Patiromer

Medically reviewed by Drugs.com. Last updated on Jul 14, 2020.

Pharmacology
Uses
Contraindications
Dosage
Storage
Interactions
Warnings
Pregnancy
Patient education

Pronunciation

(pa TIR oh mer)

Index Terms

Patiromer Sorbitex Calcium

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Packet, Oral:

Veltassa: 8.4 g (1 ea, 4 ea, 30 ea); 16.8 g (1 ea, 30 ea); 25.2 g (1 ea, 30 ea)

Brand Names: U.S.

Veltassa

Pharmacologic Category

Antidote
Potassium Binder

Pharmacology

Patiromer, a non-absorbed, cation exchange polymer that contains a calcium-sorbitol counterion, increases fecal potassium excretion through binding of potassium in the lumen of the gastrointestinal tract, resulting in a reduction of serum potassium levels.

Absorption

Not systemically absorbed

Excretion

Feces (unchanged)

Onset of Action

7 hours (Bushinsky 2015)

Duration of Action

24 hours (Bushinsky 2015)

Use: Labeled Indications

Hyperkalemia: Treatment of hyperkalemia

Limitations of use: Patiromer should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

Contraindications

Hypersensitivity to patiromer or any component of the formulation.

Canadian labeling: Additional contraindications (not in US labeling): Hereditary condition of fructose intolerance (eg, sorbitol).

Dosing: Adult

Hyperkalemia: Oral: Initial: 8.4 g once daily; adjust dose at ≥1-week intervals in increments of 8.4 g (maximum dose: 25.2 g/day)

Dosing: Geriatric

Refer to adult dosing.

Reconstitution

Immediately prior to administration, measure ¹/₃ cup of water and pour half into an empty glass; empty entire contents of the packet(s) into the glass and stir. Add the remaining water to the mixture; stir thoroughly (powder will not dissolve and the mixture will look cloudy). Add more water as needed for desired consistency.

Administration

Administer without regard to food. Do not administer patiromer in its dry form. Following reconstitution, drink mixture immediately. If powder remains in the glass after drinking, add more water, stir, and drink immediately; repeat as needed to ensure the entire dose is administered. Do not heat patiromer (eg, microwave) or add to heated foods or liquids. Administer other oral medications at least 3 hours before or 3 hours after patiromer.

Storage

Store at 2°C to 8°C (36°F to 46°F). If stored at room temperature (25°C ± 2°C [77°F ± 4°F]), use within 3 months of being taken out of the refrigerator. Avoid exposure to excessive heat above 40°C (104°F).

Drug Interactions

Ciprofloxacin (Systemic): Patiromer may decrease the serum concentration of Ciprofloxacin (Systemic). Management: Administer oral ciprofloxacin at least 3 hours before or 3 hours after patiromer. Consider therapy modification

Levothyroxine: Patiromer may decrease the serum concentration of Levothyroxine. Management: Administer oral levothyroxine at least 3 hours before or 3 hours after patiromer. Consider therapy modification

MetFORMIN: Patiromer may decrease the serum concentration of MetFORMIN. Management: Administer metformin at least 3 hours before or 3 hours after patiromer. Consider therapy modification

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Endocrine & metabolic: Hypomagnesemia (5% to 9%), hypokalemia (5%)

Gastrointestinal: Constipation (7%; transient), diarrhea (5%), abdominal distress (2%), flatulence (2%), nausea (2%)

<1%, postmarketing, and/or case reports: Hypersensitivity reaction (including lip edema)

Warnings/Precautions

Concerns related to adverse effects:

• GI effects: Avoid use in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders; patiromer may be ineffective and may worsen GI conditions.

• Hypomagnesemia: Patiromer binds to magnesium in the colon, which can lead to hypomagnesemia. Monitor serum magnesium and consider magnesium supplementation if hypomagnesemia develops.

Special populations:

• Elderly: May experience more gastrointestinal adverse reactions.

Monitoring Parameters

Serum potassium and magnesium.

Pregnancy Considerations

Patiromer is not absorbed systemically following oral administration. Use during pregnancy is not expected to result in significant exposure to the fetus.

Patient Education

What is this drug used for?

• It is used to treat high potassium levels.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Constipation

• Diarrhea

• Nausea

• Abdominal pain

• Passing gas

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Low magnesium like mood changes, muscle pain or weakness, muscle cramps or spasms, seizures, tremors, lack of appetite, severe nausea or vomiting, an abnormal heartbeat

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine’s uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.