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cation exchange resins

V04CG01

Forms & Strengths

Powder for oral suspension 15% w/v
Powder for oral suspension 30% w/v
Granules for oral suspension 15% w/v
Granules for oral suspension 30% w/v

Adult Dosing

15-30 g orally once daily, titrate to serum K+ target
Severe hyperkalemia: 30 g every 2-4 h until K+ normal, max 100 g/24 h
Maximum usual dose 75 g/day divided doses
Adjust dose in renal impairment; avoid overdosing

Pediatric Dosing

1-2 g/kg/day divided every 6-8 h (max 30 g/day)
Neonates: 0.5-1 g/kg/day, monitor for GI tolerance
Use lowest effective dose; avoid >30 g/day in children
Dose reduction if concomitant K+ sparing agents

Indications

Acute or chronic hyperkalemia
Potassium overload in renal failure
Adjunct in digitalis toxicity with hyperkalemia
Pre‑dialysis potassium control

Mechanism of Action

Non‑absorbed polymer exchanges Na+ (or Ca2+) for K+ in colon
Increases fecal excretion of potassium
May bind other cations (e.g., calcium, magnesium) in GI tract

Contraindications

Intestinal obstruction or ileus
Severe constipation or risk of bowel perforation
Known hypersensitivity to polystyrene sulfonate
Use with sorbitol in patients at risk of colonic necrosis

Adverse Reactions

Nausea, vomiting, abdominal cramps
Constipation or diarrhea
Risk of colonic necrosis, especially with sorbitol
Electrolyte shifts: hypocalcemia, hypernatremia
Rare GI hemorrhage or perforation

Drug Interactions

Sorbitol increases risk of bowel necrosis; avoid combination
ACE inhibitors, ARBs, potassium‑sparing diuretics blunt potassium‑lowering effect
Concurrent oral K+ binders may cause additive hypokalemia
Antacids or other cationic drugs may have reduced absorption
Magnesium or calcium supplements may be bound, reducing their bioavailability

Curated Content: Needs Vetting Before Put to Clinical Use