Patiromer

Indications

Patiromer is used for: Indicated for hyperkalemia

Adult Dose

Oral Hyperkalemia Indicated for hyperkalemia Initial: 8.4 g PO qDay Monitor serum potassium and adjust dose based on the serum potassium level and the desired target range May increase or decrease dose as necessary; not to exceed 25.2 g qDay May titrate upward at 1-week or longer intervals, in increments of 8.4 g

Child Dose

Renal Dose

Renal impairment No dosing adjustments are needed Of the 666 patients treated with patiromer in clinical studies, 93% had chronic kidney disease

Administration

Oral suspension preparation Prepare each dose immediately prior to administration following the steps below 1: Measure 1/3 cup of water and pour half of water into a glass 2: Empty the entire contents of the packet(s) into the glass or cup and stir 3: Add the remaining half of water and stir the mixture thoroughly 4: The powder will not dissolve and the mixture will look cloudy; add more water to the mixture as needed for desired consistency 5: Drink the mixture immediately; if some powder remains in the glass after drinking, add more water, stir and drink immediately; repeat as needed to ensure the entire dose is administered Oral administration Prepare oral suspension and drink immediately after preparation Do not heat patiromer (eg, microwave) or add to heated foods or liquids Do not take patiromer in its dry form

Contra Indications

Hypersensitivity to patiromer or its components

Precautions

Patiromer binds many orally administered medications, which could decrease their GI absorption and lead to reduced efficacy (see Administration) Avoid use with severe constipation, bowel obstruction, or impaction, including abnormal postoperative bowel motility disorders; patiromer may be ineffective with these conditions present and may worsen GI conditions Patients with a history of bowel obstruction or major GI surgery, severe GI disorders, or swallowing disorders were not included in clinical trials Binds to magnesium in the colon, which can lead to hypomagnesemia; monitor serum magnesium; consider magnesium supplementation if low serum magnesium levels observed

Pregnancy-Lactation

Pregnancy Not absorbed systemically following oral administration, and maternal use is not expected to result in fetal risk Lactation Not absorbed systemically by the mother, so breastfeeding is not expected to result in risk to the infant

Interactions

Adverse Effects

Side effects of Patiromer : 1-10% Constipation (7.2%) Hypomagnesemia (5.3%) Diarrhea (4.8%) Hypokalemia, <3.5 mEq/L (4.7%) Nausea (2.3%) Abdominal discomfort (2%) Flatulence (2%)

Mechanism of Action

Binds and removes potassium from the GI tract, particularly the colon Patiromer is a nonabsorbed, cation exchange polymer that contains a calcium-sorbitol counterion