Special Warning : אזהרת שימוש

4.4. Special warnings and precautions for use

Lesions of the gastrointestinal tract
The preparation should be stopped immediately if the following occur during treatment: marked nausea, severe vomiting, severe abdominal pains, flatulence, diarrhoea or gastrointestinal bleeding. These symptoms may be evidence of an ulceration or even a perforation of the GIT.
The associated risk is increased in the presence of oesophageal stenoses, known ulcus ventriculi and duodeni, delayed intestinal transit or intestinal ischaemia due to generalised arteriosclerotic vascular changes.

Hyperkalaemia
Potassium salts may cause hyperkalaemia and cardiac arrest in patients with potassium- excretion disorders. This predominantly occurs in patients whose potassium is administered intravenously but should not be excluded for those taking it orally. Potential fatal hyperkalaemia can develop quickly and is asymptomatic. Therefore, patients with chronic renal failure or with other illnesses, which lead to potassium-excretion disorders, should be carefully monitored (Serum K+ concentration determinations). The dosage must be adapted to the circumstances.

Metabolic acidosis
Patients with hypokalaemia and a metabolic acidosis should not receive potassium chloride, but be treated with alkalising potassium salts, like potassium bicarbonate, potassium citrate or potassium acetate.

Periodic Serum-K+ concentration determinations are recommended throughout long-term potassium substitution therapy, particularly for the increased risk of hyperkalaemia (e.g. with renal function disorders and heart diseases). In addition, the acid-base balance, other serum electrolyte levels (e.g. Magnesium, see below), the ECG and the overall clinical status should all be monitored.

For blood samples to determine the K+ plasma concentration it needs to be considered that artificial increases in the potassium levels may occur following an improper venous puncture or as a result of in vitro haemolysis of the blood taken.

Other pharmaceutical forms of potassium salts are favoured for patients with stomas, due to the possible change to intestinal transit.
Balancing the intracellular potassium deficiency is complicated for certain patients who have a diuretic-induced magnesium deficiency in addition to hypokalaemia. Therefore, the magnesium deficiency should be treated at the same time.

Potassium serum levels may also be influenced by reduced salt or reduced sugar diets or through regular consumption of large quantities of liquorice. Regular check-ups of serum electrolytes levels should be undertaken and an abrupt change to dietary habits should be avoided.

Effects on Driving

4.7 Effects on ability to drive and use machines

Micro Kalium prolonged-release capsules has no or a negligible influence on the ability to drive and use machines.