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Sodium Polystyrene Sulfonate

(pol ee stye' reen)

Brand Name(s): Kalexate®, Kayexalate®, Kionex®, SPS®; also available generically

WHY is this medicine prescribed?

Sodium polystyrene sulfonate is used to treat hyperkalemia (increased amounts of potassium in the body). Sodium polystyrene sulfonate is in a class of medications called potassium-removing agents. It works by removing excess potassium from the body.

HOW should this medicine be used?

Sodium polystyrene sulfonate comes as a suspension and as an oral powder for suspension to take by mouth. The suspension may also be given rectally as an enema. Sodium polystyrene sulfonate is usually taken or used one to four times a day. Take or use sodium polystyrene sulfonate at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take or use sodium polystyrene sulfonate exactly as directed. Do not take or use more or less of it or take or use it more often than prescribed by your doctor.

Shake the suspension well before each use to mix the medication evenly.

If you are taking sodium polystyrene sulfonate powder by mouth, mix the powder with 20 to 100 mL (about 1 to 3 ounces) of water or syrup as directed by your doctor. Measure carefully, using level teaspoonfuls of the powder. Use the mixture shortly after preparation; do not store beyond 24 hours.

Do not heat sodium polystyrene sulfonate suspension or add it to heated foods or liquids.

If you are receiving sodium polystyrene sulfonate as an enema, you will probably be given a cleansing enema before and after you receive this medication. Hold the sodium polystyrene sulfonate enema contents as long as possible, up to several hours.

Do not use sorbitol along with sodium polystyrene sulfonate products. Serious problems have been reported when sorbitol was used with sodium polystyrene sulfonate.

What SPECIAL PRECAUTIONS should I follow?

Before taking or receiving sodium polystyrene sulfonate,

  • tell your doctor and pharmacist if you are allergic to sodium polystyrene sulfonate, other polystyrene sulfonate resins, any other medications, or any of the ingredients in sodium polystyrene sulfonate products. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antacids, antibiotics taken by mouth; anticoagulants such as warfarin (Coumadin, Jantoven); digoxin (Lanoxin); laxatives; lithium (Lithobid); or thyroxine. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. If you are taking any other medications by mouth, take them at least 3 hours before or 3 hours before or after taking sodium polystyrene sulfonate.
  • tell your doctor if you have low levels of potassium in your blood, a blockage in your intestine or colon, or if you have recently had surgery and your bowel function has not returned to normal. Your doctor will probably tell you not to take sodium polystyrene sulfonate. Newborn infants should not receive sodium polystyrene sulfonate.
  • tell your doctor if you have or have ever had constipation; surgery to remove all or part of your large bowel or surgery for other intestinal problems; inflammatory bowel disease, ischemic colitis (decreased blood flow to the bowels), gastroparesis (slowed movement of food from the stomach to the small intestine) or other bowel problems; heart failure; high blood pressure; edema (fluid retention; excess fluid held in body tissues); or kidney disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking sodium polystyrene sulfonate, call your doctor.
  • tell your doctor if you are on a sodium-restricted diet.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor before using salt substitutes containing potassium or foods that are high in potassium.

What should I do IF I FORGET to take a dose?

Take or use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take or use a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Sodium polystyrene sulfonate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • diarrhea
  • nausea
  • vomiting
  • loss of appetite

Some side effects can be serious. If you experience any of these symptoms, stop taking or using sodium polystyrene sulfonate and call your doctor immediately:

  • constipation
  • seizures
  • unusual bleeding
  • confusion
  • muscle weakness
  • abdominal pain
  • fast, pounding, or irregular heartbeat

Sodium polystyrene sulfonate may cause other side effects. Call your doctor if you have any unusual problems while taking or using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature (unless told otherwise by your pharmacist) and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

  • irritability
  • confusion
  • muscle weakness

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to sodium polystyrene sulfonate.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists® represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists® makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists® does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

Pronunciation Guide for Drug Names is used with permission. © 2009. The United States Pharmacopeial Convention. All Rights Reserved.

AHFS® Patient Medication Information™. © Copyright, 2020. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: November 15, 2017.