Adult Dosing
Hyperkalemia
- 30-50 g PR q6 hrs as a warm emulsion (at body temperature) in 100 mL of aqueous vehicle; retain enema as long as possible followed by a cleansing enema
- Agitate the emulsion gently during administration
- Intensity and duration of therapy depend upon the severity and resistance of hyperkalemia
Notes:- Do not heat, as it may alter the exchange properties of the resin
- Use of sorbitol as an aqueous vehicle is not recommended; caution advised if the cleansing enema contains sorbitol
Pediatric Dosing
Hyperkalemia [Non-FDA Approved]
- Neonates/infants/children
- 1 g/kg PR q2-6 hrs as a warm emulsion (at body temperature) in aqueous vehicle; retain enema as long as possible followed by a cleansing enema (1 mEq of potassium/1 g resin can be used as a guide to calculate dose)
- Agitate the emulsion gently during administration
- Intensity and duration of therapy depends upon the severity and resistance of hyperkalemia
Notes:- Safety and effectiveness in pediatric patients have not been established
- Do not heat, as it may alter the exchange properties of the resin
- Use of sorbitol as an aqueous vehicle is not recommended; caution advised if the cleansing enema contains sorbitol
- During rectal administration, exercise extreme caution in neonates and children, as excessive dosage or inadequate dilution could result in resin impaction
[Outline]
- Intestinal necrosis, which may be fatal, and other serious gastrointestinal adverse events (bleeding, perforation, ischemic colitis) have been reported with this drug. However, majority of these cases were associated with concomitant sorbitol use. Risk factors for GI adverse events included prematurity, history of intestinal disease or surgery, hypovolemia, renal insufficiency and failure. It is advised not to use sorbitol concomitantly
- Use only in patients with normal bowel function; do not use in patients who have not had a bowel movement post-operatively
- Not recommended in patients who are at risk for developing constipation or impaction including those with history of impaction, chronic constipation, inflammatory bowel disease, ischemic colitis, vascular intestinal atherosclerosis, previous bowel resection, or bowel obstruction. Discontinue therapy in case of constipation
- Risk for developing serious potassium deficiency may be associated with this therapy; monitor serum potassium levels frequently within each 24-hour period. Intracellular potassium deficiency is not always reflected by serum potassium levels; hence, the level at which therapy should be discontinued must be determined individually for each patient. Patient’s clinical condition and ECG may be used as important aids in making this determination
- ECG changes of severe hypokalemia include a lengthened Q-T interval, widening, flattening, or inversion of the T wave, and prominent U waves. Cardiac arrhythmias such as premature atrial, nodal, and ventricular contractions, and supraventricular and ventricular tachycardias may also occur. Toxic effects of digitalis are likely to be exaggerated
- Significant hypokalemia may also be manifested by severe muscle weakness and even frank paralysis
- In case of severe hyperkalemia associated with states of rapid tissue breakdown (e.g., burns and renal failure) or hyperkalemia requiring emergency treatment, consider using an alternative therapy including dialysis, as sodium polystyrene sulfonate alone may be insufficient to rapidly correct severe hyperkalemia
- Patients receiving therapy should be monitored for all applicable electrolyte disturbances as this drug is not totally selective (for potassium) in its actions, and small amounts of other cations such as magnesium and calcium can also be lost during therapy
Cautions: Use cautiously in
- Renal impairment
- Premature or low birth weight infants
- Pediatric patients
- Elderly patients
- History of GI disease or surgery
- Severe CHF
- Severe hypertension
- Marked edema
- Hypernatremia
- Sodium restriction
- Severe hyperkalemia
- Hypovolemia
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer advises caution.
US Trade Name(s)
- Kalexate
- Kayexalate
- Kionex
- SPS
US Availability
sodium polystyrene sulfonate (generic)
- PWDR for SUSP: 454 g/bottle
- PWDR for SUSP: 453.6 g/bottle
- SUSP: 15 g/60mL
Kalexate (generic)
- PWDR for SUSP: 454 g/bottle
Kayexalate
- PWDR for SUSP: 453.6 g/bottle
Kionex (generic)
- SUSP: 15 g/60mL
- PWDR for SUSP: 454 g/bottle
SPS (generic)
Canadian Trade Name(s)
Canadian Availability
Solystat
UK Trade Name(s)
UK Availability
Resonium A
Australian Trade Name(s)
Australian Availability
Resonium A
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Kayexalate POWD [Jar] (SANOFI-AVENTIS U.S.)
453.6 = $403.92
1360.8 = $1182.59 - Sodium Polystyrene Sulfonate POWD [Jar] (CAROLINA MEDICAL PRODUCTS)
454 = $142.97
1362 = $416.89
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.