calcium polystyrene sulfonate: clinical use

Prescribing considerations

• Base continued use on regular clinical review and serum electrolyte measurements.
• Avoid use in compromised gastrointestinal motility, including immediately after surgery or when drug-induced.
• Stop and reassess if clinically significant constipation develops.
• Use careful positioning during oral administration to minimise aspiration.
• Neonates must not receive the product orally; rectal use in children and neonates requires particular care to avoid impaction or bowel injury.

Contraindications and cautions

• Plasma potassium below 5 mmol/L
• Conditions associated with hypercalcaemia
• Obstructive bowel disease
• Hypersensitivity to polystyrene sulfonate resins, the active substance or an excipient
• Oral administration to neonates
• Neonates with reduced gut motility

Monitoring

• Serum potassium, calcium, magnesium and other relevant electrolytes
• Bowel function and symptoms of obstruction, ischaemia or bleeding
• Clinical features of aspiration
• Digitalis toxicity and cardiac rhythm where clinically indicated

Clinical pharmacology

A non-absorbed, non-selective cation-exchange resin that exchanges calcium for gastrointestinal potassium and increases faecal potassium elimination.

Formulation and product differences

• The selected product is a golden or brown powder for oral or rectal suspension.
• It contains vanilla flavour with sodium benzoate.
• Multi-dose containers and single-use sachets are described; not all pack sizes may be marketed.
• Prepare the suspension immediately before use.

Enema

Route: Rectal

Strengths: 99.75%, 99.934% w/w