Sodium polystyrene sulfonate (Oral)

Sodium polystyrene sulfonate is used to treat high levels of potassium in the blood, which is known as hyperkalemia.

This medicine is available only with your doctor's prescription.

It is very important for your doctor to monitor you or your child closely to ensure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Hypokalemia (low potassium in the blood) may happen while you are using this medicine. Contact your doctor right away if you experience confusion, dry mouth, increased thirst, irregular heartbeat, irritability, muscle cramps, nausea or vomiting, or trouble breathing.

This medicine may lead to a serious stomach or bowel issue called intestinal necrosis. This is more likely to happen if you have a history of bowel disease, bowel surgery, low blood volume, kidney problems, or if you take sorbitol along with this medicine. Inform your doctor immediately if you or your child have severe constipation, severe stomach pain, bloody, black, or tarry stools, or vomit blood or material that looks like coffee grounds.

Notify your doctor if you experience unexplained weight gain or edema (fluid retention or body swelling) while using this medicine.

This medicine may cause lung or breathing issues (such as bronchitis or bronchopneumonia) when you inhale its powder form. It may also increase your risk of aspiration. Take this medicine in an upright position to prevent this. Discuss any questions with your doctor.

If you are taking antacids or laxatives that contain aluminum or magnesium, consult your doctor before using them with sodium polystyrene sulfonate. These medicines may prevent sodium polystyrene sulfonate from working properly and could cause serious side effects.

Do not take other medicines unless you have talked about them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you need to consider the risks of taking it against the benefits it will provide. This decision is made between you and your doctor. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you have, including to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

There have not been appropriate studies to determine how sodium polystyrene sulfonate affects children. However, there are no expected pediatric-specific problems that would limit the use of this medicine in children.

This medicine should be used cautiously in newborn infants with reduced or slow bowel movements. The oral form should not be given to newborn infants.

Geriatric

There is no information available on how sodium polystyrene sulfonate affects older patients.

Breast Feeding

Studies in women indicate that this medication poses minimal risk to infants when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while others may be combined even if an interaction might happen. In those cases, your doctor may adjust the dose or take other precautions. When you are taking this medicine, it is crucial that your healthcare professional knows if you are taking any of the following medicines. The following interactions are based on their potential significance and are not a complete list.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may change the dose or frequency of one or both medicines.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Calcium
• Calcium Carbonate
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Magaldrate
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate
• Meloxicam
• Sorbitol

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be the best treatment for you. If both are prescribed, your doctor may change the dose or frequency of one or both medicines.

• Liothyronine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used around the time of eating or with specific foods due to possible interactions. Alcohol or tobacco may also cause interactions with some medicines. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect the use of this medicine. Make sure to tell your doctor if you have any other medical conditions, especially:

• Bowel blockage or
• Newborn infants with slow bowel movements—Should not be used in patients with these conditions.

• Congestive heart failure, or
• Edema (fluid retention) or
• Heart rhythm problems (e.g., arrhythmia, QT prolongation) or
• Severe hypertension (high blood pressure), or
• Hypocalcemia (low calcium in the blood) or
• Hypokalemia (low potassium in the blood)
• Hypomagnesemia (low magnesium in the blood)—Use with caution. May worsen these conditions.

• Life-threatening hyperkalemia—Should not be used as an emergency treatment because of its delayed onset of action.

• Hypovolemia (low blood volume) or
• Kidney disease—Use with caution. May worsen side effects.

• Patients who have not had any bowel movements after surgery
• Stomach or bowel problems (e.g., bleeding, colitis, constipation, perforation), history of—Avoid use in patients with these conditions.

Along with its necessary effects, this medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they might require medical attention.

Check with your doctor right away if you experience any of the following side effects:

Rare

• Bloody vomit
• Chest pain or tightness
• Cough
• Cough that produces mucus
• Difficulty breathing
• Fever or chills
• Severe stomach pain
• Sneezing
• Sore throat
• Trouble breathing

Incidence not known

• Confusion
• Constipation
• Decrease in urine output
• Diarrhea
• Dry mouth
• Increased thirst
• Irregular heartbeat
• Loss of appetite
• Muscle cramps in the hands, arms, feet, legs, or face
• Nausea or vomiting
• Noisy, rattling breathing
• Numbness and tingling around the mouth, fingertips, or feet
• Seizures
• Severe constipation
• Swelling of the fingers, hands, feet, or lower legs
• Stomach cramps or pain
• Tremor
• Unusual tiredness or weakness
• Weight gain or loss

Get emergency help right away if you notice any of the following symptoms of overdose:

Symptoms of overdose

• Dizziness
• Drowsiness
• Fainting
• Fast, slow, or irregular heartbeat
• Lightheadedness
• Muscle spasms (tetany) or twitching
• Pounding or rapid pulse
• Trembling

Other side effects not listed may also happen in some patients. If you notice any other effects, contact your healthcare professional.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Kalexate
• Kayexalate
• Kionex

In Canada

• Pms-Sodium Polystyrene Sulfonate

Available Dosage Forms:

• Powder for Suspension
• Powder
• Suspension

Therapeutic Class: Exchange Resin

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes as a liquid suspension and as a powder for suspension that is mixed with water or syrup. If you or your child are not able to swallow the liquid, the medicine can be given in the stomach using a special tube. Talk to your doctor if you have questions about this.

Mix the powder with 3 to 4 milliliters (mL) of water or syrup. Each dose of the powder must be mixed with a liquid right before you take it. Stir the powder mixture to dissolve the medicine. Do not store the liquid mixture to take later. Use it while in an upright position within 24 hours after it is mixed.

Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. Shake the bottle of medicine well just before each use.

Take this medicine at least 3 hours before or after taking other oral medicines. If your stomach takes too long to empty food (gastroparesis), take this medicine 6 hours before or after other oral medicines.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (powder, suspension):For treatment of hyperkalemia: Adults—15 grams (4 level teaspoons) one to four times a day. Children and infants—Dose is based on the potassium blood level and must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.