MedPath

Potassium

Generic Name
Potassium
Drug Type
Small Molecule
Chemical Formula
K
CAS Number
7440-09-7
Unique Ingredient Identifier
RWP5GA015D
Background

Potassium is an essential nutrient, like Calcium and Magnesium. It was identified as a shortfall nutrient by the 2015-2020 Advisory Committee of Dietary Guidelines for Americans. Many conditions and diseases interfere with normal body potassium balance, and underconsumption of potassium is one example. Hypokalemia (low potassium) or hyperkalemia (high potassium) may result, manifesting as various signs and symptoms. Some examples of potassium-related complications include life-threatening arrhythmia, neuromuscular dysfunction, diarrhea, nausea, and vomiting.

Various pharmacological preparations have been formulated to replenish potassium. They are available in an assortment of tablet, injection, and other forms, depending on the setting and condition being treated. Potassium is often a key ingredient for intravenous fluids, given to patients in clinical settings for rehydration, nutrition, and replenishment of electrolytes. Examples of potassium formulations include potassium citrate, potassium chloride, and potassium with dextrose and sodium chloride.

Indication

General uses of potassium

Potassium is indicated to treat a variety of conditions. Firstly, it used to replenish potassium that has been depleted by conditions including but not limited to malabsorption, decreased intake, or excess sodium intake. The causes of potassium deficiency are numerous. The following indications for potassium are not comprehensive, but include the main indications for which this nutrient is used. Various products and preparations contain potassium.

Potassium chloride

Potassium chloride is one of the main preparations of potassium used in a clinical setting. The oral solution is indicated for the prevention and treatment of hypokalemia presenting with or without metabolic alkalosis, in patients who have failed conservative management with potassium-rich foods or diuretic dose titrations. The injection form of potassium chloride is indicated to replenish potassium in patients who are not feasible candidates for oral potassium. Highly concentrated potassium is intended for the treatment of potassium deficiency in fluid restricted individuals who cannot tolerate fluid volumes normally associated with injected potassium solutions that contain lower concentrations.

Finally, the extended-release tablet preparation of potassium chloride is used to treat hypokalemia with or without metabolic alkalosis, to treat digitalis intoxication, and to manage patients with hypokalemic familial periodic paralysis. It is also used in the prevention of hypokalemia in those who are at a high risk of negative clinical outcomes if hypokalemia occurs; patients on digitalis or those with cardiac arrhythmias would be at particular risk of negative outcomes.

Potassium chloride with dextrose and sodium chloride

This liquid preparation is is indicated in a clinical setting as a source of water, calories and electrolytes. Potassium acetate solution is meant as an alternative to potassium chloride, replenishing potassium and added to large volume infusion fluids for intravenous injection.

Potassium citrate

The potassium citrate preparation is used for the management of renal tubular acidosis (RTA) with calcium stones (nephrolithiasis); calcium oxalate stones by any cause, and uric acid nephrolithiasis (with or without calcium stones). This regimen also includes adequate water intake (leading to a urine out put of 2 L/day or more) and sodium restriction.

Associated Conditions
Caloric Intake, Electrolyte and fluid balance conditions, Hydration, Hypokalemia, Potassium

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FDA Approves First Liquid Losartan Formulation for Hypertension Treatment

• Scienture Holdings announced FDA approval of Arbli™ (losartan potassium) Oral Suspension, the first and only ready-to-use liquid losartan formulation in the U.S. market for treating hypertension in patients over 6 years old. • The novel formulation addresses significant unmet needs for patients requiring liquid medications, eliminating risks associated with crushing tablets and providing consistent dosing with an 18-month shelf life at room temperature. • Arbli™ is indicated for hypertension treatment, stroke risk reduction in patients with left ventricular hypertrophy, and diabetic nephropathy management, with commercial launch expected in Q3 2025.

Cadrenal Therapeutics Plans Phase 3 Trial for Tecarfarin in LVAD Patients

• Cadrenal Therapeutics aims to initiate a Phase 3 clinical trial for tecarfarin in LVAD patients in 2025, following discussions with the FDA. • Tecarfarin received FDA Orphan Drug Designation for preventing thromboembolism in LVAD patients and Fast Track designation for ESKD patients with AFib. • The company is exploring collaborations to advance tecarfarin's clinical trial and improve anticoagulation outcomes for patients with rare cardiovascular conditions. • Clinical data suggests tecarfarin may offer a safer alternative to warfarin for LVAD patients, addressing limitations of current anticoagulation treatments.

TenNor's Rifasutenizol Demonstrates Superior Efficacy Against H. pylori in Phase III Trial

• TenNor Therapeutics' rifasutenizol-based triple therapy achieved a >90% eradication rate in treating Helicobacter pylori (H. pylori) infections, outperforming bismuth-containing quadruple therapy. • The Phase III trial showed rifasutenizol's superiority (p=0.0338) in the mITT population and non-inferiority (p<0.0001) in both mITT and PP populations compared to the standard BQT regimen. • Rifasutenizol maintained high efficacy against antibiotic-resistant H. pylori strains, showing a 90.9% eradication rate versus 87.2% with BQT (p<0.0001 for non-inferiority). • The rifasutenizol regimen exhibited a better safety profile with fewer treatment-emergent adverse events compared to BQT, positioning it as a potential first-line treatment.

TenNor's Rifasutenizol Demonstrates Superior Efficacy Against H. pylori in Phase III Trial

• TenNor Therapeutics' rifasutenizol-based triple therapy achieved a >90% eradication rate in H. pylori-infected patients, surpassing the standard bismuth-containing quadruple therapy. • The Phase III trial in China showed rifasutenizol was also more effective in patients with antibiotic-resistant H. pylori infections compared to the standard treatment. • Rifasutenizol exhibited a better safety and tolerability profile than the bismuth-containing quadruple therapy, with fewer treatment-emergent adverse events. • Rifasutenizol has the potential to be the first new drug developed specifically for H. pylori in over 30 years, offering a treatment option without requiring drug sensitivity tests.

FDA Approves Revuforj (revumenib) for Relapsed or Refractory Acute Leukemia with KMT2A Translocation

• The FDA has approved Revuforj (revumenib) as the first menin inhibitor for relapsed or refractory acute leukemia with KMT2A translocation in adults and children. • Revuforj's approval was based on the AUGMENT-101 trial, which showed robust and durable remission rates in patients with R/R acute leukemia with a KMT2A translocation. • Syndax Pharmaceuticals plans to launch Revuforj this month and continue its development across the treatment spectrum for KMT2A-rearranged acute leukemias and mutant NPM1 AML. • Revuforj demonstrated a 21% complete remission rate with partial hematological recovery, offering a significant improvement over historical outcomes for these patients.

Tecarfarin Shows Promise in LVAD Patients with Potential to Improve Anticoagulation

• Tecarfarin's data and Cadrenal's trial protocol were presented at the EACTS Mechanical Circulatory Support Summit, focusing on LVAD patients. • Data suggests tecarfarin may improve Time in Therapeutic Range (TTR) and reduce bleeding events compared to warfarin in HM3 LVAD patients. • The TECH-LVAD trial, submitted to the FDA, aims to evaluate tecarfarin versus warfarin in patients with the Abbott HeartMate3 LVAD. • Tecarfarin's pharmacokinetics are not affected by end-stage kidney disease, unlike warfarin, making it suitable for LVAD patients with renal impairment.

Relaxed Potassium Control Non-Inferior to Tight Control for Preventing Atrial Fibrillation After CABG

• A recent study found that relaxed potassium control (supplementation only if levels drop below 3.6 mEq/L) is non-inferior to tight control (below 4.5 mEq/L) in preventing atrial fibrillation after CABG. • The TIGHT-K trial showed no significant difference in new-onset atrial fibrillation between the relaxed and tight potassium control groups post-CABG surgery. • Relaxed potassium control led to a four-fold reduction in costs related to potassium administration without increasing the risk of dysrhythmias or adverse clinical outcomes. • Findings suggest that routine high-normal potassium supplementation after CABG can be safely abandoned, improving patient experience and reducing healthcare costs.

RYBREVANT® Plus Lazertinib Shows Significant PFS Improvement in EGFR-Mutated NSCLC

• The Phase 3 MARIPOSA study demonstrated that RYBREVANT® (amivantamab-vmjw) plus lazertinib significantly improved progression-free survival (PFS) compared to osimertinib in first-line EGFR-mutated NSCLC. • The combination therapy reduced the risk of disease progression or death by 30% compared to osimertinib, establishing a potential new standard of care. • An interim overall survival (OS) analysis showed a favorable trend for the RYBREVANT® and lazertinib combination, with ongoing monitoring to determine statistical significance. • The safety profile of the combination was consistent with individual treatments, with manageable adverse events and infrequent discontinuations, supporting its clinical utility.
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