9.2. Fluids and electrolytes
9.2.1. Oral preparations for fluid and electrolyte imbalance
9.2.1.1. Oral potassium
Prescribing Notes:
Available in several formulations:
- effervescent tablets (Sando-K®), each containing 12mmol of potassium.
- syrup (Kay-Cee-L®) containing 1mmol potassium in 1ml.
A potassium-sparing diuretic and potassium supplements should not be used concomitantly because of the risk of hyperkalaemia.
Restrictions:
For use within the acute (hospital) sector only.
Prescribing Notes:
Please note, different preparations of calcium polystyrene sulphonate may require different dosing schedules.
Restrictions:
Restricted to specialist use in the emergency care setting for the treatment of acute, life-threatening hyperkalaemia alongside standard care.
Restrictions:
Restricted to specialist initiation in patients with hyperkalaemia (serum potassium >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure who would otherwise need to downtitrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level.
Prescribing Notes:
Please refer to section 9.2.1.1 for treatment of acute, life-threatening hyperkalaemia.
Restrictions:
Restricted to specialist initiation in patients with hyperkalaemia (serum potassium >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level.
9.2.1.2. Oral sodium and water
Restrictions:
Restricted to specialist initiation.
Prescribing Notes:
Please note, expiry dates of licensed and unlicensed oral solutions can vary greatly.
9.2.1.3. Oral bicarbonate
Restrictions:
Restricted to specialist initiation.
Prescribing Notes:
Please note, expiry dates of licensed and unlicensed oral solutions can vary greatly.
Restrictions:
Use for the treatment of distal renal tubular acidosis (dRTA) is restricted to specialist initiation.
Prescribing Notes:
Monitoring and review of treatment will remain with renal clinics.