Enteral administration of
injectable ammonium chloride may offer an effective method for the treatment of persistent metabolic
alkalosis, without the adverse effects associated with the intravenous route. This case series describes 3 pediatric patients who received
ammonium chloride enterally for the treatment of persistent metabolic
alkalosis. The patients were a 2-month-old female infant, a 6-week-old male infant, and a 3-year-old male toddler. Four to 18 doses of
ammonium chloride were administered enterally (range, 3-144 mEq/dose). Two of the 3 patients achieved resolution of metabolic
alkalosis with
ammonium chloride, while 1 patient's condition was refractory to treatment. Resolution of metabolic
alkalosis occurred at 4 and 8 days, which required a total weight-based dose of 10.7 mEq/kg and 18 mEq/kg, respectively. No adverse effects were recorded. The use of
ammonium chloride injection administered enterally was a safe and effective option in 2 of the 3 pediatric patients with persistent metabolic
alkalosis.