Patiromer is used in adults to treat hyperkalemia (high levels of potassium in your blood).

Patiromer may also be used in adults for purposes not listed in this medication guide.

Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

Avoid taking other medicines by mouth within 3 hours before or 3 hours after you take patiromer.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Patiromer is usually taken once daily with or without food.

Patiromer oral powder must be mixed with water before you take it. Stir this mixture well and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away, repeat as needed.

Do not mix patiromer oral powder with hot liquid or hot food. Do not take the dry powder without mixing it with water.

You can mix patiromer oral powder with other beverages or soft food like apple sauce, yogurt, or pudding instead of water.

While taking patiromer, your blood will need to be tested often and your dose may be changed based on the results.

You may need to follow a special diet. Follow all instructions of your doctor or dietitian. Learn about the foods you should eat or avoid.

Store unmixed oral powder in the refrigerator. Do not open a medicine packet until you are ready to mix a dose.

If stored at room temperature away from moisture and heat, you should use this medication within 3 months.

Usual Adult Dose for Hyperkalemia:

Initial dose: 8.4 g orally once a day
-Monitor serum potassium level and adjust dose in 8.4 mg increments at 1-week intervals based on serum potassium level and desired target range
Maintenance dose: 8.4 to 25.2 mg/day
Maximum dose 25.2 g/day

Comments:
-This drug should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.
-This drug should be administered at least 3 hours before or 3 hours after other oral medications.

Use: For the treatment of hyperkalemia.

You should not use patiromer if you are allergic to it, or if you have:

• bowel obstruction;

• bowel problems caused by recent surgery;

• trouble swallowing;

• severe constipation; or

• low levels of magnesium in your blood.

Tell your doctor if you are pregnant or breastfeeding.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause low potassium (leg cramps, constipation, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling).

Keep this medication in the container it came in, closed, and out of reach of children. Store it in either the refrigerator or at room temperature away from excess heat and moisture (not in the bathroom). If patiromer powder is stored at room temperature, dispose of it after 90 days.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Your doctor may tell you to limit the amount of potassium in your diet. Follow these instructions carefully. Talk to your doctor about the amount of potassium-rich foods such as artichokes, avocados, bananas, cantaloupe, grapefruit juice, milk, orange juice, potatoes, prunes, raisins, squash, tomato paste, and tomato juice you may have in your diet.

Avoid taking other medicines within 3 hours before or 3 hours after you take patiromer. Patiromer can make it harder for your body to absorb other medicines you take by mouth.

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

Patiromer may cause serious side effects. Call your doctor at once if you have:

• low magnesium--dizziness, irregular heartbeats, feeling jittery, muscle cramps, muscle spasms, cough or choking feeling.

Common side effects of patiromer may include:

• constipation, diarrhea;

• stomach discomfort, nausea; or

• gas.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Patiromer can make it harder for your body to absorb other medicines you take by mouth. If you take any of the following medications, take them 3 hours before or after you take patiromer:

• telmisartan;

• bisoprolol, carvedilol, nebivolol;

• ciprofloxacin;

• levothyroxine;

• metformin;

• mycophenolate;

• quinidine; or

• thiamine.

This list is not complete and many other drugs may affect patiromer. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to patiromer.