USES:Prevention and treatment of hypokalaemic
Pack quantity: 100
Therapeutic indications
Prevention and treatment of hypokalaemic states such as those associated with:
i) Use of drugs which can induce potassium depletion eg. frusemide, thiazide diuretics, corticosteroids, carbenoxolone and cardiac glycosides, especially in combination with diuretics;
ii) Potassium loss resulting from severe diarrhoea, vomiting or fistulas;
iii) Acid-base disturbances e.g. alkalosis, renal tubular acidosis, states in which there is aldosterone excess, Cushing syndrome;
iv) Decreased intake of potassium e.g. malnutrition, alcoholism, some elderly patients with deficient diets;
v) Since SANDO-K Effervescent Tablets contain Cl- they may be used in the treatment of hypokalaemia associated with hypochloraemic alkalosis.
Posology and method of administration
Oral administration, after dissolution of the tablet in water. May be taken with food if preferred.
Adults and children: Dosage is dependent upon the clinical conditions and diet of the patient, however the administration of 2 to 4 tablets daily (24 to 48 mmol K+) is likely to provide an adequate prophylactic or therapeutic dose in most patients. Large doses may be indicated in more severe hypokalaemic conditions when the dose should be regulated by the patient's response as determined by serum electrolyte levels and acid-base studies.
Dosage guidelines: A drop in serum potassium level of 1 mmol/l represents a loss of about 100-200 mmol of potassium from body stores. While serum potassium levels below 2 mmol/l may warrant intravenous replacement therapy, following are approximate guidelines in less severe potassium depletion:
For serum levels between 2-3 mmol/l, a maximum daily dose of 100-200 mmol K+ (8-16 tablets) and for serum levels between 3-4 mmol/l, a maximum daily dose of 50-100 mmol K+ (4-8 tablets) should be considered.
Elderly: No evidence exists that elderly patients require different dosages or show different side-effects than younger patients. However, such patients should be carefully supervised as factors sometimes associated with ageing, such as poor diet or impaired renal function, may indirectly affect the dosage or tolerability
Contraindications
Severe renal impairment with oliguria, inadequately treated Addison's disease, hyperkalaemia from any cause, crush injuries and acute dehydration.
Special warnings and precautions for use
Periodic evaluation of the patient's clinical status, serum electrolytes and the ECG should be carried out when replacement therapy is undertaken. This is particularly important in patients with cardiac disease and in those receiving digitalis. Care should be taken to avoid dosage in excess of requirements for patients with impaired renal function. Caution is also necessary in patients receiving potassium-sparing diuretics and ACE-inhibitors, and in patients with myotonia congenita or severe haemolysis. In patients with acidosis, the acid-base balance should be monitored. In patients with hypertension, it should be remembered that correction of hypokalaemia may lower blood pressure
Interaction with other medicinal products and other forms of interaction
If co-administered with potassium-sparing diuretics and ACE-inhibitors, the risk of hyperkalaemia must be considered
Pregnancy and lactation
No clinical problems have been encountered during pregnancy and lactation. Nevertheless, the benefit of treatment should be considered in relation to the risks before SANDO-K is given to pregnant or nursing women.
Undesirable effects
Abdominal discomfort, diarrhoea, nausea and vomiting may occur. If there are any signs of gastric irritancy, SANDO-K, in common with all other potassium salts, should be given with or after food. Gastric irritancy has occurred but this is rare since the tablets dissolve in water and are taken in solution, thus preventing high local concentrations. A moderate hyperkalaemia may be asymptomatic; if suspected reference to the section on overdosage is recommended.
