The Scooter Cat
Scooter's Supplies for Chronic Renal Failure (CRF)

About Potassium Supplements

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Potassium Gluconate Potassium Citrate Potassium Chloride Inj. RenaKare Potassium depletion is relatively common in CRF cats.  The common supplements used in the USA are:
  • Potassium gluconate (Tumil-K®, RenaKare™, over-the-counter products such as Vitamin Power and Now), available in tablets, powders and gels.  Potassium gluconate tablets are widely available under a host of brand names in almost every pharmacy and health food store in the U.S.
  • Potassium citrate, available in liquids (Poly-Citra-K, Citra-K) and tablets (Urocit-K). 
  • Potassium chloride, commonly injected directly into fluids IV bags so that potassium is supplemented with each infusion.
The best supplement and appropriate dosage for your cat should be thoroughly discussed with your veterinarian.  This page lays out the supplies available and sources for purchase - for better medical information, see the Feline CRF Information Center.



Potassium Gluconate

Potassium gluconate comes in pills, powders and gels.  Dosage can be a little confusing because products are marked with the amount of elemental potassium or the amount of potassium gluconate or the milliequivalents (mEq) or all three.  If possible, reduce all dosages to elemental potassium or mEq (milliequivalents) and compare at that level.
 
 

Comparison of Potassium Gluconate Products
Elemental Potassium and mEq (1) are What Count

Brand
Form
Potassium
Gluconate
Elemental 
Potassium
  

mEq (2)
Tumil-K® Caplet
468 mg
78.0 mg
2.00
RenaKare™ Tablet
468 mg
78.0 mg
2.00
NOW® Foods Tablet
(3)
99.0 mg
2.53
VitaminPower Tablet
500 mg
83.5 mg
2.14
GNC Tablet
(3)
99.0 mg
2.53
Sundown® Tablet
595 mg
99.0 mg
2.53
Nature Made® Tablet
550 mg
90.0 mg
2.30
Tumil-K® Gel - 1/2 tsp.
468 mg
78.0 mg
2.00
RenaKare™ Gel - 1/2 tsp.
468 mg
78.0 mg
2.00
Tumil-K® Powder - 1/4 tsp
468 mg
78.0 mg
2.00
RenaKare™ Powder - 1/4 tsp.
650 mg
78.0 mg
2.00
NOW® Foods Powder - 1/4 tsp
870 mg
135.0 mg
3.45
  1. mEq = milliequivalents
  2. To change mg of elemental potassium to mEq, take mg and divide it by 39.0983 (atomic weight of potassium).  For example, 90 mg is equivalent to 2.30 mEq, 99 mg is equivalent to 2.53 mEq.  Conversely, if you know the mEq, multiply by 39.0983 to find the elemental potassium.  For example, 2 mEq is equal to 78.0 mg, and so on.
For example, let's say the vet prescribes one Tumil-K® twice a day and you want to switch to NOW® Foods potassium gluconate to save money. Each Now Foods pill contains about 25% more elemental potassium, so you'd have to give your cat 4/5 of a NOW® Foods pill twice a day to provide the same potassium as Tumil-K®.  You do want to be careful not to overdose potassium - hyperkalemia or high potassium is a serious condition.

 


 
  • Tumil-K® from Virbac Corporation is the potassium supplement most commonly dispensed by vets.  It's available in caplets, powder and a gel, and requires a veterinary prescription to purchase from sources other than the veterinary clinic.  The suggested dose of Tumil-K® for adult cats is one caplet, 1/4 level teaspoonful (0.65g) of powder or 1/2 teaspoonful (468 mg) of gel per 10 lb. (4.5 kg) body weight twice daily.  Each dose contains of Tumil-K® contains 2 mEq of potassium or 468 mg of potassium gluconate or 78 mg of elemental potassium.  Dosage may be adjusted to satisfy patient's need.  Form administered is based on what your cat will tolerate.  Some will lick the gel, some will eat the powder mixed with food, some will swallow the pill or swallow the pill in a gel cap.  Prices vary widely at veterinary clinics.  Many purchase elsewhere (with a veterinary prescription) to save a little money:
    • Allivet sells Tumil-K® 100 tablets for $18.99, 5 oz. of gel for 13.99 and 4 oz. of powder for 19.99 plus shipping.
    • EntirelyPets.com sells Tumil-K® a bottle of 100 caplets for $19.90, a 5oz. tube of gel for $13.95 and 4oz of powder for $27.99.  Shipping is a flat $4.45 per order.
    • Heartland Veterinary Supply and Pharmacy sells Tumil-K® -- 5 oz of gel for $13.95, 100 tablets for $20.49 and 4 oz of powder for $23.95 plus shipping.
    • Medi-Vet.comsells Tumil-K® -- 100 tablets for $26.00, 5 oz of gel for $19.30 and 4 oz of powder for $22.45. Medi-Vet's web site does not work well with Netscape!  Shipping is $7.99 for orders under 3 lbs.
    There are many suppliers for Tumil-K®, far too many to list.  Search for Tumil-K on Google's product search.

    Powder

    Caplet

    Caplets & Gel
     

    RenaKare™ from AMVET Scientific Products (a division of Neogen Corporation) is a lower priced Tumil-K® clone available available in tablets, powder and a gel formats.  The suggested dosage for adult cats are is one tablet, 1/4 level teaspoonful (0.65g) of powder or 1/2 teaspoonful (468 mg) of gel per 10 lb. (4.5 kg) body weight twice daily.  Each dose contains 2 mEq of potassium or 468 mg of potassium gluconate or 78 mg of elemental potassium.  Like Tumil-K®, RenaKare™ requires a veterinary prescription if dispensed by other than a veterinary clinic.  Mail order vendors:
    • Heartland Veterinary Supply and Pharmacy sells Renakare -- 4 oz of powder for $14.95, 100 tablets for $14.95 and 5 oz of gel for $10.95, plus shipping.
    • Medi-Vet.com sells Renakare -- 100 tablets for $14.89, the 5 oz gel for $13.89 and the 4 oz powder for $15.89.  Shipping is $7.99 for orders under 3 lbs.  Note -- Medi-Vet's web site does not work well with Netscape!

    Gel

    Powder

    Tablets
    . 
    100 Tablets


    1 lb.. of Powder

    		 NOW® Foods makes potassium gluconate powder and tablets.  The powder is a pure form that delivers 540 mg of elemental potassium per teaspoon.  The powder comes in 1 lb containers (#1471).  The tablets deliver 99 mg of elemental potassium and are packaged in 100 tablet bottles (#1460) and a 250 tablet bottles (#1462).  Tablet ingredients include potassium gluconate, stearic acid, magnesium stearate, and cellulose. NOW® Foods products are widely available in health food and vitamin stores - use the store finder to find local dealers.  If you can't find it locally:

    (3/25/08) - NOW® Foods no longer distributes potassium gluconate powder in 3 lb containers, only 1 lb containers.  The 3 lb containers may still be available from some of the vendors listed below.

    250 Tablets

     


    GNC sells GNC Potassium Gluconate 99 - 100 tablets with each containing pure potassium gluconate with 99 mg of elemental potassium - other ingredients: Dextrose.  One correspondent suggests that this is a better choice for tablets because it's pure and does not contain the stearic acid and magnesium stearate found in the NOW tablets and the magnesium stearate found in Sundown potassium gluconate tablets.  GNC products are sold at their own stores and a variety of other health food and drug stores.  If you can't find it locally:



     
     
     
     
     

    Folks using powdered forms of potassium gluconate (including those who grind pills into powder) often recommend a set of mini-measuring spoons to parcel out the exact dose  The set includes five measures from 1/4 teaspoon to 1/64 teaspoon--a tad, a dash, a pinch, a smidgen, and a drop -- and costs anywhere from $3 to $6.  You can find it at your local Bed, Bath and Beyond or Linens n' Things or at a cooking shop or online at Amazon.com. 


    Potassium Citrate

    Many vets like to use potassium citrate to supplement potassium because it also addresses the metabolic acidosis common in CRF cats.  It's a prescription drug available in both in a wax-matrix tablets (UROCIT®-K) and liquids (Polycitra-K and Citra-K).  Potassium citrate drugs require a prescription.
  • UROCIT®-K from Mission® Pharmacal is available in controlled release tabs, UROCIT®-K 5 (540 mg) and UROCIT®-K 10 (1020 mg).  It's relatively inexpensive - 30 tablets of UROCIT®-K 5 costs $14.69 from Costco.  Please be aware that enalapril (Vasotec), an ace inhibitor often prescribed for CRF cats with hypertension, can interact with potassium citrate.  UROCIT®-K is readily available from pharmacies. There's a minor controversy over whether the UROCIT®-K pills can be cut or crushed into cat size doses and given via gel cap. The directions from the manufacturer say that you should "Take each dose without crushing, chewing or sucking the tablet." Many in the Feline CRF Support Group have given the medication via gel cap without problem. Check with your veterinarian and your pharmacist about whether it's safe to cut or crush the wax matrix pills.
  • PolyCitra-K is syrup which has 1100 mg of Potassium and 334 334 mg citric acid per teaspoon (5 mL).  It's commonly given in gel caps with other meds.  Citra-K is a generic version of PolyCitra-K.  Both are commonly sold in 480 mL bottles (a pint is 473 mL).  A quick price check of online pharmacies showed that PolyCitra-K cost $24-$30 per bottle, while Citra-K was $14-$22 a bottle.  Please be aware that enalapril (Vasotec), an ace inhibitor often prescribed for CRF cats with hypertension, can interact with potassium citrate.  PolyCitra-K and Citra-K is readily available in pharmacies.
    		•


    Potassium Chloride Injectable (Rx) - fluids additive
        Comes in single use bottles and pre filled syringes

    Potassium chloride (KCL) is a prescription drug injected directly into IV fluids bags so that cats receive potassium supplementation with each infusion.  This works fine as long as the cat is receiving frequent infusions.  Potassium chloride is not recommended for use orally as it may be contribute to the development of metabolic acidosis - too much acid in the blood.  Also, there have been some reports of cats reacting negatively to KCL added to fluids.  Don't invest heavily in KCL and syringes until you know your cat can tolerate the infusion of KCL.

    Potassium Chloride injectable is generally sold in vials ranging from 5 - 30 mL, often in packages of 12 or 25, and in pre filled syringes, often in packs of 10 or 25.  Most branded Potassium Chloride injectable is 2 mEq (milliequivalents) per mL. The vials or syringes are each labeled with the total mEq, e.g., a 10 mL bottle will be labeled 20 mEq.  20 mEq is a common dose that's added to a liter (1000 mL) bag of fluids. 

    You'll need a prescription from your vet and sources to obtain the Potassium Chloride INJ in appropriately sized vials or prefilled syringes.  If you're using vials, you'll also disposable syringes with needles.  Further, you'll need to master appropriate sterile technique to inject the solution into IV bags.  And since an overdose of potassium chloride can be fatal, you must exercise extreme care in affirming that you're injecting the correct dosage each time.  You should triple check - first checking at the time of purchase that the vials or syringes contain the exact the amount you'll inject each time, second checking at the time of you lay out the vials/syringes for each injection, and last checking when you've filled the syringe and are ready to inject.  Remember that high levels of potassium (hyperkalemia) can be as or more harmful than low levels (hypokalemia).  Be sure you follow your vets prescription and dosage instructions precisely and have regular blood tests to monitor potassium levels.

    Buying Potassium Chloride Injectable. Any pharmacy should be able to provide potassium chloride injectable in either vials or pre filled syringes.  If they don't have it in stock, they can get it overnight from their wholesaler.  Since this is not a common prescription, however, you may have to use some persuasion to get the clerk/pharmacist to find it in their data base, to quote a reasonable price, and to sell it to you.  To help in that quest, following are some excerpts from the National Drug Code data base.  The NDC codes are vital in helping the clerk/pharmacist find the right drug.  All of the following are for 2 mEq/mL solution of potassium chloride injectable in 10 mL volumes - the most common dosage.  The key number below is the NDC format -  nnnnn-nnnn-nn.  The first section of 4-5 digits identifies the vendor, the next 4 digits the drug, and the last two the package size.  Drug store computer systems often show all vendor codes as 5 digits, adding a leading zero to the 4-digit vendor numbers.  Thus Hospira vendor code of  0409 becomes 00409 in the computer systems of CVS, Target and many others.  Potassium chloride should be relatively inexpensive - about $.50-$1.00 a vial.

    Sample of 20 mEq potassium chloride injectables - both prefilled syringes and vials:

    POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE  2MEQ/ML  0517-2210-25  10 ML X 25  VIALS  INJ SOL  R
    AMERICAN REGENT LABORATORIES INC - 25 vials of 20 mEq potassium chloride

    POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE  20MEQ/10ML  10797- 221-04  25 X 10 ML  VIAL  INJ SOL  R 
    LUITPOLD PHARMACEUTICALS INC  - 25 vials of 20 mEq potassium chloride

    POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE  2MEQ/ML  0469-0965-10  25 X 10 ML  VIALS  INJ SOL CO  R 
    FUJISAWA HEALTHCARE INC  - 25 vials of 20 mEq potassium chloride

    You can check the NDC yourself - http://www.fda.gov/cder/ndc/database/default.htm - and search under proprietary name for - POTASSIUM CHLORIDE FOR INJECTION or POTASSIUM CHLORIDE.


    This page is the product of me, David Jacobson, and is maintained as a service for members of the Feline CRF Support Group and others treating sick cats and dogs.  The information presented here is not guaranteed.  Contact the vendors mentioned for their current prices and policies.  Feel free to link this page to other pages and web sites dealing with the medical treatment of cats and dogs.  And please contact me with any updated information or additional vendors, or your comments , criticisms and suggestions.  I appreciate your help.