potassium para-aminobenzoate: clinical use

Prescribing considerations

• Assess renal and hepatic function, baseline potassium, hyperkalaemia risk factors and interacting medicines before treatment.
• Interrupt treatment during fasting, anorexia, nausea or other periods of substantially reduced food intake because hypoglycaemia may occur.
• Safety and efficacy have not been established in children or adolescents.
• Stop permanently following DRESS or significant hypersensitivity; do not rechallenge.

Contraindications and cautions

• Hypersensitivity to potassium para-aminobenzoate, listed excipients or related para-substituted aromatic amines such as benzocaine or procaine
• Renal insufficiency with GFR below 45 mL/min
• Hyperkalaemia
• Concurrent sulfonamide treatment
• Severe liver damage

Monitoring

• Perform liver-function tests regularly; the SmPC specifies at least every four weeks.
• Check serum potassium before treatment and periodically thereafter, with closer monitoring where hyperkalaemia risk is increased.
• Measure potassium promptly if compatible neuromuscular, cardiac or respiratory symptoms develop.
• Stop immediately for elevated liver tests, suspected liver injury, severe rash or hypersensitivity symptoms.

Clinical pharmacology

The mechanism is uncertain. The oral drug is well absorbed; aminobenzoate conjugates and potassium are eliminated through the kidneys.

Formulation and product differences

• The selected product is a sachet containing white or off-white powder for oral solution.
• The powder is dissolved in cold water or fruit juice and taken with food.
• The selected presentation contains no excipients but provides a clinically relevant potassium load.

Sachet

Route: Oral

Strengths: 3 g