Polystyrene Sulfonate

Polystyrene Sulfonate is a prescription medication used to treat Hyperkalemia.

• Polystyrene Sulfonate is available under the following different brand names: SPS, Kayexalate, Kionex, Kalexate

Adult and pediatric dosage

Powder for oral suspension

• 454g

Oral suspension

• 15g/60mL

Rectal suspension

15g/60mL

Hyperkalemia

Adult dosage

• Orally: 15 g once daily or every 6-12 hours
• Rectal: 30-50 g every 6 hours

Pediatric dosage

• Orally: 1 g/kg every 6 hours as needed; alternatively, use exchange ration of 1 mEq K+ to 1 g of resin for lower dose (oral use not recommended in patients younger than 1 month of age)
• Rectal: 1 g/kg every 2-6 hours as needed; alternatively, use exchange ration of 1 mEq K+ to 1 g of resin for lower dose

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Polystyrene Sulfonate include:

• nausea, 
• vomiting, 
• diarrhea, 
• constipation, and 
• loss of appetite

Serious side effects of Polystyrene Sulfonate include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• stomach pain, 
• rectal pain, 
• severe constipation, 
• severe stomach pain, 
• bloating, 
• fever, 
• chills, 
• vomiting, 
• confusion, 
• thinking problems, 
• irritableness, 
• leg cramps, 
• constipation, 
• irregular heartbeats, 
• fluttering in the chest, 
• increased thirst or urination, 
• numbness or tingling, 
• muscle weakness, 
• limp feeling, 
• muscle spasms or contraction, 
• numbness or tingly feeling (around the mouth, or in the fingers and toes), 
• bloody or tarry stools, 
• coughing up blood, and
• vomit that looks like coffee grounds

Rare side effects of Polystyrene Sulfonate include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Polystyrene Sulfonate has severe interactions with the following drug:
  • meloxicam
• Polystyrene Sulfonate has serious interactions with the following drug:
  • sorbitol
• Polystyrene Sulfonate has moderate interactions with the following drugs:
  • deflazacort
  • magnesium sulfate
  • sodium sulfate/magnesium sulfate/potassium chloride
  • sodium sulfate/potassium sulfate/magnesium sulfate
  • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
• Polystyrene Sulfonate has minor interactions with at least 11 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity to polystyrene sulfonate resins
• Hypokalemia
• Obstructive bowel disease
• Neonates with reduced gut motility (postoperative or drug-induced), oral administration
• Rectal administration of suspension with sorbitol in neonates, particularly in premature infants

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Polystyrene Sulfonate?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Polystyrene Sulfonate?”

Cautions

• Use caution in congestive heart failure, severe hypertension, marked edema (due to sodium content; 1 g contains 100 mg of sodium, 1/3 of which is delivered to body)
• Best when used in non-life-threatening hyperkalemia
• Monitor electrolytes
• Large doses may result in fecal impaction, especially in the elderly
• Hypokalemia may occur monitor serum potassium frequently within each 24-hour period; ECG monitoring may be appropriate in some patients; cation exchange resins may also affect concentrations of other cations, including calcium and magnesium
• In severe hyperkalemia, consider more immediate treatment modalities (eg, dialysis, IV calcium, bicarbonate, glucose, and insulin)
• Products can contain as much as 20 g of sorbitol per 15 g of sodium polystyrene
• Use caution with dosage forms containing propylene glycol; large amounts are potentially toxic; associated with hyperosmolality, seizures, lactic acidosis, and respiratory depression
• Do not use in patients who do not have normal bowel function, including postoperative patients who have not had a bowel movement since operation' avoid use in postoperative patients at risk of constipation or impaction until normal bowel function resumes; discontinue use if constipation occurs
• Do not mix oral dose with banana or orange juice (potassium-rich)
• If there is clinically significant constipation, discontinue until normal bowel motion; do not use magnesium-containing laxatives or sorbitol
• In children and neonates rectal administration, excessive dosage or inadequate dilution could result in impaction of resin
• Premature and low-birth-weight infants: Risk of digestive hemorrhage or colonic necrosis
• Enema may reduce serum concentrations faster than oral administration but oral route will achieve greater reduction over several hours
• Risk of colonic necrosis and other serious GI adverse events (eg, bleeding, ischemic colitis, perforation), most frequently with concomitant use of sorbitol
• Concomitant administration of sorbitol is not recommended
• Risk factors for GI adverse events include prematurity, history of intestinal disease or surgery, hypovolemia, and renal insufficiency or failure
• Cases of acute bronchitis or bronchopneumonia caused by inhalation of sodium polystyrene sulfonate particles reported; patients with impaired gag reflex, altered level of consciousness, or patients prone to regurgitation may be at increased risk; administer product with patient in upright position
• May bind orally administered medications, which could decrease their gastrointestinal absorption and lead to reduced efficacy; administer other oral medications at least 3-hours before or 3-hours after therapy; patients with gastroparesis may require a 6-hour separation

Pregnancy and Lactation

• Not absorbed systemically following oral or rectal administration and maternal use is not expected to result in fetal risk.  
• Not absorbed systemically by the mother, so breastfeeding is not expected to result in risk to the infant.