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Sodium polystyrene sulfonate

KAYEXALATE

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Sodium polystyrene sulfonate ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Sodium polystyrene sulfonate ballicule

Sodium polystyrene sulfonate KAYEXALATE mascot mnemonic cartoon — Visual mnemonic: Sodium polystyrene sulfonate mascot
**“Styro Polly, K+ extractor”**
swaps Na+ for K+

What it isSodium polystyrene sulfonate, a cation exchange resin; hyperkalemia.

Why this oneUnlike newer potassium binders, its effect is poorly predictable and supported by weak evidence.

What limits itIt acts too slowly for emergencies, and sorbitol co-formulation has caused fatal colonic necrosis.

Sodium polystyrene sulfonate molecular structure (skeletal formula) — Molecular structure: Sodium polystyrene sulfonate

FDA label

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FDA dosing	Population	Start	Target	Max
Hyperkalemia (oral)	Adults	15 g (60 mL) QD	15 g (60 mL) 1–4×/day	60 g/day
Hyperkalemia (rectal enema)	Adults	30–50 g q6h	30–50 g q6h	—
Hyperkalemia	Children/infants	Dose based on 1 mEq potassium per gram of resin	—	—

Renal Undefined

Hepatic Undefined

Instructions

Administer at least 3 hours before or after other oral medications (6 hours in gastroparesis)
Administer with patient in an upright position
May be given via gastric tube or as a retention enema (followed by cleansing enema)
Do not heat the suspension

Available strengths

powder 15, 453.6, 454 g/bot
susp 15 g/60 mL

Contraindications

Hypokalemia
Obstructive bowel disease
Oral or rectal administration in neonates

Cautions

Intestinal necrosis, GI ulceration/perforation, ischemic colitis
Electrolyte disturbances (hypokalemia, hypocalcemia, hypomagnesemia)
Significant sodium retention / fluid overload
Fecal impaction (esp. rectal use in children, elderly)
GI concretions/bezoars

Adverse reactions

Gastric irritation
Anorexia
Nausea
Vomiting
Constipation
Diarrhea
Hypokalemia
Hypocalcemia
Hypomagnesemia
Sodium retention

Pregnancy Animal reproduction studies not conducted; use only if clearly needed

Lactation Undefined

Cost

Sodium polystyrene sulfonate (KAYEXALATE)

Strength		#/mo	CostPlus
15 g/bot	powder	per unit	not offered
453.6 g/bot	powder	per unit	not offered
454 g/bot	powder	per unit	not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Sodium polystyrene sulfonate is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry1982

NO BOXED WARNINGS

Principal riskColonic necrosis with sorbitol; slow and poorly effective

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.

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