.0 mmol/L)
- Hyperchloraemia: Abnormally high chloride levels in the blood
These are absolute contraindications. Adding further potassium to a patient who already has elevated potassium levels can precipitate life-threatening cardiac arrhythmias, including ventricular fibrillation and cardiac arrest. Before initiating potassium replacement therapy, a current serum potassium measurement must be obtained.
Warnings and Precautions
Inform your physician before receiving Addens-Kaliumklorid B. Braun if you have any of the following conditions, as they require special caution and closer monitoring:
- Heart disease: Cardiac conditions, including heart failure and arrhythmias, require particularly careful potassium management because both hypokalemia and hyperkalemia can destabilise cardiac rhythm
- Kidney impairment: The kidneys are the primary route of potassium excretion. Reduced kidney function impairs the body's ability to eliminate excess potassium, increasing the risk of hyperkalemia. In severe renal impairment or dialysis patients, a nephrologist should be consulted before administration
- Addison's disease: Adrenal insufficiency is associated with reduced aldosterone production, which leads to decreased potassium excretion by the kidneys
- Sickle cell disease: This inherited blood disorder can be associated with abnormal potassium handling
- Shock: Acute circulatory failure with low blood pressure, cold skin, rapid heartbeat and irregular breathing affects tissue perfusion and can alter potassium distribution
- Extensive tissue damage: Burns, crush injuries or rhabdomyolysis can release large amounts of intracellular potassium into the bloodstream
- Hyperkalemic familial periodic paralysis: A genetic condition causing episodes of muscle weakness associated with elevated potassium levels
- Severe malnutrition: Refeeding severely malnourished patients carries a risk of refeeding syndrome, a potentially fatal condition involving dangerous shifts in electrolytes including potassium
The healthcare professional administering the infusion must ensure that the solution is delivered into a vein. Extravasation (leakage outside the vein into surrounding tissue) can cause significant tissue damage and necrosis. If initial treatment is for potassium deficiency, concurrent glucose infusions should generally be avoided as glucose can further reduce serum potassium by stimulating insulin release and driving potassium into cells.
During treatment, your healthcare team will regularly monitor your serum electrolyte concentrations and acid-base balance to ensure values remain within the normal range. ECG monitoring may also be performed, particularly in patients with cardiac disease or severe hypokalemia. Elderly patients are at increased risk of cardiac and renal complications and will be monitored especially closely, with careful dose adjustment.
Pregnancy and Breastfeeding
If you are pregnant, think you may be pregnant, or are planning to become pregnant, discuss this with your physician before receiving this medication. Potassium is a normal body electrolyte, and maintaining adequate potassium levels is important during pregnancy for both maternal and foetal health. Your physician will determine whether the benefits of treatment outweigh any potential risks.
Addens-Kaliumklorid B. Braun can be used during breastfeeding. Potassium is a natural constituent of breast milk, and appropriate correction of maternal potassium deficiency is not expected to pose a risk to the nursing infant.
This medication has no known effect on the ability to drive or operate machinery.
How Does Addens-Kaliumklorid B. Braun Interact with Other Drugs?
Potassium chloride has clinically significant interactions with several important drug classes. Medications that reduce potassium excretion (such as potassium-sparing diuretics, ACE inhibitors, ARBs, immunosuppressants, NSAIDs and heparin) can increase the risk of dangerous hyperkalemia when combined with potassium supplementation. Cardiac glycosides have altered effectiveness depending on potassium levels. Always inform your doctor about all medications you are taking.
Drug interactions with potassium chloride can be grouped into three main categories: medications that increase the risk of hyperkalemia, medications that increase potassium excretion (potentially requiring dose adjustments), and medications whose effects are altered by changes in potassium levels. Understanding these interactions is critical for safe therapy.
Major Interactions — Increased Risk of Hyperkalemia
| Drug Class | Examples | Mechanism | Clinical Significance |
|---|---|---|---|
| Potassium-sparing diuretics | Spironolactone, amiloride, triamterene, eplerenone | Reduce renal potassium excretion by blocking aldosterone or epithelial sodium channels | High — concurrent use with potassium supplementation can cause severe hyperkalemia |
| ACE inhibitors | Enalapril, ramipril, lisinopril, perindopril | Reduce aldosterone secretion, decreasing renal potassium excretion | High — regular monitoring of serum potassium is essential |
| Angiotensin II receptor blockers (ARBs) | Losartan, valsartan, candesartan, irbesartan | Reduce aldosterone secretion similarly to ACE inhibitors | High — potassium monitoring required during concurrent use |
| Immunosuppressants | Tacrolimus, ciclosporin | Reduce renal potassium excretion through multiple mechanisms including tubular dysfunction | High — hyperkalemia is a common complication |
| NSAIDs | Ibuprofen, diclofenac, naproxen | Reduce renal blood flow and aldosterone secretion, impairing potassium excretion | Moderate — especially significant in patients with renal impairment |
| Heparin | Unfractionated heparin, LMWH | Suppresses aldosterone synthesis | Moderate — risk increases with prolonged use |
| Neuromuscular blockers | Suxamethonium (succinylcholine) | Suxamethonium causes potassium release from muscle cells | High — combined use can cause dangerous hyperkalemia and cardiac arrhythmias |
Interactions Affecting Potassium Levels
| Drug Class | Examples | Effect |
|---|---|---|
| Loop diuretics | Furosemide, bumetanide, torasemide | Significantly increase urinary potassium loss; may reduce effectiveness of potassium supplementation |
| Thiazide diuretics | Hydrochlorothiazide, indapamide, chlorthalidone | Increase urinary potassium excretion; common cause of hypokalemia requiring replacement |
| Corticosteroids | Prednisolone, dexamethasone, hydrocortisone | Mineralocorticoid activity promotes renal potassium wasting |
| ACTH | Tetracosactide (Synacthen) | Stimulates adrenal cortisol and aldosterone production, increasing potassium excretion |
Effect on Cardiac Glycosides
Cardiac glycosides such as digoxin have a complex and clinically important relationship with potassium levels. The therapeutic and toxic effects of digoxin are directly influenced by serum potassium concentration:
- When potassium increases: The effect of digoxin becomes weaker. This means that correcting hypokalemia in a patient on digoxin may reduce the drug's therapeutic effect, potentially requiring dose adjustment
- When potassium decreases: The effect of digoxin becomes stronger, and the risk of digoxin toxicity (which can cause dangerous cardiac arrhythmias) increases significantly
This interaction is clinically very important because many patients taking digoxin are also on diuretics, which can cause potassium depletion. Maintaining normal potassium levels is essential for the safe use of cardiac glycosides.
What Is the Correct Dosage of Addens-Kaliumklorid B. Braun?
The dose of Addens-Kaliumklorid B. Braun is individualised based on the patient's serum electrolyte concentrations, acid-base balance, age and clinical condition. The concentrate must be diluted before intravenous administration. The standard maximum potassium concentration in the infusion solution is 40 mmol per litre. In severe hypokalemia (serum potassium below 2 mmol/L), concentrations up to 80 mmol per litre may be used under close monitoring.
Addens-Kaliumklorid B. Braun is always administered after dilution with a suitable infusion fluid. It is given through a cannula or small tube inserted into a vein (intravenous infusion). The dose is determined by the treating physician based on individual patient assessment, including laboratory results and clinical status.
Adults
Standard Dosing Guidelines
The typical daily potassium requirement for maintenance in adults is approximately 40–80 mmol per day, although this varies considerably depending on the clinical situation. For correction of hypokalemia, higher doses may be needed. Key principles include:
- Maximum 40 mmol potassium per litre of infusion fluid under standard conditions
- Up to 80 mmol per litre may be used when serum potassium is below 2 mmol/L, with close monitoring
- Maximum infusion rate should generally not exceed 10–20 mmol per hour
- Up to 4 ampoules (80 mmol, from 20 ml ampoules at 1 mmol/ml) can be added to 1000 ml of most common infusion fluids
- An infusion pump should be used when correcting potassium levels to ensure accurate delivery
Compatible infusion fluids include amino acid solutions, glucose solutions, glucose-electrolyte solutions and standard electrolyte solutions. The potassium chloride concentrate must be added aseptically to the infusion fluid immediately before starting the infusion. Thorough mixing is essential to prevent layering of the concentrated solution at the bottom of the infusion bag, which could deliver a dangerously high bolus of potassium.
Children
Paediatric Dosing
Potassium replacement in children requires careful calculation based on body weight and individual needs. General guidelines include:
- Typical maintenance requirement: 1–2 mmol/kg/day
- Maximum infusion rate: 0.5 mmol/kg/hour (not to exceed adult maximum)
- Serum potassium must be monitored frequently during replacement
- All paediatric doses should be calculated and verified by a paediatric specialist or clinical pharmacist
Elderly Patients
Elderly patients have an increased susceptibility to both cardiac and renal complications and will be monitored particularly closely during treatment. Dose adjustments are typically necessary due to the age-related decline in renal function that reduces the body's ability to handle excess potassium. The dose should be carefully titrated based on frequent serum electrolyte measurements and clinical response.
Missed Dose
As this medication is administered in a hospital setting by healthcare professionals, missed doses are unlikely. If an infusion is interrupted, your healthcare team will assess your electrolyte levels and determine whether to resume the infusion and at what rate.
Overdose
Overdose with potassium chloride can cause hyperkalemia (abnormally high potassium levels in the blood), which is a medical emergency. Since this medication is administered in a controlled clinical environment, overdose is unlikely but can occur if the infusion rate is too fast or the dose is miscalculated.
Symptoms of potassium overdose (hyperkalemia) include:
- Slow heart rate (bradycardia) or cardiac arrest
- ECG changes (peaked T waves, widened QRS complex, loss of P waves)
- Low blood pressure (hypotension)
- Muscle weakness and fatigue
- Numbness and tingling in the extremities (paraesthesia)
- Confusion and mental status changes
- Muscle twitching or paralysis
Severe hyperkalemia (serum potassium > 6.5 mmol/L or with ECG changes) requires immediate treatment, which may include intravenous calcium gluconate to stabilise the heart, insulin with glucose to shift potassium into cells, sodium bicarbonate, inhaled salbutamol and, in severe cases, haemodialysis. Any potassium-containing infusion must be stopped immediately.
What Are the Side Effects of Addens-Kaliumklorid B. Braun?
Like all medicines, Addens-Kaliumklorid B. Braun can cause side effects, although not everyone experiences them. The most serious potential side effect is cardiac arrhythmia from too-rapid infusion. Other side effects include hyperkalemia, metabolic acidosis, hyperchloraemia, nausea and local reactions at the injection site. Contact your healthcare team immediately if you experience an irregular heartbeat during the infusion.
The side effects of intravenous potassium chloride are primarily related to the rate and concentration of the infusion and to the resulting serum potassium levels. When administered correctly according to guidelines, with appropriate monitoring and at the proper infusion rate, serious side effects are uncommon.
Serious — Seek Immediate Medical Attention
May affect an unknown number of users
- Cardiac arrhythmia — irregular heartbeat caused by too-rapid infusion; can be life-threatening
Overdose-Related Effects (Hyperkalemia)
Occurs when serum potassium exceeds normal range
- Slow heart rate (bradycardia) or cardiac arrest
- ECG changes
- Low blood pressure (hypotension)
- Redistribution of blood from limbs to trunk
- Muscle weakness and fatigue
- Confusion
- Heaviness in limbs
- Muscle twitching
- Numbness or tingling (paraesthesia)
- Paralysis
Metabolic Side Effects
Frequency not known
- Metabolic acidosis — accumulation of acid in the blood
- Hyperchloraemia — abnormally high chloride levels in the blood
Gastrointestinal
Frequency not known
- Nausea
Injection Site Reactions
Frequency not known
- Local pain at the infusion site
- Irritation of the vein
- Thrombophlebitis — inflammation of the vein at the infusion site
- Extravasation — leakage of the solution into surrounding tissue, which can cause tissue damage
The risk of injection site reactions can be minimised by ensuring correct cannula placement, using appropriate dilution, and infusing at the recommended rate. If you notice any pain, swelling or redness at the infusion site, inform your nurse or doctor immediately, as this may indicate extravasation or phlebitis.
It is important to report suspected side effects after the medicine has been authorised. This allows continuous monitoring of the benefit-risk balance of the medicine. Healthcare professionals and patients are encouraged to report suspected adverse reactions to their national regulatory authority (e.g. the EMA in the EU, the FDA in the United States, the MHRA in the United Kingdom).
How Should You Store Addens-Kaliumklorid B. Braun?
Addens-Kaliumklorid B. Braun requires no special storage conditions. Store at room temperature, keep out of reach of children, and do not use after the expiry date. Only use the solution if it is clear, colourless and the container is undamaged. The container is for single use only.
Proper storage and handling of potassium chloride concentrate is essential for patient safety. The following guidelines apply:
- Temperature: No special temperature requirements. Store at normal room temperature away from direct sunlight and extreme heat
- Children: Keep out of the sight and reach of children at all times
- Expiry date: Do not use after the expiry date printed on the label and carton (after "EXP"). The expiry date refers to the last day of the month indicated
- Visual inspection: Only use the solution if it is clear and colourless. Do not use if the container or closure is damaged or if there are any particles visible in the solution
- Single use: The container is designed for single use only. Discard any unused solution after opening
- After dilution: From a microbiological standpoint, the diluted product should be used immediately. If not used immediately, storage time should not exceed 24 hours at 2–8°C, provided dilution took place under controlled and validated aseptic conditions
- Disposal: Unused medicine and waste material should be disposed of in accordance with local regulations and hospital protocols
In healthcare settings, concentrated potassium chloride solutions should be stored separately from other medications and clearly labelled to prevent inadvertent undiluted administration. Many hospitals have implemented specific safety protocols for the storage and handling of concentrated potassium solutions as recommended by the WHO and patient safety organisations.
What Does Addens-Kaliumklorid B. Braun Contain?
The active substance is potassium chloride. Each millilitre of the 1 mmol/ml solution contains 74.5 mg of potassium chloride, equivalent to 1 mmol of potassium and 1 mmol of chloride. The only other ingredient is water for injections.
Active Ingredient
Potassium chloride (KCl) is the sole active ingredient. It is an inorganic compound that dissolves readily in water, dissociating into potassium (K+) and chloride (Cl−) ions. Both ions are essential electrolytes with important physiological roles.
| Container | Volume | KCl Content | Potassium Content |
|---|---|---|---|
| Mini Plasco plastic ampoule | 20 ml | 1.49 g | 20 mmol |
| Glass bottle | 50 ml | 3.73 g | 50 mmol |
Inactive Ingredient
The only excipient is water for injections (aqua ad iniectabilia), a highly purified sterile water that meets strict pharmacopoeial standards for use in injectable preparations.
Appearance
Addens-Kaliumklorid B. Braun is a clear, colourless aqueous solution with a pH range of 4.5 to 7.5.
Available Packaging
- Mini Plasco polyethylene plastic ampoules: 20 × 20 ml
- Mini Plasco Connect polyethylene plastic ampoules: 20 × 20 ml
- Glass bottles with halobutyl rubber stopper: 20 × 50 ml
Not all pack sizes may be marketed in all countries.
Known Brand Names
Potassium chloride for injection is available from several manufacturers under different brand names. Other brands containing the same active substance include:
- Kaliumklorid Noridem
- Addex-Kaliumklorid
- Kaliumklorid Orifarm
While these products contain the same active ingredient, they may differ in concentration, packaging and excipients. Always check the specific product label and prescribing information.
Frequently Asked Questions
Addens-Kaliumklorid B. Braun is a concentrated potassium chloride solution used to treat or prevent low potassium levels (hypokalemia) in the blood. It is administered intravenously after dilution with a suitable infusion fluid, particularly when oral potassium replacement is not possible or sufficient. It is also used as a component of parenteral nutrition for patients who cannot eat normally. Hypokalemia is a common electrolyte disturbance that can cause muscle weakness, cardiac arrhythmias and other complications if left untreated.
Absolutely not. Addens-Kaliumklorid B. Braun is a concentrated solution that must always be diluted with a suitable infusion fluid before intravenous administration. Undiluted intravenous potassium chloride can cause fatal cardiac arrhythmias and death. The concentrated potassium chloride must be mixed into an infusion bag (typically 500 ml or 1000 ml) to achieve a safe concentration before being infused. The maximum recommended concentration is normally 40 mmol of potassium per litre of infusion fluid.
The most serious potential complication is hyperkalemia (abnormally high blood potassium), which can lead to dangerous cardiac arrhythmias, cardiac arrest and death. Symptoms of hyperkalemia include slow or irregular heartbeat, muscle weakness, numbness, tingling, confusion and characteristic ECG changes. Too-rapid infusion can also directly cause cardiac arrhythmias even before significant hyperkalemia develops. Additionally, extravasation (leakage of the solution into tissue outside the vein) can cause significant local tissue damage. These risks are minimised by proper dilution, controlled infusion rates and regular monitoring.
Several drug classes require caution when combined with potassium supplementation. Potassium-sparing diuretics (spironolactone, amiloride, triamterene), ACE inhibitors (enalapril, ramipril), angiotensin receptor blockers (losartan, valsartan), immunosuppressants (tacrolimus, ciclosporin), NSAIDs (ibuprofen, diclofenac) and heparin can all increase the risk of dangerous hyperkalemia. Suxamethonium (a muscle relaxant) can also cause a dangerous rise in potassium when given with potassium supplements. Additionally, changes in potassium levels affect the action of cardiac glycosides like digoxin, potentially leading to toxicity.
Potassium is a normal body electrolyte, and maintaining normal potassium levels is important during pregnancy for both maternal and foetal health. Your physician will evaluate whether the benefits of treatment outweigh any potential risks based on your individual circumstances. During breastfeeding, Addens-Kaliumklorid B. Braun can be used, as potassium is a natural component of breast milk and appropriate correction of maternal hypokalemia is not expected to harm the nursing infant. Always inform your physician if you are pregnant, planning pregnancy or breastfeeding.
Addens-Kaliumklorid B. Braun has no special storage requirements. It should be kept at room temperature, out of direct sunlight, and out of the reach of children. Do not use the solution after the printed expiry date, if the solution is not clear and colourless, or if the container is damaged. The container is for single use only — discard any unused solution. After dilution, the product should be used immediately or stored at 2–8°C for a maximum of 24 hours if prepared under validated aseptic conditions.
References and Sources
This article is based on the following evidence-based sources, international guidelines and regulatory documents:
- European Medicines Agency (EMA). Summary of Product Characteristics: Potassium Chloride Concentrate for Solution for Infusion. EMA Product Database. Available at: www.ema.europa.eu
- World Health Organization. WHO Model List of Essential Medicines – 23rd List (2023). World Health Organization. Geneva: WHO; 2023.
- British National Formulary (BNF). Potassium Chloride. In: BNF 86. London: BMJ Group and Pharmaceutical Press; 2024.
- Unwin RJ, Luft FC, Shirley DG. Pathophysiology and management of hypokalemia: a clinical perspective. Nature Reviews Nephrology. 2011;7(2):75–84. doi:10.1038/nrneph.2010.175
- Kardalas E, Paschou SA, Anagnostis P, et al. Hypokalemia: a clinical update. Endocrine Connections. 2018;7(4):R135–R146. doi:10.1530/EC-18-0109
- Institute for Safe Medication Practices (ISMP). ISMP List of High-Alert Medications in Acute Care Settings. ISMP. 2024. Available at: www.ismp.org
- Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Treatment of electrolyte disorders in adult patients in the intensive care unit. American Journal of Health-System Pharmacy. 2005;62(16):1663–1682. doi:10.2146/ajhp040300
- Palmer BF, Clegg DJ. Physiology and pathophysiology of potassium homeostasis: Core Curriculum 2019. American Journal of Kidney Diseases. 2019;74(5):682–695. doi:10.1053/j.ajkd.2019.03.427
- World Health Organization. Medication Safety in High-risk Situations. WHO Technical Report Series. Geneva: WHO; 2019.
- B. Braun Melsungen AG. Package Leaflet: Information for the User – Addens-Kaliumklorid B. Braun. Melsungen, Germany: B. Braun Melsungen AG; 2018.
Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, which includes specialist physicians with expertise in clinical pharmacology, internal medicine and critical care medicine.
Medical Writing
iMedic Medical Editorial Team — specialists in clinical pharmacology and internal medicine with extensive experience in drug information and patient education.
Medical Review
iMedic Medical Review Board — independent panel of board-certified physicians who verify all medical content against current international guidelines and evidence-based standards.
Editorial Standards: All content follows the GRADE evidence framework, adheres to WHO, EMA and BNF guidelines, and is free from commercial influence. For more information, see our Editorial Standards.