Patiromer Sorbitex Calcium

Administration

Oral Administration

Administer ≥6 hours before or ≥6 hours after other oral drugs.1 (See Effects on GI Absorption of Drugs under Interactions.)

Administer with food.1

Do not heat (e.g., in microwave) or add to heated foods or liquids.1

Administer as oral suspension; do not administer in dry form.1

Empty entire contents of the packet(s) containing patiromer into glass or cup containing approximately 30 mL of water.1 Stir thoroughly, then add additional 60 mL of water. 1 Stir thoroughly again, then administer immediately.1

If powder remains in glass after initial administration, add more water, stir, and administer immediately; repeat, as needed, until the entire dose is administered.1

Dosage

Available as patiromer sorbitex calcium; dosage expressed in terms of patiromer.1

Adults

Initially, 8.4 g once daily.1 Monitor serum potassium concentration; dosage may be increased (in 8.4-g increments at intervals of ≥1 week, up to 25.2 g daily) or reduced based on serum potassium concentration and desired target range.1

Prescribing Limits

Adults

Maximum 25.2 g once daily.1

Special Populations

Hepatic Impairment

No special dosage recommendations.1

Renal Impairment

Dosage adjustments not necessary.1

Geriatric Patients

No special dosage recommendations.1

No formal drug interaction studies performed to date in humans.1

Effects on GI Absorption of Drugs

Binds to approximately 50% of the oral drugs tested in vitro.1 Binding could reduce GI absorption of the drugs and result in loss of efficacy when administration times are close to those of patiromer.1

Administer other oral agents ≥6 hours before or ≥6 hours following administration of patiromer.1 Monitor clinical response and/or blood concentrations of the drugs whenever possible.1 If adequate separation of dosing is not possible, select an alternative to either patiromer or the other oral agent.1

Absorption

Bioavailability

Not absorbed systemically after oral administration.1 6

Onset

Onset of lowering of serum potassium observed in 7 hours.1 7 Maximum (steady-state) effects attained within 7–14 days with twice-daily dosing.8 (See Actions.)

Elimination

Elimination Route

Excreted in feces.1 6

Storage

Oral

2–8°C; if stored at 25°C, use within 3 months.1 Do not expose to >40°C.1

• Patiromer sorbitex calcium consists of patiromer, a nonabsorbed cation-exchange polymer, and a calcium-sorbitol counterion; used for the removal of excess potassium.1 3 5 7

• Increases fecal potassium excretion via binding of potassium in the GI lumen, which decreases the free potassium concentration in the GI lumen and, consequently, reduces serum potassium concentrations.1

• In patients with chronic kidney disease and hyperkalemia (mean serum potassium concentration of 5.9 mEq/L), patiromer (16.8 g daily in divided doses for 2 days) reduced serum potassium concentrations by 0.2 and 0.8 mEq/L at 7 and 48 hours, respectively; potassium concentrations stable for 24 hours after last dose, then began to increase.1 7

• In healthy individuals, exhibits a dose-dependent increase in fecal potassium excretion and corresponding dose-dependent decrease in urinary potassium excretion, with no change in serum potassium concentrations.1 Effects on fecal and urinary potassium excretion similar whether administered as single daily dose or in 2 or 3 divided doses daily.1