Hyperkalaemia associated with anuria or severe oliguria and in dialysis patients
Calcium Polystyrene Sulfonate acts by a cumulative process throughout the gastrointestinal tract, removing potassium ions which are excreted in the feces. Calcium Polystyrene Sulfonate passes through the colon and comes into contact with fluids containing increased amounts of potassium. The result is that potassium is taken up in increasing amounts in exchange for calcium ions. The length of time Calcium Polystyrene Sulfonate remains in the body is a decisive factor in its effectiveness. For this reason oral administration is more effective than rectal administration.
For adults the usual dose is 15 g, 3 or 4 times a day. The resin is given by mouth as a suspension in a little water, or for greater palatability, the resin may be made into a paste with some sweetened vehicle, but not orange juice or other fruit juices that are known to contain potassium. The amount of fluid usually ranges from 3 to 4 mL per gram of resin. If there is difficulty with swallowing, it may be given through a gastric tube, 2 to 3 mm in diameter.
Concomitant use of Calcium Polystyrene Sulfonate is not recommended with Sorbitol, Digitalis drugs, Cation donating agents, Non-absorbable cation-donating antacids and laxatives, Aluminum hydroxide, Lithium, Thyroxine.
Hyperparathyroidism . Metastatic carcinoma . multiple myeloma . obstructive bowel disease . Sarcoidosis
Anorexia . constipation (discontinue treatment—avoid magnesium-containing laxatives) . diarrhoea . Gastric irritation . gastro-intestinal obstruction . Hypercalcaemia (including in dialysed patients and occasionally in those with renal impairment) . hypomagnesaemia . intestinal necrosis (reported with concomitant sorbitol) . ischaemic colitis . nausea . necrosis . ulceration . vomiting
Manufacturers advise use only if potential benefit outweighs risk—no information available.
Clinical signs and symptoms of hypokalemia including irritability, confusion, delayed thought processes, muscle weakness, hyporeflexia and eventually frank paralysis. Apnea may be a serious consequence of this progression. Electrocardiographic changes may be consistent with hypokalemia or hypercalcemia; cardiac arrhythmia may occur.
Store at below 30°C in a dry place protected from light. Keep out of reach of children.
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