Hyperkalemia

Antidote

Onset of action: May be delayed 1 to 2 days due to GI transit time
Absorption: None
Excretion: Feces (100%)

Hypersensitivity to polystyrene sulfonate resins or any component of the formulation; potassium <5 mmol/L (5 mEq/L); conditions associated with hypercalcemia (eg, metastatic carcinoma, multiple myeloma, hyperparathyroidism, or sarcoidosis); obstructive bowel disease; oral administration in neonates; use in neonates with reduced gut motility (postoperative, drug induced)

C Does not undergo gastrointestinal (GI) absorption. There are no adequate and well-controlled studies in pregnant women. In general, medications used as antidotes should take into consideration the health and prognosis of the mother; antidotes should be administered to pregnant women if there is a clear indication for use and should not be withheld because of fears of teratogenicity (Bailey 2003).

Does not undergo GI absorption

Frequency not defined: Endocrine & metabolic: Hypokalemia Gastrointestinal: Anorexia, constipation, diarrhea, gastric irritation, nausea, vomiting Respiratory: Acute bronchitis, bronchopneumonia <1%, postmarketing, and/or case reports: Bezoar formation (oral administration), fecal impaction (rectal administration), gastrointestinal necrosis, gastrointestinal obstruction (rare), gastrointestinal ulcer, hypercalcemia, hypomagnesemia, intestinal stenosis, ischemic colitis, mesenteric ischemia, rectal hemorrhage

Hyperkalemia: Initiate treatment if potassium level >6 mmol/L (6 mEq/L); discontinue when potassium ?5 mmol/L (5 mEq/L). Oral: Usual dose: 15 g 3 to 4 times daily; dose should be based on clinical presentation and serum electrolyte levels Rectal: 30 g once daily

Hyperkalemia: Initiate treatment if potassium level >6 mmol/L (6 mEq/L); discontinue when potassium ?5 mmol/L (5 mEq/L). In small children and infants, employ lower doses by using the practical exchange ratio of 1 mEq potassium per gram of resin as the basis for calculation. Neonates: Rectal: 0.5 to 1 g/kg/dose Children: Oral (preferred route): Initial: 1 g/kg daily in divided doses; Maintenance: May reduce dose to 0.5 g/kg daily in divided doses Rectal: Initial: 1 g/kg daily in divided doses; Maintenance: May reduce dose to 0.5 g/kg daily in divided doses

There are no specific dosage adjustments provided in the manufacturer’s labeling; however, dosage adjustments may be necessary based on changes in serum potassium and/or calcium levels.

There are no dosage adjustments provided in the manufacturer’s labeling.

Store away from direct sunlight, heat and moisture.