Drugs Details

Drugs Info of Kalexate, Kayexalate, Kionex
Drugs Details
  • Drugs Type  : Multum
  • Date : 14th Jul 2015 02:59 am
  • Brand Name : Kalexate, Kayexalate, Kionex
  • Generic Name : sodium polystyrene sulfonate (Pronunciation: SOE dee um pol ee STEER een SUL foe nate)
Descriptions

Kayexalate, brand of sodium polystyrene sulfonate is a benzene, diethenyl-polymer, with ethenylbenzene, sulfonated, sodium salt and has the following structural formula:

 

Kayexalate® 
   (sodium polystyrene sulfonate) Structural Formula Illustration

The drug is a cream to light brown finely ground, powdered form of sodium polystyrene sulfonate, a cation-exchange resin prepared in the sodium phase with an in vitro exchange capacity of approximately 3.1 mEq (in vivo approximately 1 mEq) of potassium per gram. The sodium content is approximately 100 mg (4.1 mEq) per gram of the drug. It can be administered orally or in an enema.

What are the possible side effects of sodium polystyrene sulfonate (Kalexate, Kayexalate, Kionex)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have any of these serious side effects:

  • pain or fluttering in your chest;
  • uneven heartbeats;
  • feeling irritable or confused;
  • increased thirst or urination;
  • severe muscle weakness;
  • inability to move your muscles;
  • black, bloody, or tarry stools;
  • pain in your lower stomach or rectum;...

Read All Potential Side Effects and See Pictures of Kayexalate »

What are the precautions when taking sodium polystyrene (Kayexalate)?

Before using sodium polystyrene sulfonate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication contains a large amount of salt (sodium). Do not use salt substitutes that contain potassium without asking your doctor first. If you have any of these conditions, follow your doctor's instructions for limiting the amount of sodium in your diet: kidney problems, heart failure, high blood pressure, swelling hands/ankles/feet.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestine/bowel problems (such as inflammatory bowel...

Indications

Kayexalate (sodium polystyrene) is indicated for the treatment of hyperkalemia.

Dosage Administration

Suspension of this drug should be freshly prepared and not stored beyond 24 hours.

The average daily adult dose of the resin is 15 g to 60 g. This is best provided by administering 15 g (approximately 4 level teaspoons) of Kayexalate (sodium polystyrene) one to four times daily. One gram of Kayexalate (sodium polystyrene) contains 4.1 mEq of sodium; one level teaspoon contains approximately 3.5 g of Kayexalate (sodium polystyrene) and 15 mEq of sodium (A heaping teaspoon may contain as much as 10 g to 12 g of Kayexalate (sodium polystyrene) ). Since the in vivo efficiency of sodium-potassium exchange resins is approximately 33 percent, about one third of the resin's actual sodium content is being delivered to the body.

In smaller children and infants, lower doses should be employed by using as a guide a rate of 1 mEq of potassium per gram of resin as the basis for calculation.

Each dose should be given as a suspension in a small quantity of water or, for greater palatability, in syrup. The amount of fluid usually ranges from 20 mL to 100 mL, depending on the dose, or may be simply determined by allowing 3 mL to 4 mL per gram of resin. Healthcare professionals should follow full aspiration precautions when administering this product, such as placing and maintaining the patient in an upright position while the resin is being administered.

The resin may be introduced into the stomach through a plastic tube and, if desired, mixed with a diet appropriate for a patient in renal failure.

The resin may also be given, although with less effective results, in an enema consisting (for adults) of 30 g to 50 g every six hours. Each dose is administered as a warm emulsion (at body temperature) in 100 mL of aqueous vehicle. The emulsion should be agitated gently during administration. The enema should be retained as long as possible and followed by a cleansing enema.

After an initial cleansing enema, a soft, large size (French 28) rubber tube is inserted into the rectum for a distance of about 20 cm, with the tip well into the sigmoid colon, and taped in place. The resin is then suspended in the appropriate amount of aqueous vehicle at body temperature and introduced by gravity, while the particles are kept in suspension by stirring. The suspension is flushed with 50 mL or 100 mL of fluid, following which the tube is clamped and left in place. If back leakage occurs, the hips are elevated on pillows or a knee-chest position is taken temporarily. A somewhat thicker suspension may be used, but care should be taken that no paste is formed, because the latter has a greatly reduced exchange surface and will be particularly ineffective if deposited in the rectal ampulla. The suspension is kept in the sigmoid colon for several hours, if possible. Then, the colon is irrigated with nonsodium containing solution at body temperature in order to remove the resin. Two quarts of flushing solution may be necessary. The returns are drained constantly through a Y tube connection. While the use of sorbitol is not recommended, particular attention should be paid to this cleansing enema if sorbitol has been used.

The intensity and duration of therapy depend upon the severity and resistance of hyperkalemia. Kayexalate (sodium polystyrene) should not be heated for to do so may alter the exchange properties of the resin.

How Supplied

Kayexalate (sodium polystyrene) is available as a cream to light brown, finely ground powder in jars of 1 pound (453.6 g), NDC 0024-1075-01.

Store at 25° C (77° F); excursions permitted to 15° - 30° C (59° - 86° F) [see USP Controlled Room Temperature]

Side Effects

Kayexalate (sodium polystyrene) may cause some degree of gastric irritation. Anorexia, nausea, vomiting, and constipation may occur especially if high doses are given. Also, hypokalemia, hypocalcemia, hypomagnesemia and significant sodium retention, and their related clinical manifestations, may occur (see WARNINGS). Occasionally diarrhea develops. Large doses in elderly individuals may cause fecal impaction (see PRECAUTIONS). Rare instances of intestinal necrosis have been reported. Intestinal obstruction due to concretions of aluminum hydroxide, when used in combination with Kayexalate (sodium polystyrene) , has been reported.

The following events have been reported from worldwide post marketing experience:

  • Fecal impaction following rectal administration, particularly in children;
  • Gastrointestinal concretions (bezoars) following oral administration;
  • Ischemic colitis, gastrointestinal tract ulceration or necrosis which could lead to intestinal perforation; and,
  • Rare cases of acute bronchitis and/or broncho-pneumonia associated with inhalation of particles of polystyrene sulfonate.

Interactions

Antacids

The simultaneous oral administration of Kayexalate (sodium polystyrene) with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability.

Non-absorbable cation-donating antacids and laxatives

Systemic alkalosis has been repotted after cation-exchange resins were administered orally in combination with nonabsorbable cation-donating antacids and laxatives such as magnesium hydroxide and aluminum carbonate. Magnesium hydroxide should not be administered with Kayexalate (sodium polystyrene) . One case of grand mal seizure has been reported in a patient with chronic hypocalcemia of renal failure who was given Kayexalate (sodium polystyrene) with magnesium hydroxide as a laxative.

Intestinal obstruction due to concretions of aluminum hydroxide when used in combination with Kayexalate (sodium polystyrene) has been reported.

Digitalis

The toxic effects of digitalis on the heart, especially various ventricular arrhythmias and A-V nodal dissociation, are likely to be exaggerated by hypokalemia, even in the face of serum digoxin concentrations in the "normal range" (See WARNINGS).

Sorbitol: Concomitant use of Sorbitol with Kayexalate (sodium polystyrene) has been implicated in cases of intestinal necrosis, which may be fatal. Therefore, concomitant administration is not recommended (See WARNINGS).

Lithium

Kayexalate (sodium polystyrene) may decrease absorption of lithium.

Thyroxine

Kayexalate (sodium polystyrene) may decrease absorption of thyroxine.

Warnings

Colonic Necrosis

Cases of colonic necrosis and other serious gastrointestinal adverse events (bleeding, ischemic colitis, perforation) have been reported in association with KAYEXALATE (sodium polystyrene) use. The majority of these cases reported the concomitant use of sorbitol. Risk factors for gastrointestinal adverse events were present in many of the cases including prematurity, history of intestinal disease or surgery, hypovolemia, and renal insufficiency and failure. Concomitant administration of sorbitol is not recommended (see PRECAUTIONS: DRUG INTERACTIONS).

Alternative Therapy in Severe Hyperkalemia

Since effective lowering of serum potassium with KAYEXALATE (sodium polystyrene) may take hours to days, treatment with this drug alone may be insufficient to rapidly correct severe hyperkalemia associated with states of rapid tissue breakdown (e.g., burns and renal failure) or hyperkalemia so marked as to constitute a medical emergency. Therefore, other definitive measures, including dialysis, should always be considered and may be imperative.

Hypokalemia

Serious potassium deficiency can occur from therapy with KAYEXALATE (sodium polystyrene) . The effect must be carefully controlled by frequent serum potassium determinations within each 24 hour period. Since intracellular potassium deficiency is not always reflected by serum potassium levels, the level at which treatment with KAYEXALATE (sodium polystyrene) should be discontinued must be determined individually for each patient. Important aids in making this determination are the patient's clinical condition and electrocardiogram. Early clinical signs of severe hypokalemia include a pattern of irritable confusion and delayed thought processes.

Electrocardiographically, severe hypokalemia is often associated with a lengthened Q-T interval, widening, flattening, or inversion of the T wave, and prominent U waves. Also, cardiac arrhythmias may occur, such as premature atrial, nodal, and ventricular contractions, and supraventricular and ventricular tachycardias. The toxic effects of digitalis are likely to be exaggerated. Marked hypokalemia can also be manifested by severe muscle weakness, at times extending into frank paralysis.

Electrolyte Disturbances

Like all cation-exchange resins, KAYEXALATE (sodium polystyrene) 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 treatment. Accordingly, patients receiving KAYEXALATE (sodium polystyrene) should be monitored for all applicable electrolyte disturbances.

Systemic Alkalosis

Systemic alkalosis has been reported after cation-exchange resins were administered orally in combination with nonabsorbable cation-donating antacids and laxatives such as magnesium hydroxide and aluminum carbonate. Magnesium hydroxide should not be administered with KAYEXALATE (sodium polystyrene) . One case of grand mal seizure has been reported in a patient with chronic hypocalcemia of renal failure who was given KAYEXALATE (sodium polystyrene) with magnesium hydroxide as laxative. (See PRECAUTIONS: DRUG INTERACTIONS.)

Precautions

Caution is advised when KAYEXALATE (sodium polystyrene) is administered to patients who cannot tolerate even a small increase in sodium loads (i.e., severe congestive heart failure, severe hypertension, or marked edema). In such instances compensatory restriction of sodium intake from other sources may be indicated.

In the event of clinically significant constipation, treatment with KAYEXALATE (sodium polystyrene) should be discontinued until normal bowel motion is resumed. Magnesium-containing laxatives or sorbitol should not be used (see PRECAUTIONS: DRUG INTERACTIONS).

Carcinogenesis, Mutagenesis, Impairment of Fertility

Studies have not been performed.

Pregnancy Category C

Animal reproduction studies have not been conducted with KAYEXALATE (sodium polystyrene) . It is also not known whether KAYEXALATE (sodium polystyrene) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. KAYEXALATE (sodium polystyrene) should be given to a pregnant woman only if clearly needed.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when KAYEXALATE (sodium polystyrene) is administered to a nursing woman.

Pediatric Use

The effectiveness of KAYEXALATE (sodium polystyrene) in pediatric patients has not been established. In neonates, KAYEXALATE (sodium polystyrene) should not be given by the oral route. In both children and neonates particular care should be observed with rectal administration, as excessive dosage or inadequate dilution could result in impaction of the resin.

Due to the risk of digestive hemorrhage or colonic necrosis, particular care should be observed in premature infants or low birth weight infants.

OverDose

Overdosage may result in electrolyte disturbances including hypokalemia, hypocalcemia, and hypomagnesemia. Biochemical disturbances resulting from overdosage may give rise to clinical signs and symptoms of hypokalemia, including: irritability, confusion, delayed thought processes, muscle weakness, hyporeflexia, which may progress to frank paralysis and/or apnea. Tetany may occur. Electrocardiographic changes may be consistent with hypokalemia or hypocalcemia; cardiac arrhythmias may occur. Appropriate measures should be taken to correct serum electrolytes (potassium, calcium, magnesium), and the resin should be removed from the alimentary tract by appropriate use of laxatives or enemas.

ContrainDications

Kayexalate (sodium polystyrene) is contraindicated in the following conditions: patients with hypokalemia, patients with a history of hypersensitiviry to polystyrene sulfonate resins, obstructive bowel disease, neonates with reduced gut motiliry (postoperatively or drug induced) and oral administration in neonates (see PRECAUTIONS).

Clinical Pharamacology

As the resin passes along the intestine or is retained in the colon after administration by enema, the sodium ions are partially released and are replaced by potassium ions. For the most part, this action occurs in the large intestine, which excretes potassium ions to a greater degree than does the small intestine. The efficiency of this process is limited and unpredictably variable. It commonly approximates the order of 33 percent but the range is so large that definitive indices of electrolyte balance must be clearly monitored.

Patient Information

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Consumer Overview Uses

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

 

SODIUM POLYSTYRENE SULFONATE POWDER FOR SUSPENSION - ORAL, RECTAL

 

(SOE-dee-um POL-ee-STYE-reen SUL-foe-nate)

 

COMMON BRAND NAME(S): Kayexalate, Kionex, Marlexate

 

USES: This medication is used to treat a high level of potassium in your blood. Too much potassium in your blood can sometimes cause heart rhythm problems. Sodium polystyrene sulfonate works by helping your body get rid of extra potassium.

 

HOW TO USE: Take this medication by mouth, or use it rectally as directed by your doctor.

If you are taking this medication by mouth, take it usually 1 to 4 times a day as directed by your doctor. To prepare the liquid suspension, carefully measure the prescribed dose of the powder and mix it with the prescribed amount of water or flavored syrup as directed. Stir well and drink the entire dose. Stay upright (sitting, standing, or walking) and do not lie down for at least an hour after your dose. Consult your doctor for details.

Certain antacids and laxatives should not be taken at the same time as sodium polystyrene sulfonate. See the Drug Interactions section for details.

To give this medication rectally as an enema, use the prescribed dose usually every 6 hours as needed or as directed by your doctor. Consult your doctor or pharmacist for directions on how to prepare and mix the dose into a suspension and how to use the enema. Follow instructions for the use of a cleansing enema both before and after your dose of sodium polystyrene sulfonate. The cleansing enema after each rectal dose of this medication should be a non-sodium-containing enema.

Stir the suspension well, and use it soon after mixing. Do not store the mixture for more than 24 hours.

Do not heat this medication because it may not work as well.

The dosage and length of treatment are based on your medical condition and response to treatment. Follow your doctor's instructions carefully. Do not use more of this medication or use it for longer than directed because your potassium blood level may drop too low.

Keep all laboratory and medical appointments so your doctor can check your potassium blood level.

Consumer Overview Side Effect

SIDE EFFECTS: Loss of appetite, nausea, vomiting, or constipation may occur. Diarrhea may occur less frequently. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise, unless otherwise directed by your doctor. Severe constipation can become very serious. Consult your doctor or pharmacist for help in selecting a laxative. Certain laxatives should not be taken with this medication. See the Drug Interactions section.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: muscle weakness/spasms, fast/irregular heartbeat, mental/mood changes (such as irritability, confusion, slowed thinking), swelling hands/ankles/feet.

Get medical help right away if you have any very serious side effects, including: severe constipation, bloating/swelling/pain in the stomach/abdomen, black/bloody stools, vomit that looks like coffee grounds, inability to move your muscles (paralysis), seizures.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

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

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

 

Read the Kayexalate (sodium polystyrene) Side Effects Center for a complete guide to possible side effects

Learn More »

PRECAUTIONS: Before using sodium polystyrene sulfonate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication contains a large amount of salt (sodium). Do not use salt substitutes that contain potassium without asking your doctor first. If you have any of these conditions, follow your doctor's instructions for limiting the amount of sodium in your diet: kidney problems, heart failure, high blood pressure, swelling hands/ankles/feet.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestine/bowel problems (such as inflammatory bowel disease, bowel obstruction, chronic constipation, fecal impaction), low level of potassium in the blood.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at greater risk for severe constipation.

This medication must not be given by mouth to newborns, especially premature infants. Also, newborns with slow gut function must not use this drug. Caution is advised when using this medication rectally in newborns and children. They may be more sensitive to the side effects of this drug, especially severe constipation and intestinal problems.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk, and the effect on a nursing infant is unknown. Consult your doctor before breast-feeding.

Consumer Overview Missed Dose

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: antacids/laxatives that contain aluminum/calcium/magnesium (such as aluminum carbonate, aluminum hydroxide, calcium carbonate, magnesium hydroxide), lithium.

Taking the laxative sorbitol with sodium polystyrene sulfonate by mouth is not recommended because doing so may cause serious intestinal problems in some people. If you are using sodium polystyrene sulfonate rectally with sorbitol, using a non-sodium-containing cleansing enema after the dose of this medication may help to decrease the risk of intestinal side effects. Consult your doctor or pharmacist for more details.

This medication may decrease the absorption of levothyroxine into your body. Therefore, if you take levothyroxine, take it 4 hours before or after using this medication.

 

OVERDOSE: If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: mental/mood changes, muscle weakness, fast/irregular heartbeat, slowed breathing, paralysis.

 

NOTES: Do not share this medication with others.

Laboratory and/or medical tests (such as blood levels of potassium and other minerals, EKG) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

 

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

 

STORAGE: Store tightly closed at room temperature away from light and moisture. Do not store in the bathroom. After mixing, use the suspension within 24 hours. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Patient Detailed Side Effect

Brand Names: Kalexate, Kayexalate, Kionex

Generic Name: sodium polystyrene sulfonate (Pronunciation: SOE dee um pol ee STEER een SUL foe nate)

  • What is sodium polystyrene sulfonate (Kayexalate)?
  • What are the possible side effects of sodium polystyrene sulfonate (Kayexalate)?
  • What is the most important information I should know about sodium polystyrene sulfonate (Kayexalate)?
  • What should I discuss with my health care provider before receiving sodium polystyrene sulfonate (Kayexalate)?
  • How is sodium polystyrene sulfonate given (Kayexalate)?
  • What happens if I miss a dose (Kayexalate)?
  • What happens if I overdose (Kayexalate)?
  • What should I avoid while receiving sodium polystyrene sulfonate (Kayexalate)?
  • What other drugs will affect sodium polystyrene sulfonate (Kayexalate)?
  • Where can I get more information?

What is sodium polystyrene sulfonate (Kayexalate)?

Sodium polystyrene sulfonate affects the exchange of sodium and potassium in the body.

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

Sodium polystyrene sulfonate may also be used for purposes other than those listed here.

What are the possible side effects of sodium polystyrene sulfonate (Kayexalate)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have any of these serious side effects:

  • pain or fluttering in your chest;
  • uneven heartbeats;
  • feeling irritable or confused;
  • increased thirst or urination;
  • severe muscle weakness;
  • inability to move your muscles;
  • black, bloody, or tarry stools;
  • pain in your lower stomach or rectum; or
  • swelling, rapid weight gain.

Less serious side effects may include:

  • diarrhea or constipation;
  • nausea or vomiting;
  • upset stomach; or
  • loss of appetite.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Read the Kayexalate (sodium polystyrene) Side Effects Center for a complete guide to possible side effects

Learn More »

What is the most important information I should know about sodium polystyrene sulfonate (Kayexalate)?

Sodium polystyrene sulfonate can be given as a liquid by mouth, through a stomach feeding tube, or as a rectal enema. This medication is usually given 1 to 4 times daily by a healthcare professional in a hospital setting.

If possible, before you receive this medication, tell your doctor if you have a bowel obstruction, low blood levels of potassium, heart disease or high blood pressure, congestive heart failure, edema (water weight gain), kidney disease, or if you are constipated or on a low-salt diet.

In an emergency situation, it may not be possible before you are treated with sodium polystyrene sulfonate to tell your caregivers about any health conditions you have or if you are pregnant or breast-feeding. However, make sure any doctor caring for your pregnancy or your baby knows that you have received this medication.

Tell your caregivers right away if you have any signs that your potassium level is getting too low, such as: pain or fluttering in your chest, uneven heartbeats, feeling irritable or confused, severe muscle weakness, breathing problems, or inability to move your muscles.

Tell your doctor if you also take digoxin (digitalis, Lanoxin), lithium (Eskalith, Lithobid), thyroxine, or a diuretic (water pill).

Do not use salt substitutes or take potassium or calcium supplements unless your doctor has told you to. Avoid using antacids or laxatives without your doctor's advice.

You will need to keep using this medication even if you feel fine. Hyperkalemia often has no symptoms that you will notice.

Patient Detailed How Take

What should I discuss with my health care provider before receiving sodium polystyrene sulfonate (Kayexalate)?

You should not receive this medication if you are allergic to sodium polystyrene sulfonate, or have certain conditions. Be sure your doctor knows if you have:

  • low potassium levels (hypokalemia); or
  • a bowel obstruction.

Before receiving sodium polystyrene sulfonate, tell your doctor if you are allergic to any drugs, or if you have:

  • heart disease or high blood pressure;
  • congestive heart failure;
  • edema (water weight gain);
  • kidney disease;
  • constipation; or
  • if you are on a low-salt diet.

If you have any of these conditions, you may not be able to use sodium polystyrene sulfonate, or you may need dosage adjustments or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible before treatment to tell your caregivers if you are pregnant or breast-feeding. However, make sure any doctor caring for your pregnancy or your baby knows that you have received this medication.

How is sodium polystyrene sulfonate given (Kayexalate)?

Sodium polystyrene sulfonate can be given as a liquid by mouth, through a stomach feeding tube, or as a rectal enema. This medication is usually given 1 to 4 times daily by a healthcare professional in a hospital setting.

The powder form of this medicine is mixed with water, or syrup (to make it taste better if given by mouth).

If you are given the rectal enema, the liquid will be given slowly while you are lying down. You may need to hold the enema in for up to several hours. The sodium polystyrene sulfonate enema is usually followed with a second cleansing enema.

You will need to keep using this medication even if you feel fine. Hyperkalemia often has no symptoms that you will notice.

To be sure this medication is helping your condition, your blood will need to be tested often. This will help your doctor determine how long to treat you with sodium polystyrene sulfonate.

Patient Detailed Avoid Taking

What happens if I miss a dose (Kayexalate)?

Since this medication is usually given in a hospital, it is not likely that you will miss a dose.

What happens if I overdose (Kayexalate)?

Tell your caregivers at once if you think you have received too much of this medicine.

Overdose symptoms may include confusion, irritability, trouble thinking or concentrating, muscle weakness, or trouble breathing.

What should I avoid while receiving sodium polystyrene sulfonate (Kayexalate)?

Do not use salt substitutes or take potassium or calcium supplements unless your doctor has told you to.

Avoid using antacids or laxatives without your doctor's advice. Antacids or laxatives can make sodium polystyrene sulfonate less effective or cause serious side effects.

Avoid eating or drinking anything that contains sorbitol (a fruit sugar often used as a sweetener in chewing gum, diet drinks, baked goods, or frozen desserts).

What other drugs will affect sodium polystyrene sulfonate (Kayexalate)?

Before receiving this medicine, tell your doctor if you also use:

  • digoxin (digitalis, Lanoxin);
  • lithium (Eskalith, Lithobid);
  • thyroxine; or
  • a diuretic (water pill) such as triamterene (Dyrenium, Maxzide, Dyazide), spironolactone (Aldactone), or amiloride (Midamor).

This list is not complete and there may be other drugs that can interact with sodium polystyrene sulfonate. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about sodium polystyrene.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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