Pronunciation:

SOE-dee-um pol-ee-STYE-reen SUL-foe-nate

Brand Names:

• Kalexate
• Kayexalate
• Kionex
• Pms-Sodium Polystyrene Sulfonate

Dosage Forms:

• Powder for Suspension
• Powder
• Suspension

Classifications:

Therapeutic—

Exchange Resin

Uses of This Medicine:

Sodium polystyrene sulfonate is used to treat high levels of potassium in the blood, also called hyperkalemia.

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

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of sodium polystyrene sulfonate in the pediatric population. However, pediatric-specific problems that would limit the usefulness of this medicine in children are not expected.

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

Older adults—

No information is available on the relationship of age to the effects of sodium polystyrene sulfonate in geriatric patients.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the 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 cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Liothyronine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

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

• Congestive heart failure, or
• Edema (fluid retention) or
• Heart rhythm problems (eg, arrhythmia, QT prolongation) or
• Hypertension (high blood pressure), severe or
• Hypocalcemia (low calcium in the blood) or
• Hypokalemia (low potassium in the blood)
• Hypomagnesemia (low magnesium in the blood)—Use with caution. May make these conditions worse.

• Hyperkalemia, life-threatening—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 cause side effects to become worse.

• Patients not having any bowel movements after a surgery
• Stomach or bowel problems (eg, bleeding, colitis, constipation, perforation), history of—Avoid use in patients with these conditions.

Proper Use of This Medicine:

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.

Precautions While Using This Medicine:

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

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

This medicine may cause a serious stomach or bowel problem, called intestinal necrosis. This is more likely to occur if you have a history of bowel disease, bowel surgery, low blood volume, kidney problems or if you take sorbitol together with this medicine. Tell your doctor right away if you or your child have severe constipation, severe stomach pain, bloody, black, or tarry stools, or vomit blood or a material that looks like coffee grounds.

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

This medicine may cause lung or breathing problems (eg, bronchitis, bronchopneumonia) when you inhale its powder form. It may also increase your risk of having aspiration. Take this medicine in an upright position to prevent this. Talk to your doctor if you have questions.

If you are taking aluminum or magnesium-containing antacids or laxatives, talk to your doctor first before using them together with sodium polystyrene sulfonate. These medicines may keep sodium polystyrene sulfonate from working properly and may cause serious side effects.

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

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Bloody vomit

chest pain or tightness

cough

cough producing mucus

difficulty with breathing

fever or chills

severe stomach pain

sneezing

sore throat

trouble breathing

Incidence not known

Confusion

constipation

decrease in the amount of urine

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 immediately if any of the following symptoms of overdose occur:

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 occur in some patients. If you notice any other effects, check with your healthcare professional.

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