Drug Detail:Kalexate (Sodium polystyrene sulfonate [ soe-dee-um-pol-ee-steer-een-sul-foe-nate ])
Drug Class: Cation exchange resins
Usual Adult Dose for Hyperkalemia
Oral:
15 g orally once a day
Maximum dose: 15 g orally 4 times a day
Comments:
- A 15 g dose is equivalent to approximately 4 level teaspoons.
- This drug should be given as a suspension in water or syrup (not fruit juice).
Rectal:
30 g rectally every 6 hours
Maximum dose: 50 g rectally every 6 hours
Comments:
- This drug should be administered via warm emulsion in 100 mL of aqueous vehicle.
- This solution should be gently agitated during administration.
- The enema should be retained as long as possible and should be followed by a cleansing enema.
Use: Treatment of hyperkalemia
Usual Pediatric Dose for Hyperkalemia
Calculate dose based on 1 mEq potassium per 1 g resin
Comment:
- A 15 g dose is equivalent to approximately 4 level teaspoons.
- This drug should be given as a suspension in water or syrup (not fruit juice).
- The oral route should be avoided in neonates.
Use: Treatment of hyperkalemia
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dose Adjustments
Treatment intensity and duration should be based upon the severity and resistance of hyperkalemia.
Precautions
Safety has not been established in patients younger than 1 month (oral); effectiveness has not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Shake well before using suspension and gently agitate during administration if given rectally.
- May be given with water or syrup, but avoid fruit juices.
- This drug may be administered through a plastic tube introduced into the stomach.
- Enema should be kept in the rectum for as long as possible and rectum should be washed with a cleansing enema after use.
Storage requirements:
- Once prepared, use within 24 hours.
- Store in an airtight container protected from light and heat.
- If repackaging powder formulation, refrigerate and use within 14 days of opening.
Reconstitution/preparation techniques:
- Oral formulations should be suspended in 3 to 4 mL of liquid per 1 g resin.
- Enemas should be suspended in 100 mL body-temperature vehicle prior to administration.
General:
- This drug was shown to have lower results as an enema compared to oral suspension.
- If using rectally, may require up to 2 quarts of cleansing solution.
- Each 15 g dose of this drug contains 60 mEq sodium.
- The efficiency of ion exchange is predicted to be around 33%, but is highly variable.
Monitoring:
- Measure potassium levels at least every 24 hours
- Obtain calcium, magnesium, sodium levels periodically
Patient advice:
- Tell patients to contact healthcare provider if constipation, diarrhea, bloody stools, confusion, weakness, or delayed though processes occur.
- Caution patients to avoid taking antacids or laxatives with this drug (e.g., sorbitol, magnesium hydroxide)
- Patients should be advised to speak to healthcare provider if pregnant, intend to become pregnant, or are breastfeeding.