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IV fluid (mixed) Pregnancy: SPC section 4.6: Pregnancy - Intrapartum maternal intravenous glucose infusion may result in foetal hyperglycaemia and metabolic acidosis as well as rebound neonatal hypoglycaemia due to foetal insulin production. Sodium Chloride 0.18 % w/v and Glucose 4% w/v solution should be administrated with special caution for pregnant women during labour particularly if administered in combination with oxytocin due to the risk of hyponatraemia. Fertility - There is no information on the effects of Sodium Chloride 0.18% w/v and Glucose 4% w/v solution on fertility. Lactation - Sodium Chloride 0.18% w/v and Glucose 4% w/v solution can be used during breast-feeding. The potential risks and benefits for each specific patient should be carefully considered before administration.

Potassium chloride with glucose and sodium chloride

Used in: Hyponatraemia

This is a ready-mixed intravenous maintenance fluid combining potassium chloride, glucose and sodium chloride, used to provide water, sodium, potassium and carbohydrate.

Adult dose

Dose: Prevention and treatment of potassium, sodium and chloride depletion (due to gastrointestinal fluid loss, chronic laxative abuse, malabsorption syndromes, mucus-secreting villous adenoma of the small intestine, or renal salt-losing conditions), particularly where a source of energy is required (e.g. starvation) - adults, older patients and adolescents (12 years and over): the recommended dosage is 500 ml to 3 L per 24 hours of potassium chloride 0.15% w/v, sodium chloride 0.18% w/v and glucose 4% w/v solution for infusion. The choice of concentration, dosage, volume, rate and duration depends on age, weight, clinical condition and concomitant therapy, and is to be determined by a physician.
Route: Intravenous infusion (the solution is hypotonic and, because of its glucose content, hyperosmolar; hyperosmolar solutions are recommended to be given through a large central vein).
Frequency: Per 24 hours. The infusion rate is usually 40 ml/kg/24h and should not exceed the patient's glucose oxidation capacity, to avoid hyperglycaemia; the maximum acute administration rate is 5 mg/kg/min (glucose). Consider a gradual increase of flow rate when starting.
SCOPE: this card is for ONE product only - Potassium Chloride 0.15 % w/v, Sodium Chloride 0.18 % w/v and Glucose 4% w/v Solution for Infusion (Baxter, PL001160340). Composition (SPC section 2): potassium chloride 1.5 g/l, sodium chloride 1.8 g/l, glucose 40.0 g/l (K+ 20 mmol/l, Na+ 31 mmol/l, Cl- 51 mmol/l). Other potassium, sodium chloride or glucose fluids and other concentrations differ and are not covered. The SPC section 4.2 prints NO potassium-specific dose and no potassium infusion-rate ceiling, and none is written here. Section 4.2 also notes that fluid balance, serum glucose, serum sodium and other electrolytes may need to be monitored before and during administration, especially in SIADH or with vasopressin agonists; that the solution may become extremely hypotonic after administration due to glucose metabolisation; and that rapid correction of hyponatraemia and hypernatraemia is potentially dangerous. For patients with electrolyte and glucose abnormalities and for paediatric patients, consult a physician experienced in intravenous fluid therapy. Do not use unless the solution is clear and the seal is intact; do not use plastic containers in series connections (air embolism risk). Section 4.4: infusion of solutions with sodium concentrations below 0.9% may result in hyponatraemia; this solution may also result in hypokalaemia and hyperglycaemia. Paediatric use is restricted to specialist paediatric settings (see paedDose).

Paediatric dose

Dose: Use of 0.18% sodium chloride and 4% glucose should be restricted to specialist paediatric settings such as renal, hepatic and cardiac units, high dependency units and intensive care units. Dosage varies with weight (as printed): 10-20 kg body weight, 1000 ml + (50 ml/kg over 10 kg) per 24 hours; over 20 kg body weight, 1500 ml + (20 ml/kg over 20 kg) per 24 hours.
Route: Intravenous infusion
Frequency: Per 24 hours. Administration rate varies with weight: 10-20 kg, 4-6 ml/kg/h; over 20 kg, 2-4 ml/kg/h. The infusion rate should not exceed the patient's glucose oxidation capacities, to avoid hyperglycaemia.
Weight bands as printed in SPC section 4.2. THE 0-10 kg BAND IS DELIBERATELY NOT REPRODUCED: the SPC prints it by weight, not age, so it cannot be separated from neonates and young infants, for whom IV fluid and glucose prescribing needs specialist paediatric advice - see the SPC section 4.2. The SPC also prints a paediatric maximum acute glucose administration rate that depends on total body mass; it is not banded by weight and is not reproduced. No paediatric potassium dose is printed. Section 4.4: children (including neonates and older children) are at particular risk of acute hyponatraemia and severe, life-threatening brain swelling from hyponatraemic encephalopathy; newborns are at risk of hypo- or hyperglycaemia. Dosage, rate and duration should be determined by a physician experienced in paediatric intravenous fluid therapy.

Dose adjustments

Renal

SPC section 4.3: contraindicated in severe renal insufficiency (with oliguria/anuria). Section 4.4: patients with kidney disease are at particular risk of acute hyponatraemia on infusion of hypotonic fluids, and renal disease (including renal artery stenosis and nephrosclerosis) is listed among conditions causing sodium retention, fluid overload and oedema in which the solution should be used with particular caution; glucose tolerance may be impaired in renal impairment. Section 4.2 prints no numeric renal dose reduction.

Hepatic

SPC section 4.2 prints no hepatic dose adjustment. Section 4.4: patients with liver disease (including cirrhosis) are at particular risk of acute hyponatraemia upon infusion of hypotonic fluids, and liver disease is listed among conditions causing sodium retention, fluid overload and oedema in which the solution should be used with particular caution.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via MHRA Products — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Known hypersensitivity to the product (section 4.3)
  • Hyperchloraemia and hyperkalaemia that are not related to the concentration effect associated with volume depletion (section 4.3)
  • Severe renal insufficiency (with oliguria/anuria) (section 4.3)
  • Uncompensated heart failure and severe congestive heart failure (section 4.3)
  • Addison's disease; fluid and sodium retention (section 4.3)
  • Acute ischaemic stroke; head trauma (first 24 hours) (section 4.3)
  • Uncompensated diabetes, hyperosmolar coma, hyperglycaemia, hyperlactataemia and other known glucose intolerances (such as metabolic stress situations) (section 4.3)

Side effects

  • Hyponatraemia, including hospital-acquired hyponatraemia, and hyponatraemic encephalopathy - may cause irreversible brain injury and death (frequency not known) (sections 4.4, 4.8)
  • Hypervolaemia, electrolyte imbalance, cardiac failure, polyuria (frequency not known) (section 4.8)
  • Hypersensitivity and anaphylactic reaction (frequency not known); use with caution in patients with known allergy to corn or corn products (sections 4.4, 4.8)
  • Hypokalaemia, hypo- or hyperosmolality, hypophosphataemia, hypomagnesaemia, hyperglycaemia and hyperosmolar syndrome with rapid administration (section 4.4)
  • Infusion-site effects: vein injury, superficial thrombophlebitis, injection site phlebitis, extravasation, application site pain, infection or reaction; chills and pyrexia (frequency not known) (section 4.8)

Interactions

  • Drugs that increase the vasopressin effect (chlorpropamide, clofibrate, carbamazepine, vincristine, SSRIs, MDMA, ifosfamide, antipsychotics, narcotics, NSAIDs, cyclophosphamide, desmopressin, oxytocin, vasopressin, terlipressin): reduced renal free-water excretion and increased risk of hospital-acquired hyponatraemia (section 4.5)
  • Diuretics in general and antiepileptics such as oxcarbazepine: increased risk of hyponatraemia (section 4.5)
  • Lithium: renal sodium and lithium clearance may be increased, decreasing lithium levels (section 4.5)
  • Corticosteroids: retention of sodium and water (oedema, hypertension) (section 4.5)
  • Diuretics, beta-2 agonists and insulin: increase the risk of hypokalaemia (sections 4.4, 4.5)
  • Other substances that affect glycaemic control or fluid and electrolyte balance: take both glycaemic and fluid/electrolyte effects into account (section 4.5)

Monitoring

  • Fluid balance, serum glucose, serum sodium and other electrolytes before and during administration, especially in SIADH and with vasopressin agonists; monitoring of serum sodium is particularly important for physiologically hypotonic fluids (section 4.2)
  • Clinical evaluation and periodic laboratory determinations of fluid balance, electrolytes and acid-base balance during prolonged parenteral therapy (section 4.4)
  • Blood glucose: adjust the infusion rate and/or give insulin if blood glucose exceeds acceptable levels (section 4.4)
  • Close clinical monitoring for hypokalaemia in metabolic alkalosis, increased gastrointestinal losses, prolonged low-potassium diet, primary hyperaldosteronism, or treatment with diuretics, beta-2 agonists or insulin (section 4.4)
  • Stop the infusion immediately if signs of hypersensitivity or infusion reactions develop (section 4.4)
  • Inspect the solution visually for particulate matter and discoloration before administration (section 4.2)

Clinical monograph

How it works

It supplies maintenance fluid and electrolytes, replacing sodium and potassium while glucose provides water-free calories and supports cellular potassium uptake.

Prescribing in practice

  • As a potassium-containing fluid it must be infused at a controlled rate via a ready-mixed bag and never bolused, since rapid potassium delivery can cause fatal arrhythmias.
  • Avoid or use with caution in hyperkalaemia, renal impairment and with potassium-retaining drugs, monitoring potassium closely.
  • Excess administration risks hyponatraemia from the relatively hypotonic glucose component and fluid overload, so match to the patient's daily requirements.

Monitoring

Monitor serum sodium and potassium, blood glucose and fluid balance during maintenance infusion.

Counselling the patient

  • Explain this is a maintenance drip providing fluid, salts and sugar.
  • Report palpitations, confusion or swelling during the infusion.

Evidence & guidelines

Pre-mixed potassium-glucose-sodium chloride solutions are recommended for routine maintenance to standardise electrolyte delivery and avoid bedside addition of potassium.

Reference: NICE CG174/NG29; NPSA alert 2007; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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