Potassium

Potassium supplementation · Potassium Citrate · Potassium Chloride · Potassium Gluconate

Snapshot

Indications	Contraindications
Hypertension^{1, 2} Stroke prevention³ Kidney stone prevention¹ Diuretic-induced hypokalemia¹ Ventricular arrhythmia risk reduction⁴ Heart failure potassium optimization⁵ Glucose metabolism support¹	Chronic kidney disease⁶ Adrenal insufficiency or hyperkalemia history¹

Potassium is the primary intracellular cation, essential for maintaining the transmembrane electrochemical gradient via the sodium-potassium (Na+/K+) adenosine triphosphatase (ATPase) pump, which underlies nerve transmission, muscle contraction, and blood pressure regulation.¹ Supplementation is used for blood pressure reduction, stroke prevention, and kidney stone prevention via potassium citrate, and for correcting deficiency states in patients on loop or thiazide diuretics, those with inflammatory bowel disease, and those with chronic low dietary intake.¹ Most adults in the United States consume less than the adequate intake (AI), making subclinical insufficiency common across the general population.¹

Meta-analyses of randomized controlled trials (RCTs) consistently show that potassium supplementation reduces systolic and diastolic blood pressure in patients with hypertension, with the effect attenuated or absent in normotensive individuals.^{3, 7} Stroke risk is inversely associated with potassium intake in large cohort meta-analyses, and the association persists after blood pressure adjustment. In a 2025 multicenter open-label RCT of patients with implantable cardioverter-defibrillator (ICD) devices, actively raising plasma potassium to the high-normal range reduced a composite of sustained ventricular tachycardia, arrhythmia hospitalization, and death compared with standard care.⁴ Nearly 30,000 heart failure patients pooled from 12 RCTs show a U-shaped mortality association, with lowest risk at a serum potassium of roughly 4.2–5.0 mmol/L.⁵ Supplement products include potassium chloride, potassium citrate, and potassium gluconate, available as capsules, tablets, powders, and liquids; over 29,000 products listing potassium appear in commercial databases; see Form comparison.

The most consequential contraindication is impaired renal potassium excretion: in patients with chronic kidney disease (CKD), potassium-induced natriuresis is blunted and oral loading carries a materially increased hyperkalemia risk, per a 2026 crossover RCT.⁶ Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and potassium-sparing diuretics all reduce urinary potassium excretion and require prescriber monitoring when potassium supplementation is co-prescribed; per the NIH Office of Dietary Supplements (ODS) fact sheet, concurrent use warrants provider coordination and periodic serum potassium assessment.¹

Last updated September 28, 2026. Read how we make monographs.

In the full monograph

83 sources, 66 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources