Kalexate Side Effects

Generic name: sodium polystyrene sulfonate

Note: This document contains side effect information about sodium polystyrene sulfonate. Some of the dosage forms listed on this page may not apply to the brand name Kalexate.

Some side effects of Kalexate may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to sodium polystyrene sulfonate: oral and rectal powder, oral suspension, rectal enema

Get emergency medical help if you have any of these signs of an allergic reaction while taking sodium polystyrene sulfonate (the active ingredient contained in Kalexate) hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have any of these serious side effects:

• pain or fluttering in your chest;

• uneven heartbeats;

• feeling irritable or confused;

• increased thirst or urination;

• severe muscle weakness;

• inability to move your muscles;

• black, bloody, or tarry stools;

• pain in your lower stomach or rectum; or

• swelling, rapid weight gain.

Less serious side effects of sodium polystyrene sulfonate may include:

• diarrhea or constipation;

• nausea or vomiting;

• upset stomach; or

• loss of appetite.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

For Healthcare Professionals

Applies to sodium polystyrene sulfonate: oral suspension, oral and rectal powder, rectal enema

Gastrointestinal

Gastrointestinal side effects have included anorexia, nausea, vomiting, constipation, and fecal impaction. Occasionally, diarrhea may develop. Fatal intestinal necrosis has been associated rarely with rectal administration of sodium polystyrene sulfonate (the active ingredient contained in Kalexate) in sorbitol.

Large oral doses may lead to fecal impaction. Sorbitol given orally with the resin may help to decrease the frequency of constipation. Magnesium-containing laxatives should not be used.

Fatal intestinal necrosis has occurred primarily in patients with severe renal dysfunction receiving rectal administration. Intestinal necrosis occurred rapidly (usually within 1 to 2 days) and presented as abdominal pain and distention, ileus, fever, hypotension, and/or metabolic acidosis. The manufacturer recommends a sodium-free cleansing enema after the administration of rectal sorbitol to help prevent this complication. Alternatively, an aqueous vehicle (i.e., 1% methylcellulose or 10% dextrose) may be used instead of sorbitol. Sorbitol is not necessary for effective rectal use of sodium polystyrene sulfonate.

Metabolic

Metabolic side effects have included hypokalemia. Patients should be monitored closely to help prevent this effect. ECG, muscle weakness and mental status changes should be evaluated. Sodium retention, hypocalcemia, and hypomagnesemia may also occur. Metabolic alkalosis has been reported with the combined use of sodium polystyrene sulfonate (the active ingredient contained in Kalexate) and aluminum carbonate or magnesium hydroxide in renal failure patients.

Nervous system

Nervous system side effects have been reported rarely. These have included a case report of a grand mal seizure in a patient with chronic hypocalcemia of renal failure who was administered sodium polystyrene sulfonate (the active ingredient contained in Kalexate) and magnesium hydroxide. The magnesium was being used as a laxative.

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