calcium polystyrene sulfonate

Action and Spectrum

Actions and Spectrum: 

Action: 

Ion Exchange: calcium polystyrene sulfonate works by exchanging calcium ions for potassium ions in the gastrointestinal tract. It binds to potassium in the gut, preventing its absorption and promoting its elimination through the feces. 

Potassium Reduction: By removing excess potassium from the body, calcium polystyrene sulfonate helps to lower the levels of potassium in the blood. This is important because high levels of potassium can be dangerous and lead to serious cardiac complications. 

Spectrum: calcium polystyrene sulfonate is primarily used for the treatment of hyperkalemia, which is characterized by elevated potassium levels in the blood. Hyperkalemia can occur in various medical conditions, including kidney disease, certain medications, hormonal imbalances, and severe tissue injury. By reducing potassium levels, calcium polystyrene sulfonate helps restore the electrolyte balance in the body and prevent potential complications associated with hyperkalemia. 

Drug Interaction

Adverse Reaction

Frequency not defined  

Constipation 

Diarrhoea 

Intestinal obstruction 

Intestinal necrosis 

Gastro-intestinal ulceration 

Gastro-intestinal bezoars (concretions) 

Gastro-intestinal perforation 

Hypercalcaemia 

Hypokalaemia 

Hypomagnesaemia 

Intestinal ischaemia 

Bronchopneumonia 

Decreased appetite 

Anorexia 

Gastric irritation 

Bronchitis 

Faecal impaction 

Black Box Warning

Black Box Warning:  

None

Contraindication / Caution

Contraindication/Caution:  

Hypersensitivity: Individuals with a known hypersensitivity or allergy to calcium polystyrene sulfonate or any of its components should avoid its use. 

Intestinal Obstruction: calcium polystyrene sulfonate should not be used in patients with a known or suspected gastrointestinal obstruction. This medication works by exchanging sodium ions for potassium ions in the intestine, and if there is an obstruction, it may lead to further complications. 

Bowel Perforation: If there is a risk or suspicion of bowel perforation, the use of calcium polystyrene sulfonate is contraindicated. This medication may worsen bowel perforation by binding to potassium and forming hard masses in the gastrointestinal tract. 

Slow Bowel Transit: In patients with slow bowel transit or constipation, the use of calcium polystyrene sulfonate should be avoided. This medication requires proper bowel movement for its effective action, and if there is a delay in bowel transit, it may lead to the formation of concretions or intestinal blockage. 

Sorbitol Intolerance: Some formulations of calcium polystyrene sulfonate contain sorbitol, which may cause gastrointestinal side effects such as diarrhea, cramping, and bloating. Patients with a known intolerance to sorbitol should avoid formulations containing it. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: AU TGA pregnancy category: B2 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:  

calcium polystyrene sulfonate is a medication used to treat hyperkalemia, a condition characterized by elevated levels of potassium in the blood. 

Pharmacodynamics:  

Ion Exchange: calcium polystyrene sulfonate is a cation-exchange resin that contains sulfonic acid groups on a polystyrene backbone. It exchanges its sodium ions with the potassium ions in the gastrointestinal tract, forming a non-absorbable complex. 

Binding and Elimination: The bound potassium is eliminated from the body through the feces, thereby reducing the concentration of potassium in the blood. 

Pharmacokinetics: 

Absorption 

When administered orally or rectally, calcium polystyrene sulfonate is not significantly absorbed from the gastrointestinal tract. It works locally in the intestines to remove excess potassium. 

Distribution 

calcium polystyrene sulfonate does not distribute widely throughout the body. It remains primarily in the gastrointestinal tract, where it binds to potassium ions. 

Metabolism 

calcium polystyrene sulfonate itself is not metabolized in the body. It acts as an ion-exchange resin, exchanging calcium ions for potassium ions in the intestines. The bound potassium is then eliminated in the stool. 

Excretion and Elimination  

The main route of excretion for calcium polystyrene sulfonate is through the feces. It is not significantly eliminated by the kidneys or urine. 

Adminstartion

Administration:  

Route of administration: calcium polystyrene sulfonate is most administered orally, but it can also be given rectally in some cases. Oral administration involves drinking the prepared suspension or taking it through a feeding tube, while rectal administration involves the use of an enema. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: calcium polystyrene sulfonate 

Why do we use calcium polystyrene sulfonate?  

Hyperkalemia treatment: calcium polystyrene sulfonate is commonly used to lower potassium levels in the blood. It works by exchanging calcium ions for potassium ions in the gastrointestinal tract, promoting the excretion of excess potassium through the feces. 

Emergency treatment: In severe cases of hyperkalemia, where immediate reduction of potassium levels is required, calcium polystyrene sulfonate can be administered orally or rectally as an emergency treatment to rapidly lower potassium levels. 

Adjunct to other therapies: calcium polystyrene sulfonate is often used as an adjunct to other treatments for hyperkalemia, such as diuretics or dialysis. It can help maintain potassium balance during the course of treatment. 

Prevention in high-risk patients: Patients with chronic kidney disease, heart failure, or those taking certain medications like angiotensin-converting enzyme (ACE) inhibitors or potassium-sparing diuretics may be at higher risk for developing hyperkalemia. In such cases, calcium polystyrene sulfonate may be prescribed to help prevent the occurrence of high potassium levels.