Generic
Sodium Polystyrene Sulfonate
2 brands available in the market
At a glance
Sodium Polystyrene Sulfonate is a cation exchange resin used for the treatment of hyperkalemia (high blood potassium). It exchanges sodium ions for potassium ions in the intestine, eliminating potassium through feces.
Description
Sodium Polystyrene Sulfonate is a cation exchange resin. It releases sodium ions in the stomach in exchange for hydrogen ions. When the resin reaches the large intestine, hydrogen ions are exchanged for free potassium ions; the resin is then eliminated in feces. This reduces potassium available for absorption into blood and increases potassium excretion via feces.
Indications
- Hyperkalemia
Therapeutic class
Calcium Regulator
Pharmacological class
Cation Exchange Resin
Pharmacology
Sodium Polystyrene Sulfonate releases sodium ions in the stomach in exchange for hydrogen ions. In the large intestine, hydrogen ions are exchanged for free potassium ions, and the resin is eliminated in feces. This reduces potassium absorption and increases fecal potassium excretion, lowering blood potassium levels.
Mechanism of action
Exchanges sodium ions for potassium ions to eliminate potassium through the intestine.
Dosage
Adult Dose (Oral):
- Average daily dose: 15-60 g (1 sachet 1-4 times daily)
- As suspension in water or syrup: 15 g up to 4 times daily
- Not to be taken with high-potassium fruit juices
Adult (Rectal/Enema):
- 30-50 g resin once or twice daily (6-hour intervals)
- As warm emulsion in 150-200 mL aqueous vehicle
Children and Neonates (Oral/Rectal):
- Acute hyperkalemia: 1 g/kg/day in divided doses
- Maintenance: 0.5 g/kg/day
Administration
- Oral: Administer with patient in upright position; may give via NG tube
- Shake suspension well; do not store beyond 24 hours
- Rectal: Administer cleansing enema beforehand; give as warm emulsion (body temperature)
- Retain in colon for at least 30-60 minutes (several hours if possible)
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for the next dose, skip it; do not double the dose.
Side effects
Common Side Effects (1-10%):
- GI disturbance, constipation
- Hypokalemia, hypocalcemia, hypomagnesemia
- Sodium retention, nausea, vomiting
Rare but Serious:
- GI ulceration/necrosis (may lead to perforation)
- Fecal impaction (especially in children)
- Bronchitis/bronchopneumonia (polystyrene particle inhalation)
Precautions & warnings
- Caution in renal failure and sodium-restricted conditions (heart failure, severe hypertension)
- Caution with rectal administration in neonates and children
- Monitor for electrolyte disturbances and hypokalemia symptoms
- Discontinue if clinically significant constipation develops
- Irrigate colon after rectal administration to ensure resin removal
Contraindications
- Hypersensitivity to polystyrene sulfonate resins
- Oral administration in neonates
- Neonates with reduced gut motility
- Obstructive bowel disease
- Hypokalemia
Drug interactions
- Reduces absorption of thyroxine and lithium salts
- Enhances adverse effects of cardiac glycosides
- Potassium-lowering effect may be reduced with other cation-containing antacids
Food interactions
Caution is advised when consuming alcohol with Sodium Polystyrene Sulfonate; consult your doctor.
Use in pregnancy
Use in Pregnancy: No adequate studies; use only if clearly needed; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unknown if excreted in human milk; caution required; consult your doctor.
Pediatric use
Efficacy not established in pediatric patients; do not use oral route in neonates; caution in premature or low birth weight infants
Geriatric use
Elderly: Large doses may cause fecal impaction; caution required
Renal / hepatic impairment
Renal Impairment: Caution required; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Caution required; consult your doctor.
Overdose effects
Overdose may cause electrolyte disturbances (hypokalemia, hypocalcemia, hypomagnesemia); symptoms: irritability, confusion, muscle weakness, hyporeflexia, paralysis, apnea; provide symptomatic treatment.
Storage conditions
Store below 30°C; freshly prepare suspension and do not store beyond 24 hours; keep out of reach of children.
Chemical structure
Sodium Polystyrene Sulfonate