Indication

Hyperkalemia

Administration

$4e

Adult Dose

Oral\r\nHyperkalaemia\r\nAdult: As suspension in water or syrup or as sweetened paste: 15 g up to 4 times daily. Not to be taken with fruit juices that have high potassium content. \r\n\r\nRectal\r\nHyperkalaemia\r\nAdult: As enema (suspension): 30 g in 100 ml of 2% methylcellulose '450' and 100 ml of water, retained for at least 9 hr, if possible. Higher doses may be retained for a shorter period of time. Irrigate colon after retention to remove the resin. \r\n

Child Dose

Oral\r\nHyperkalaemia\r\n Child: Acute hyperkalaemia: 1 g/kg daily in divided doses. Maintenance: 500 mg/kg daily. \r\n\r\nRectal\r\nHyperkalaemia\r\nChild: and neonates: Acute hyperkalaemia: 1 g/kg daily in divided doses. Maintenance: 500 mg/kg daily.

Contraindication

Hypersensitivity to polystyrene sulfonate resins. Oral admin to neonates; neonates with reduced gut motility; obstructive bowel disease. Hypokalaemia.

Mode of Action

Sodium polysytrene sulfonate exchanges sodium ions for potassium ions and other cations in the GI tract before the resin is excreted in the faeces.

Precaution

Renal failure and conditions requiring a restricted sodium intake e.g. heart failure and severe hypertension. Rectal admin to neonates and children. Monitor for electrolyte disturbances and symptoms of hypokalaemia. Discontinue treatment if clinically significant constipation develops. Irrigate colon after admin of enema to ensure removal of resin. Pregnancy; lactation.\r\n\r\nLactation\r\nNot absorbed systemically by the mother, so breastfeeding is not expected to result in risk to the infant

Side Effect

1-10%\r\nGI disturbance\r\nConstipation\r\nHypokalemia\r\nHypocalcemia\r\nHypomagnesemia\r\nSodium retention\r\nNausea\r\nVomiting\r\n\r\nFrequency Not Defined\r\nGI concretions (bezoars) after oral use\r\nGI tract ulceration or necrosis, which could lead to perforation\r\nFecal impaction after rectal administration (especially in children)\r\nAcute bronchitis or bronchopneumonia associated with inhalation of polystyrene particles (rare)

Interaction

Reduces absorption of thyroxine and lithium salts. Enhances adverse effects of cardiac glycosides. Potassium-lowering effect may be reduced when used with other cation-containing antacids.