Kayexalate Side Effects

Generic Name: sodium polystyrene sulfonate

Please note - some side effects for Kayexalate may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Kayexalate - for the Consumer

Kayexalate Powder

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Kayexalate Powder:

Appetite loss; constipation; nausea; upset stomach; vomiting.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); change in emotions, mood, or behavior; change in heartbeat; muscle cramps; swelling of the feet or hands; unexplained muscle weakness.

Kayexalate Side Effects - for the Professional

Kayexalate

Kayexalate may cause some degree of gastric irritation. Anorexia, nausea, vomiting, and constipation may occur especially if high doses are given. Also, hypokalemia, hypocalcemia, and significant sodium retention, and their related clinical manifestations, may occur. Occasionally diarrhea develops. Large doses in elderly individuals may cause fecal impaction. Rare instances of colonic necrosis have been reported. Intestinal obstruction due to concretions of aluminum hydroxide, when used in combination with Kayexalate, has been reported.

The following events have been reported from worldwide post marketing experience:

• Fecal impaction following rectal administration, particularly in children;
• Gastrointestinal concretions (bezoars) following oral administration;
• Gastrointestinal tract ulceration or necrosis which could lead to intestinal perforation; and,
• Rare cases of acute bronchitis and/or broncho-pneumonia associated with inhalation of particles of polystyrene sulfonate.

Side Effects by Body System

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 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 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 and magnesium hydroxide. The magnesium was being used as a laxative.

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