KCL

The dosage is dependent on age, weight and clinical condition of the patient, especially those with renal or cardiac insufficiency. Fluid balance, serum glucose, serum sodium and other electrolytes may need to be monitored before and during administration, especially in patients with increased non-osmotic vasopressin release (syndrome of inappropriate antidiuretic hormone secretion, SIADH) and in patients co-medicated with vasopressin agonist drugs due to the risk of hyponatraemia.

Monitoring of serum sodium is particularly important for physiologically hypotonic fluids. 8). Dosage and rate of infusion should be determined by ECG and serum electrolyte monitoring. w. in 24 h. /d should be supplied.

Children:

The volume and rate of infusion will depend upon the requirements of the individual patient. Reduced volumes and rates of infusion will be required.

Rate of Infusion :

The rate of infusion should be guided by ECG and serum electrolyte monitoring. Adequate urine flow must be ensured. 5 mmol/l and 40 mmol/h if serum potassium levels are below 2 mmol/l. 18% NaCl, and 4% Glucose” may be administered as long as there is an indication for energy, electrolyte and fluid administration.

Method and route of administration Intravenous infusion via a large peripheral or central vein to avoid the risk of sclerosing. If infused through a central vein, to avoid localised hyperkalaemia the catheter must not be in the atrium or ventricle.

This container contains a significant volume of air. To avoid risk of air embolism, this product must not be administered by pressure infusion.

Listing of undesirable effects Undesirable effects are listed according to their frequencies as follows: Very common (≥ 1/10) Common (≥ 1/100 to < 1/10) Uncommon (≥ 1/1,000 to < 1/100) Rare (≥ 1/10,000 to < 1/1,000) Very rare (< 1/10,000) Not known (frequency cannot be estimated from the available data) General disorders and administration site conditions Not known: Local pain and phlebitis may occur during administration of solutions containing 40 mmol or more potassium per litre.

4). In patients with severe renal or metabolic impairment or when the infusion is either carried out too rapidly or to excess, it is possible that overhydration, hyperglycaemia or potassium intoxication results. Symptoms of hyperkalaemia include paresthesias of extremities, muscle or respiratory paralysis, areflexia, weakness, listlessness, cold skin, gray pallor, mental confusion, weakness and heaviness of legs, hypotension, cardiac arrhythmia, heart block, ECG abnormalities with development of biphasic curves and cardiac arrest.

Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard.

– Solutions with low salt, especially sodium, should only be administered with special caution to children and close monitoring of electrolyte and fluid balance should be performed. − Solutions containing potassium should be administered slowly and only after renal function has been established and proved adequate.

In patients with renal impairment, its use must be carefully controlled by frequent determinations of plasma potassium concentrations and periodic ECGs. The infusion must be discontinued if signs of renal insufficiency develop during infusion.

− Solutions containing sodium chloride must be used with caution in patients who have an impaired ability to handle sodium and fluid such as heart disease especially with a history of congestive heart failure, patients with renal insufficiency, cirrhosis of the liver, cardio-pulmonary disease, or patients receiving salt-retaining steroids.

− Potassium supplements should be administered with caution in patients with cardiac disease particularly in digitalised patients. g. when discontinuing the infusion) in digitalised patients can cause cardiac glycoside toxicity. 18% NaCl, and 4% Glucose” is a slightly hypertonic solution.

2). Depending on the tonicity of the solution, the volume and rate of infusion and depending on a patient's underlying clinical condition and capability to metabolise glucose, intravenous administration of these solutions can cause electrolyte disturbances most importantly hypo- or hyperosmotic hyponatraemia.

g. 5) are at particular risk of acute hyponatraemia upon infusion of hypotonic fluids. Acute hyponatraemia can lead to acute hyponatraemic encephalopathy (brain oedema) characterized by headache, nausea, seizures, lethargy and vomiting.

Patients with brain oedema are at particular risk of severe, irreversible and life-threatening brain injury. g. meningitis, intracranial bleeding, and cerebral contusion) are at particular risk of the severe and life-threatening brain swelling caused by acute hyponatraemia.

− Hyperkalaemia, − Severe renal impairment with oliguria, anuria, or azotaemia, − Hyperchloraemia, − Acute ischaemic stroke, − Head trauma (first 24 hours) − Hyperhydration.