How to convert Potassium Chloride (KCl) 20 milliequivalents (mEq)/15 milliliters (mL) (10%) solution to tablets?

Converting Potassium Chloride Solution to Tablets

For a patient taking Potassium Chloride 20 mEq/15 mL (10%) solution, the equivalent tablet dose is one 20 mEq extended-release tablet taken once daily, or two 10 mEq extended-release tablets taken once daily. 1

Direct Conversion

• The FDA-approved potassium chloride extended-release tablets contain either 1500 mg of microencapsulated potassium chloride (equivalent to 20 mEq) or 750 mg (equivalent to 10 mEq) per tablet 1
• One 20 mEq extended-release tablet provides the exact same potassium content as 15 mL of the 10% solution 1
• Alternatively, two 10 mEq extended-release tablets can be used to achieve the same 20 mEq daily dose 1

Administration Instructions for Tablets

• Tablets must be taken with meals and a full glass of water to minimize gastrointestinal irritation 1
• Patients should swallow tablets whole without crushing, chewing, or sucking 1
• If swallowing whole tablets is difficult, the tablet may be broken in half and each half taken separately with water 1
• An alternative aqueous suspension method can be used: place the whole tablet in approximately 4 fluid ounces of water, allow 2 minutes to disintegrate, stir for 30 seconds, and consume immediately 1

Advantages of Tablet Formulation Over Liquid

• The extended-release tablet formulation is designed to slow potassium release, reducing the likelihood of high localized concentrations in the gastrointestinal tract 1
• Tablets begin disintegrating into microencapsulated crystals within seconds and completely disintegrate within 1 minute in simulated gastric fluid 1
• Patient tolerance is superior with tablets compared to liquid formulations, with 92% of subjects reporting "bad taste" with potassium chloride solution versus minimal taste complaints with tablets 2
• Bioavailability is equivalent between extended-release tablets and liquid preparations, with complete absorption occurring within 24 hours for both formulations 2
• The tablet formulation releases potassium approximately 30 minutes slower than liquid solution, which may improve gastrointestinal tolerance 2

Critical Monitoring Requirements

• When converting from liquid to tablet formulation, check serum potassium and renal function within 2-3 days and again at 7 days after the conversion 3
• Continue monitoring at least monthly for the first 3 months, then every 3 months thereafter 3
• More frequent monitoring is required in patients with renal impairment (creatinine >1.6 mg/dL), heart failure, or concurrent use of medications affecting potassium homeostasis 3

Important Caveats

• Patients should be instructed to check with their physician immediately if they notice tarry stools or other evidence of gastrointestinal bleeding, as potassium tablets can cause local mucosal necrosis 1, 4
• The extended-release formulation is not enteric-coated or wax matrix, but rather contains individually microencapsulated crystals that provide controlled release 1
• Aqueous suspensions of potassium chloride tablets that are not consumed immediately should be discarded; other liquids for suspending tablets are not recommended 1