K-Dur 1.5 mg Conversion to mEq
There appears to be an error in the stated dose, as K-Dur (potassium chloride extended-release) is not manufactured in a 1.5 mg strength. K-Dur is available as 10 mEq (750 mg KCl) and 20 mEq (1500 mg KCl) tablets 1.
Likely Intended Dose Conversions
If the intended dose is 1.5 grams (1500 mg):
If the intended dose is 750 mg:
Critical Considerations for Heart Failure Patients with Renal Impairment
Target Potassium Range
- Maintain serum potassium between 4.0-5.0 mEq/L in heart failure patients, as both hypokalemia and hyperkalemia increase mortality risk with a U-shaped correlation 2, 3
- High-normal potassium levels (5.0-5.5 mEq/L) are associated with improved survival in heart failure patients 3
Dosing Recommendations
- For prevention of hypokalemia: 20 mEq per day 1
- For treatment of potassium depletion: 40-100 mEq per day, divided so no more than 20 mEq is given in a single dose 1
- Each dose should be taken with meals and a full glass of water to minimize gastric irritation 1
Monitoring in Renal Impairment
- Check potassium and renal function within 2-3 days and again at 7 days after initiation, then monthly for 3 months, then every 3 months thereafter 2
- More frequent monitoring is essential in patients with renal impairment, heart failure, or concurrent use of RAAS inhibitors 2
Special Cautions
- Avoid potassium supplementation if patient is on ACE inhibitors or ARBs combined with aldosterone antagonists, as this dramatically increases hyperkalemia risk 4, 2
- Potassium-sparing diuretics (spironolactone, amiloride, triamterene) are more effective than oral supplements for persistent diuretic-induced hypokalemia and provide more stable levels 2, 5, 6
- If potassium rises above 5.5 mEq/L, halve the dose; if >6.0 mEq/L, stop immediately 4
Common Pitfall
Never supplement potassium without first checking and correcting magnesium levels, as hypomagnesemia is the most common cause of refractory hypokalemia 2, 7