Version July 2025
Hypokalemia (mild to moderate), treatment (alternative agent):
Note: Doses are expressed as mEq of potassium (1 mEq = 1 mmol potassium). Typically, potassium chloride is preferred because it corrects serum potassium more quickly than other salts and hypochloremia may develop with potassium citrate use (Asmar 2012; Cohn 2000). Consider use in patients with hypokalemia accompanied by metabolic acidosis (eg, due to diarrhea or renal tubular acidosis). Individualize dosing based on serum potassium levels and clinical factors (eg, underlying cause, presence of symptoms, concomitant medications, ongoing potassium losses). Concurrent hypomagnesemia requires correction to facilitate potassium repletion (Ref). General guidance is provided below; refer to institutional protocols.
Mild to moderate (serum potassium 3 to 3.4 mEq/L): Oral: Initial: 10 to 20 mEq 2 to 4 times daily; base subsequent dosing on electrolyte monitoring (eg, serum potassium, sodium, chloride, carbon dioxide concentrations (Ref)) and clinical factors; limit single doses to 20 to 25 mEq/dose to avoid GI discomfort (Ref).
There are no dosage adjustments provided in the manufacturer's labeling. However, patients with chronic kidney disease require serum potassium monitoring and appropriate dosage adjustment.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Endocrine & metabolic: Hyperkalemia
Gastrointestinal: Abdominal pain, diarrhea, nausea, vomiting
Hyperkalemia. Note: The manufacturer's labeling also states that concomitant use of potassium-sparing diuretics is contraindicated. While this combination should generally be avoided, in select patients under close medical supervision, combined use of potassium supplements and potassium-sparing diuretics may be considered.
Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Concerns related to adverse effects:
• GI effects: May cause GI upset (eg, nausea, vomiting, diarrhea, abdominal pain, discomfort) and lead to GI ulceration, bleeding, perforation and/or obstruction.
• Hyperkalemia: Close monitoring of serum potassium concentrations is needed to avoid hyperkalemia; severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (eg, heart block, ventricular arrhythmias, asystole).
Disease-related concerns:
• Acid/base disorders: Use with caution in patients with acid/base alterations; changes in serum potassium concentrations can occur during acid/base correction, monitor closely.
• Cardiovascular disease: Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.
• Metabolic acidosis: Patients with hypokalemia accompanied by metabolic acidosis should be treated with an alkalinizing potassium salt.
• Potassium-altering conditions/disorders: Use with caution in patients with disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (eg, untreated Addison's disease, heat cramps, severe tissue breakdown from trauma or burns).
• Renal impairment: Use with caution in patients with renal impairment; monitor serum potassium concentrations closely. Avoid with severe impairment.
Concurrent drug therapy issues:
• Digitalis: Use with caution in digitalized patients; may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations.
• Potassium-altering therapies: Use with caution in patients receiving concomitant medications or therapies that increase potassium (eg, ACE inhibitors, potassium-sparing diuretics, potassium-containing salt substitutes).
Each tablet contains 10, 20, or 25 mEq potassium and delivers approximately 10, 20 or 25 mEq bicarbonate.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Tablet Effervescent, Oral:
Effer-K: 10 mEq
Effer-K: 10 mEq [contains fd&c red #40 (allura red ac dye); cherry-vanilla flavor]
Effer-K: 20 mEq [scored]
Effer-K: 20 mEq [scored; contains fd&c red #40 (allura red ac dye), fd&c yellow #6 (sunset yellow); orange cream flavor]
Effer-K: 25 mEq [lime flavor]
Effer-K: 25 mEq [contains fd&c red #40 (allura red ac dye), fd&c red #40(allura red ac)aluminum lake, saccharin; cherry berry flavor]
Effer-K: 25 mEq [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6(sunset yellow)alumin lake, saccharin; orange flavor]
Effer-K: 25 mEq [contains quinoline (d&c yellow #10) aluminum lake, quinoline yellow (d&c yellow #10), saccharin; lemon citrus flavor]
Effer-K: 25 mEq [contains saccharin; unflavored flavor]
K-Prime: 25 mEq [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6(sunset yellow)alumin lake, saccharin; orange flavor]
Klor-Con/EF: 25 mEq [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6(sunset yellow)alumin lake, saccharin]
Klor-Con/EF: 25 mEq [DSC] [sugar free; contains fd&c yellow #6 (sunset yellow), fd&c yellow #6(sunset yellow)alumin lake, saccharin]
No
Tablet, effervescent (Effer-K Oral)
10 mEq (per each): $0.57
20 mEq (per each): $0.66
25 mEq (per each): $0.47
Tablet, effervescent (K-Prime Oral)
25 mEq (per each): $0.33
Tablet, effervescent (Klor-Con/EF Oral)
25 mEq (per each): $1.57
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Oral: Do not remove tablet from pouch until ready to use. Completely dissolve tablet in 4 ounces (115 mL) of water. Administer with meals and sip slowly over 5 to 10 minutes.
Hypokalemia, treatment: Treatment of hypokalemia, particularly when it is necessary to avoid chloride or the acid/base status requires bicarbonate.
Klor-Con may be confused with Klaron
Refer to individual components.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Agents with Clinically Relevant Anticholinergic Effects: May increase ulcerogenic effects of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid
Aliskiren: Potassium Salts may increase hyperkalemic effects of Aliskiren. Risk C: Monitor
Aluminum Hydroxide: Citric Acid Derivatives may increase absorption of Aluminum Hydroxide. Risk C: Monitor
Amantadine: Alkalinizing Agents may increase serum concentration of Amantadine. Risk C: Monitor
AMILoride: Potassium Salts may increase hyperkalemic effects of AMILoride. Management: Amiloride and potassium supplements should not be used except in severe or refractory cases of hypokalemia. If coadministered, monitor serum potassium closely as rapid increases in potassium are possible. Risk D: Consider Therapy Modification
Amphetamines: Alkalinizing Agents may decrease excretion of Amphetamines. Management: Consider alternatives to using amphetamines and alkalinizing agents in combination. If these agents must be used together, patients should be monitored closely for excessive amphetamine effects. Risk D: Consider Therapy Modification
Angiotensin II Receptor Blockers: Potassium Salts may increase hyperkalemic effects of Angiotensin II Receptor Blockers. Risk C: Monitor
Angiotensin-Converting Enzyme Inhibitors: Potassium Salts may increase hyperkalemic effects of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor
CycloSPORINE (Systemic): May increase hyperkalemic effects of Potassium Salts. Risk C: Monitor
Digitoxin: Potassium Salts may increase adverse/toxic effects of Digitoxin. Potassium Salts may decrease therapeutic effects of Digitoxin. Risk C: Monitor
Drospirenone-Containing Products: May increase hyperkalemic effects of Potassium Salts. Risk C: Monitor
Eplerenone: May increase hyperkalemic effects of Potassium Salts. Management: This combination is contraindicated in patients receiving eplerenone for treatment of hypertension. Potassium supplements may be needed to treat/prevent hypokalemia in select patients with heart failure receiving eplerenone and high dose loop diuretics. Risk D: Consider Therapy Modification
Finerenone: Potassium Salts may increase hyperkalemic effects of Finerenone. Risk C: Monitor
Flecainide: Alkalinizing Agents may decrease excretion of Flecainide. Risk C: Monitor
Heparin: May increase hyperkalemic effects of Potassium Salts. Risk C: Monitor
Heparins (Low Molecular Weight): May increase hyperkalemic effects of Potassium Salts. Risk C: Monitor
Mecamylamine: Alkalinizing Agents may increase serum concentration of Mecamylamine. Risk C: Monitor
Memantine: Alkalinizing Agents may increase serum concentration of Memantine. Risk C: Monitor
Nicorandil: May increase hyperkalemic effects of Potassium Salts. Risk C: Monitor
Nonsteroidal Anti-Inflammatory Agents: May increase hyperkalemic effects of Potassium Salts. Risk C: Monitor
QuiNIDine: Alkalinizing Agents may increase serum concentration of QuiNIDine. Risk C: Monitor
QuiNINE: Alkalinizing Agents may increase serum concentration of QuiNINE. Risk C: Monitor
Spironolactone: Potassium Salts may increase hyperkalemic effects of Spironolactone. Risk X: Avoid
Triamterene: Potassium Salts may increase hyperkalemic effects of Triamterene. Risk X: Avoid
Animal reproduction studies have not been conducted with this combination. See individual agents.
See individual agents.
Dietary adequate intake (AI) (IOM 2004): Healthy adults: 120 mEq/day (4.7 g/day)
Electrolytes (including serum potassium, chloride, magnesium, and bicarbonate); kidney function; cardiac function
Note: Reference ranges may vary depending on the laboratory
Serum potassium: 3.5 to 5 mEq/L (SI: 3.5 to 5 mmol/L).
Potassium is needed for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function
Absorption: Well absorbed from upper GI tract
Distribution: Enters cells via active transport from extracellular fluid
Excretion: Primarily urine; skin and feces (small amounts); most intestinal potassium reabsorbed
