Sodium Polystyrene Sulfonate

What is Sodium Polystyrene Sulfonate

Sodium polystyrene sulfonate is a cation-exchange resin used in the treatment of hyperkalemia.

Each gram of resin will remove roughly 3 mEq of potassium in vitro, but because sodium polystyrene sulfonate can bind other cations, the actual amount of potassium removed in vivo is closer to 1 mEq per gram of drug.

Sodium polystyrene sulfonate is available as a powdered resin or as a commercially available solution that contains sorbitol.

Sodium polystyrene sulfonate exerts its effects over a period of several hours, so it is inappropriate for the acute treatment of life-threatening hyperkalemia. Sodium polystyrene sulfonate was approved by the FDA in 1958.

Brand Names

  • Kalexate
  • Kayexalate
  • Kionex
  • Marlexate
  • SPS

Indications & Dosage

  • hyperkalemia
  • The in vivo exchange capacity is approximately 1 mEq of potassium per 1 g sodium polystyrene sulfonate; however, efficiency is variable.
  • One gram of sodium polystyrene sulfonate powder or suspension contains approximately 100 mg (4.1 meq) sodium.
  • The in vivo efficiency of sodium-potassium exchange resins is approximately 33%. On average, approximately one-third of the resin’s sodium content is delivered to the body.

Side Effects

  1. anorexia
  2. bezoar
  3. bowel necrosis
  4. colitis
  5. constipation
  6. diarrhea
  7. GI bleeding
  8. GI obstruction
  9. GI perforation
  10. hypocalcemia
  11. hypokalemia
  12. hypomagnesemia
  13. nausea
  14. vomiting

Monitoring Parameters

  • serum calcium
  • serum potassium

Contraindications

  • binding to other oral medications
  • breast-feeding
  • burns
  • children
  • colitis
  • constipation
  • edema
  • fecal impaction
  • GI bleeding
  • GI obstruction
  • heart failure
  • hypernatremia
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypovolemia
  • infants
  • inflammatory bowel disease
  • neonates
  • pregnancy
  • premature neonates
  • renal failure
  • sodium restriction
  • surgery

Interactions

  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Bumetanide
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Cardiac glycosides
  • Citric Acid; Potassium Citrate
  • Citric Acid; Potassium Citrate; Sodium Citrate
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Digitoxin
  • Digoxin
  • Ethacrynic Acid
  • Furosemide
  • Guaifenesin; Potassium Guaiacolsulfonate
  • Hetastarch; Dextrose; Electrolytes
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Ibritumomab Tiuxetan
  • Insulins
  • Iodine; Potassium Iodide, KI
  • Lithium
  • Loop diuretics
  • Magnesium Citrate
  • Magnesium Hydroxide
  • Meloxicam
  • Omeprazole; Sodium Bicarbonate
  • Potassium
  • Potassium Acetate
  • Potassium Bicarbonate
  • Potassium Chloride
  • Potassium Citrate
  • Potassium Gluconate
  • Potassium Iodide, KI
  • Sodium Bicarbonate
  • Sorbitol
  • Thyroid hormones
  • Torsemide
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