From the Guidelines
Over-the-counter potassium supplements should be taken only after consulting with a healthcare provider, as they can be dangerous if used incorrectly. The typical OTC potassium supplements contain potassium chloride and are limited to 99 mg per dose, which is only about 2.5% of the daily recommended intake of 3,500-4,700 mg 1. These supplements should be taken with a full glass of water and with food to minimize stomach irritation. Never exceed the recommended dosage on the package or prescribed by your doctor. Common OTC brands include K-Dur, Klor-Con, and Micro-K, though prescription-strength versions of these are more common. If you experience symptoms like nausea, vomiting, abdominal pain, or irregular heartbeat while taking potassium supplements, stop taking them and seek medical attention immediately. Potassium supplements can interact with many medications, including ACE inhibitors, ARBs, and certain diuretics, potentially causing dangerous elevations in blood potassium levels 1. Most people should aim to get potassium through dietary sources like bananas, potatoes, spinach, and avocados rather than supplements, as a diet rich in potassium is recommended for adults, with an adequate intake level of 4700 mg/day 1.
Some key points to consider when taking OTC potassium supplements include:
- Always consult with a healthcare provider before taking potassium supplements
- Take the supplements with a full glass of water and with food to minimize stomach irritation
- Never exceed the recommended dosage on the package or prescribed by your doctor
- Be aware of potential interactions with other medications, such as ACE inhibitors, ARBs, and certain diuretics
- Consider getting potassium through dietary sources instead of supplements, as a diet rich in potassium is recommended for adults 1.
It's also important to note that the 2020 update of the KDOQI clinical practice guideline for nutrition in CKD suggests that dietary or supplemental potassium intake should be based on a patient's individual needs and clinician judgment, especially for adults with CKD 3-5D or posttransplantation 1. However, for the general population, the recommendation is to aim for a dietary intake of potassium rather than relying on supplements, as supported by the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
From the Research
Guidelines for Taking OTC Potassium Supplements
- The decision to take over-the-counter (OTC) potassium supplements should be made with caution, as excessive potassium intake can lead to hyperkalemia, a condition characterized by elevated serum potassium levels 2.
- According to the World Health Organization, a potassium intake of at least 3,510 mg per day is recommended for optimal cardiovascular health 2.
- However, the evidence base for potassium requirements is limited, and more research is needed to define specific values for optimal potassium intakes 3.
- Potassium supplements may be necessary for individuals with certain medical conditions, such as hypokalemia (low serum potassium levels), but should only be taken under the guidance of a healthcare professional 4, 2, 5.
Special Considerations
- Increasing dietary potassium intake in the elderly and in patients with renal impairment must be considered with caution, as these individuals may be more susceptible to hyperkalemia 4.
- Patients with chronic renal failure may require potassium supplementation to maintain normal serum potassium levels, but this should be done under medical supervision 6.
- The use of potassium-sparing diuretics in combination with non-potassium-retaining diuretics is not justified for the routine treatment of hypertension and oedematous states, unless the patient has a specific condition that requires potassium supplementation 4.
Treatment of Potassium Imbalances
- Hypokalemia can be treated with oral or intravenous potassium supplements, depending on the severity of the condition 2, 5.
- Hyperkalemia can be treated with emergency measures such as intravenous calcium, insulin, and sodium bicarbonate, as well as long-term management with potassium binders and dietary counseling 2.