Can Micro-K (phylloquinone) capsules be opened?

Opening Micro-K Capsules: Safety and Administration Considerations

Micro-K (potassium chloride) capsules should not be opened as this can disrupt their extended-release properties, potentially leading to dangerous rapid release of potassium and increased risk of gastrointestinal irritation. 1

Understanding Micro-K Formulation

• Micro-K is a potassium chloride supplement formulated as extended-release capsules (Extencaps) designed to gradually release potassium over time to minimize gastrointestinal irritation and optimize absorption 2
• The extended-release mechanism is critical for safety, as rapid release of potassium can cause local gastrointestinal irritation and potentially dangerous serum potassium fluctuations 1

Risks of Opening Extended-Release Capsules

• Opening extended-release formulations like Micro-K disrupts the controlled-release mechanism, which can result in:
  • Immediate release of the full potassium dose, increasing risk of hyperkalemia 1
  • Direct contact of potassium chloride with the gastric mucosa, potentially causing irritation or ulceration 1
  • Altered drug absorption patterns that may lead to unpredictable clinical effects 1

Alternative Administration Options

For Patients with Difficulty Swallowing:

• Consider switching to a liquid potassium formulation that can be more easily administered 1
• Discuss with the prescriber about changing to another potassium supplement formulation that better meets the patient's needs 2, 3
• For patients requiring administration through feeding tubes, liquid potassium formulations are more appropriate than opened capsules 1

Important Clinical Considerations

• Patient preference studies have shown that while solid dosage forms are generally preferred over liquid forms for potassium supplementation, the specific formulation matters for adherence 2
• When changing potassium formulations, maintain equivalent dosing to ensure continued therapeutic effect 3
• For patients on anticoagulants (particularly vitamin K antagonists like warfarin), careful monitoring is needed with any change in potassium supplementation regimen, as disruptions in potassium levels can affect anticoagulation 4

Practice Recommendations

• Always consult with a pharmacist before modifying any extended-release medication formulation 1
• Document any difficulties with medication administration and communicate these to the healthcare team to find appropriate alternatives 5
• Consider patient-specific factors such as hand strength and dexterity when selecting potassium supplement formulations, particularly for elderly patients or those with rheumatoid arthritis 5