Magnesium chloride/Meglumine sodium succinate/potassium chloride/sodium chloride Dosage
Medically reviewed on June 28, 2018.
Applies to the following strengths: 64 mg; 200 mg/mL
If oral administration is tolerated, mild hypomagnesemia may be treated with Slow-Mag 1 tablet (535 mg magnesium chloride, 64 mg elemental magnesium) orally once a day.
40 mEq (4 g magnesium chloride) in 5% dextrose or normal saline by IV infusion once over 3 hours.
10 mEq in 5% dextrose or normal saline by IV infusion once within the first 24 hours of infarction.
Hypomagnesemia: IV: Magnesium chloride: 0.2 to 0.4 mEq/kg/dose every 8 to 12 hours for 2 to 3 doses
Daily maintenance magnesium: IV: Magnesium chloride: 0.25 to 0.5 mEq/kg/day
IM or IV: Magnesium chloride: 0.2 to 0.4 mEq/kg/dose every 4 to 6 hours for 3 to 4 doses; maximum single dose: 16 mEq
Oral: Note: Achieving optimal magnesium levels using oral therapy may be difficult due to the propensity for magnesium to cause diarrhea; IV replacement may be more appropriate particularly in situations of severe deficit: Magnesium chloride: 10 to 20 mg/kg elemental magnesium per dose up to 4 times/day
Daily maintenance magnesium: IV Magnesium chloride:
Infants and Children less than or equal to 45 kg: 0.25 to 0.5 mEq/kg/day
Adolescents greater than 45 kg and Adults: 0.2 to 0.5 mEq/kg/day or 3 to 10 mEq/1000 kcal/day (maximum: 8 to 20 mEq/day).
Magnesium salts should be used cautiously in patients with renal impairment due to increased risk of hypermagnesemia.
Data not available
The dose may be increased periodically to achieve a normal serum magnesium level.
Because magnesium is primarily eliminated by the kidney, there is significant risk of hypermagnesemia in patients with renal impairment.
Data not available; however, use of magnesium salts is generally contraindicated in renal failure.
Magnesium supplements are often used with "low normal" serum magnesium levels in patients predisposed to hypomagnesemia (e.g., patients on diuretics).
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Other brands: Chloromag, Mag-SR
Calcium carbonate can make it harder for your body to absorb certain drugs, making them less effective. If you take other medicines, take your Magnesium chloride dose 2 hours before or 2 hours after you take the other medicine.
Tell your doctor about all your other medicines, especially:
heart or blood pressure medicine; or
medicine to treat osteoporosis or Paget's disease of bone--Actonel, Boniva, Fosamax, Reclast, Zometa, and others.
This list is not complete. Other drugs may affect Magnesium chloride, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Magnesium chloride drug interactions (in more detail)
Alfacalcidol: May increase the serum concentration of Magnesium Salts. Consider therapy modification
Alpha-Lipoic Acid: Magnesium Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Magnesium Salts. Consider therapy modification
Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Avoid combination
Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Consider therapy modification
Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. Consider therapy modification
Calcitriol (Systemic): May increase the serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving calcitriol. If magnesium-containing products must be used with calcitriol, serum magnesium concentrations should be monitored closely. Consider therapy modification
Calcium Channel Blockers: May enhance the adverse/toxic effect of Magnesium Salts. Magnesium Salts may enhance the hypotensive effect of Calcium Channel Blockers. Monitor therapy
Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification
Dolutegravir: Magnesium Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral magnesium salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral magnesium salts. Consider therapy modification
Doxercalciferol: May enhance the hypermagnesemic effect of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If magnesium-containing products must be used with doxercalciferol, serum magnesium concentrations should be monitored closely. Consider therapy modification
Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Consider therapy modification
Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Consider therapy modification
Gabapentin: Magnesium Salts may enhance the CNS depressant effect of Gabapentin. Specifically, high dose intravenous/epidural magnesium sulfate may enhance the CNS depressant effects of gabapentin. Magnesium Salts may decrease the serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after use of a magnesium-containing antacid. Monitor patients closely for evidence of reduced response to gabapentin therapy. Monitor for CNS depression if high dose IV/epidural magnesium sulfate is used. Consider therapy modification
Levothyroxine: Magnesium Salts may decrease the serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral magnesium salts by at least 4 hours. Consider therapy modification
Multivitamins/Fluoride (with ADE): Magnesium Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). Specifically, magnesium salts may decrease fluoride absorption. Management: To avoid this potential interaction separate the administration of magnesium salts from administration of a fluoride-containing product by at least 1 hour. Consider therapy modification
Mycophenolate: Magnesium Salts may decrease the serum concentration of Mycophenolate. Management: Separate doses of mycophenolate and oral magnesium salts. Monitor for reduced effects of mycophenolate if taken concomitant with oral magnesium salts. Consider therapy modification
Neuromuscular-Blocking Agents: Magnesium Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Monitor therapy
PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Consider therapy modification
Phosphate Supplements: Magnesium Salts may decrease the serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral magnesium salt as possible to minimize the significance of this interaction. Exceptions: Sodium Glycerophosphate Pentahydrate. Consider therapy modification
Quinolones: Magnesium Salts may decrease the serum concentration of Quinolones. Management: Administer oral quinolones several hours before (4 h for moxi/pe/spar-, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome/pe-, 3 h for gemi-, and 2 h for levo-, nor-, or ofloxacin or nalidixic acid) oral magnesium salts. Exceptions: LevoFLOXacin (Oral Inhalation). Consider therapy modification
Raltegravir: Magnesium Salts may decrease the serum concentration of Raltegravir. Management: Avoid the use of oral / enteral magnesium salts with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. Avoid combination
Tetracyclines: Magnesium Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Management: Avoid coadministration of oral magnesium salts and oral tetracyclines. If coadministration cannot be avoided, administer oral magnesium at least 2 hours before, or 4 hours after, oral tetracyclines. Monitor for decreased tetracycline therapeutic effects. Exceptions: Eravacycline. Consider therapy modification
Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Consider therapy modification
Dosage depends on the type & location of the investigation.
Hypersensitivity reactions can be aggravated in patients on beta-blockers, particularly in people with bronchial asthma. Moreover, it should be considered that patients on beta-blockers may be refractory to standard treatment of hypersensitivity reactions with beta-agonists.
The prevalence of delayed reactions (eg fever, rash, flu-like symptoms, joint pain and pruritus) to contrast media is higher in patients who have received interleukin.
The presence of renal damage in diabetic patients is one of the factors predisposing to renal impairment following contrast media administration. This may precipitate lactic acidosis in patients who are taking biguanides. As a precaution, biguanides should be stopped 48 hours prior to the contrast agent examination and reinstated only after control of renal function has been regained.
Interference with diagnostic tests
Following the administration of iodinated contrast media, the capacity of the thyroid tissue to take up radioisotopes for diagnosing disorders of the thyroid is reduced for up to two weeks, and even longer in individual cases.
Pregnancy and lactation
Reproduction-toxicological studies with meglumine- or sodium amidotrizoate gave no indication of a teratogenic or other embryotoxic potential following an inadvertent administration of Urografin during pregnancy.
It has not been sufficiently demonstrated that contrast media are safe for use in pregnant patients. Since, wherever possible, radiation exposure should be avoided during pregnancy, the benefits of any X-ray examination, with or without contrast media, should be carefully weighed against the possible risk.
Renally eliminated contrast media like Urografin enter the breast milk in only very small amounts.
Limited data suggest that the risk to the suckling infant of administering salts of diatrizoic acid to its mother is low. Breastfeeding is probably safe.
Applies to the following strength(s): 8 mEq; 10 mEq; 20 mEq; 40 mEq/15 mL; 20 mEq/15 mL; 2 mEq/mL; 1.5 mEq/mL; 10 mEq/100 mL; 10 mEq/50 mL; 20 mEq/100 mL; 30 mEq/100 mL; 20 mEq/50 mL; 40 mEq/100 mL; 500 mg; 25 mEq; 15 mEq; 30 mEq/15 mL; 6.7 mEq; 3 mEq/mL; 99 mg; 40 mEq/250 mL-NaCl 0.9%; 40 mEq/500 mL-NaCl 0.9%; 50 mEq/500 mL-LR; 20 mEq/250 mL-NaCl 0.9%; 4 mEq/10 mL-NaCl 0.9%; 2 mEq/5 mL-NaCl 0.9%; 3 mEq/7.5 mL-NaCl 0.9%; 595 mg
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
40 to 100 mEq potassium chloride for injection diluted in an appropriate amount and type of solution to be intravenously infused once at a rate not to exceed 10 to 40 mEq/hour.
40 to 100 mEq orally once a day given in equally divided doses using formulations which include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution or powder for dissolution mixed with an appropriate volume of water or juice.
10 to 40 mEq potassium chloride for injection diluted in an appropriate amount and type of solution to be intravenously infused once at a rate not to exceed 40 mEq/hour.
10 to 20 mEq orally once a day given in equally divided doses using formulations which include normal-release tablets or capsules, extended-release tablets or capsules, dissolvable tablets, oral solution or powder for dissolution mixed with an appropriate volume of water or juice.
Treatment of hypokalemia: Note: High variability exists in dosing/infusion rate recommendations; therapy should be guided by patient condition and specific institutional guidelines.
Infants and Children:
Oral: 2 to 5 mEq/kg/day in divided doses; not to exceed 1 to 2 mEq/kg as a single dose; if deficits are severe or ongoing losses are great, IV route should be considered preferred route of administration.
Intermittent IV infusion (must be diluted prior to administration): 0.5 to 1 mEq/kg/dose (maximum dose: 40 mEq) to infuse at 0.3 to 0.5 mEq/kg/hour (maximum dose/rate: 1 mEq/kg/hour); then repeated as needed based on frequently obtained lab values; severe depletion or ongoing losses may require more than 200% of normal daily limit needs.
IV doses in children should be incorporated into the maintenance IV fluids. Intermittent IV potassium administration should be reserved for severe depletion situations. Continuous ECG monitoring should be used for intermittent doses greater than 0.5 mEq/kg/hour.
Normal daily requirements:
Infants: 2 to 6 mEq/kg/day
Children: 2 to 3 mEq/kg/day
Prevention of hypokalemia during diuretic therapy:
Infants and Children: 1 to 2 mEq/kg/day orally in 1 to 2 divided doses
CrCl less than 25 mL/min: Extreme caution is recommended because of the high risk of hyperkalemia. Chronic potassium chloride therapy is generally not required nor recommended for patients with renal dysfunction.
Data not available
Initial dosages may be adjusted to specific patient needs based on steady state serum potassium concentrations.
Potassium chloride (KCl) is contraindicated in the presence of hyperkalemia; renal failure and conditions in which potassium retention is present, including the concomitant use of potassium-sparing diuretics (such as triamterene, amiloride, or spironolactone); oliguria or azotemia; anuria; crush syndrome; severe hemolytic reactions; adrenocortical insufficiency (untreated Addison's disease); adynamical episodica hereditaria; acute dehydration; heat cramps; and early postoperative oliguria except during gastrointestinal drainage.
Solid dosage forms of potassium supplements are contraindicated in any patient in whom there is cause for arrest or delay in tablet passage throughout the GI tract (including patients who are also taking drugs with anticholinergic properties). Wax matrix KCl preparations have produced esophageal ulceration in cardiac patients with esophageal compression due to an enlarged left atrium. If KCl is necessary for these patients, potassium supplementation as a liquid preparation is recommended.
Some KCl products contain tartrazine, and are contraindicated in patients with tartrazine sensitivity.
Patients should not use potassium-rich salt substitutes without the advice of their healthcare professional during KCl therapy.
In patients with renal insufficiency, use of potassium chloride may cause potassium intoxication and life-threatening hyperkalemia.
The administration of intravenous solutions can cause fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, pulmonary edema or congested states. The risk of dilutional states is inversely proportional to the electrolyte concentration. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentration.
Serum potassium levels are not necessarily indicative of tissue potassium levels. Solutions containing potassium should be administered with caution in the presence of cardiac or renal disease.
Solid oral dosage forms of potassium chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract. Potassium chloride should be discontinued immediately and the possibility of ulceration, obstruction, or perforation should be considered if severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occurs.
Clinical evaluation and periodic laboratory evaluations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation. Significant deviations from normal concentrations may require the administration of additional electrolyte supplements, or the administration of electrolyte-free dextrose solutions to which individualized electrolyte supplements may be added.
Certain potassium chloride extended-release tablets contain a wax matrix. This matrix is not absorbed and is excreted in the feces. In some instances the empty matrices may be noticeable in the stool.
Dose selection in the elderly should be cautious and should start at the lower end of the dosing range.
Potassium is rarely, if ever, given to a patient who is on dialysis. Hypokalemia in this case may indicate an inappropriately low predialysis potassium concentration or resolution of an acidotic state which has resulted in a rapid shift of extracellular potassium to the intracellular compartment. Adjustment of the dialysate potassium concentration that will result in a postdialysis serum potassium concentration of 4 mEq/L (4.5 to 5 mEq/L if this patient also has a high digoxin concentration) based on the fractional dialyzer urea clearance (Kt/V) required is recommended.
Hypokalemia may be present during the early stages of dialysis-dependent renal failure because of excessive potassium losses during the early stages in the pathogenesis of renal failure and/or the continued use of a low dialysate potassium in the presence of potassium depletion during this period.
Chronic potassium chloride therapy is not recommended for this patient with dialysis-dependent renal insufficiency because of the high risk of hyperkalemia.
Patients who are extremely potassium-depleted may require higher total daily doses of potassium chloride to replenish body stores. If large doses are required, administer potassium in equally divided doses 2 to 3 times a day.
Oral potassium chloride formulations:
Because of the high incidence of gastrointestinal irritation, administering potassium chloride with food and/or a full glass of water or similar beverage is recommended.
Potassium chloride tablets or capsules should not be crushed or chewed.
Dissolvable potassium chloride tablets, powder or concentrated solutions may be mixed with 3 to 8 ounces of a suitable beverage.
Parenteral potassium chloride formulations:
The maximum recommended concentration is 60 mEq potassium/L of intravenous fluid for infusion, although extreme emergencies may dictate greater concentrations. It is recommended that potassium chloride solutions be infused slowly (up to 20 mEq/hour) to avoid venous irritation and local pain. The rate of infusion will depend on the patient's clinical condition, the initial serum potassium concentration, the rate of change in the serum potassium concentration, peripheral or central intravenous port, and the patient's renal function. Monitoring the serum potassium concentration at appropriate intervals is recommended.
The following drugs can interact with Potassium chloride. Tell your doctor about all other medicines you use, especially:
digoxin (digitalis, Lanoxin);
quinidine (Quinaglute, Quinidex, Quin-Release);
a bronchodilator such as ipratroprium (Atrovent) or tiotropium (Spiriva);
an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik); or
any type of diuretic (water pill) such as bumetanide (Bumex), chlorothiazide (Diuril), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), or torsemide (Demadex).
This list is not complete and there may be other drugs that can interact with Potassium chloride. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
Aliskiren: Potassium Salts may enhance the hyperkalemic effect of Aliskiren. Monitor therapy
Angiotensin II Receptor Blockers: Potassium Salts may enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Monitor therapy
Angiotensin-Converting Enzyme Inhibitors: Potassium Salts may enhance the hyperkalemic effect of Angiotensin-Converting Enzyme Inhibitors. Monitor therapy
Anticholinergic Agents: May enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Drospirenone: Potassium Salts may enhance the hyperkalemic effect of Drospirenone. Monitor therapy
Eplerenone: May enhance the hyperkalemic effect of Potassium Salts. Management: This combination is contraindicated in patients receiving eplerenone for treatment of hypertension. Consider therapy modification
Glycopyrrolate (Systemic): May enhance the adverse/toxic effect of Potassium Chloride. This is specific to solid oral dosage forms of potassium chloride. Avoid combination
Heparin: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Heparins (Low Molecular Weight): May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Nicorandil: May enhance the hyperkalemic effect of Potassium Salts. Monitor therapy
Potassium-Sparing Diuretics: Potassium Salts may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Management: Avoid coadministration of a potassium-sparing diuretic and a potassium salt. This combination should only be used in cases of significant hypokalemia, and only if serum potassium can be closely monitored. Consider therapy modification
As directed by a physician. Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Do not administer unless solution is clear and seal is intact.
All injections in AVIVA plastic containers are intended for intravenous administration using sterile equipment.
Additives may be incompatible. Complete information is not available. Those additives known to be incompatible should not be used.
Consult with pharmacist, if available. If, in the informed judgment of the physician, it is deemed advisable to introduce additives, use aseptic technique. Mix thoroughly when additives have been introduced. Do not store solutions containing additives.
The available sizes of each injection in AVIVA plastic containers are shown below:
|Code||Size (mL)||NDC||Product Name|
|6E1313||500||0338-6333-03||0.45% Sodium Chloride Injection, USP|
|6E1322||250||0338-6304-02||0.9% Sodium Chloride Injection, USP|
Exposure of pharmaceutical products to heat should be minimized. Avoid excessive heat. It is recommended the product be stored at room temperature (25°C/77°F); brief exposure up to 40°C (104°F) does not adversely affect the product.
Tear overwrap down side at slit and remove solution container. Moisture and some opacity of the plastic due to moisture absorption during the sterilization process may be observed. This is normal and does not affect the solution quality or safety. The opacity will diminish gradually. Check for minute leaks by squeezing inner bag firmly. If leaks are found, discard solution as sterility may be impaired. If supplemental medication is desired, follow directions below.
Caution: Do not use plastic containers in series connections.
Caution: Use only with a non-vented set or a vented set with the vent closed.
Additives may be incompatible.
To add medication before solution administration
To add medication during solution administration
Baxter HealthcareCorporation Deerfield, IL 60015 USA 07-19-51-541. Baxter and AVIVA are trademarks of Baxter International Inc. For Product Information 1-800-933-0303
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with sodium chloride, especially:
a diuretic or "water pill";
a steroid such as prednisone, fluticasone, mometasone, dexamethasone, and others;
blood pressure medication; or
medication that contains sodium, such as Alka-Seltzer or Zegrid (omeprazole and sodium bicarbonate).
This list is not complete. Other drugs may interact with sodium chloride, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Caution must be exercised in the administration of Sodium Chloride Injection, USP to patients receiving corticosteroids or corticotropin.
Studies have not been conducted to evaluate additional drug/drug or drug/food interactions with Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP.
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Information checked by Dr. Sachin Kumar, MD Pharmacology