Sodium polystyrene sulfonate belongs to the class of medications called cation-exchange resins. It is used to treat high levels of potassium in the blood (hyperkalemia).

It lowers the level of potassium in the blood by binding to potassium in the intestine.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Oral: The average adult dose is 15 grams taken 1 to 4 times daily. Each dose should be mixed in 20 mL to 100 mL of water or syrup. Do not mix it with orange or fruit juice that contains potassium. Children's doses are based on body weight.

Rectal: The recommended adult dose is 30 to 50 grams given 1 or 2 times daily (at intervals of 6 hours). Children's doses are based on body weight. The rectal enema is usually given by a doctor or a nurse.

Sodium polystyrene sulfonate can bind to other medications when they are taken at the same time. Take this medication 3 hours before or 3 hours after taking other oral medications. If you have a medical condition that affects your stomach muscles, such as gastroparesis, your doctor might suggest a longer gap period (i.e., 6 hours).

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from freezing and keep it out of the reach of children.

Each gram of cream or light-brown, fine powder contains 1 gram of sodium polystyrene sulfonate. The sodium content is approximately 4.1 mmol (100 mg) per gram of the drug.

Do not use this medication if you:

• are allergic to sodium polystyrene sulfonate or any ingredients of the medication
• have a serum potassium level less than 5 mmol/L
• have obstructive bowel disease

Sodium polystyrene sulfonate should not be given to newborns by mouth.This medication should also not be given to any newborns who have digestive systems that are not working properly.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• diarrhea
• loss of appetite
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain or swelling
• bleeding from the rectum
• blood-streaked stool or bloody diarrhea 
• symptoms of low calcium levels (e.g., abdominal cramps, irritability, muscle spasms)
• symptoms of low magnesium levels (e.g., muscle weakness, irregular heartbeat, nausea, vomiting)
• symptoms of low potassium levels (e.g., muscle weakness, irregular heartbeat, nausea, vomiting)
• symptoms of sodium retention (e.g., bloating, excessive thirst)
• symptoms of inflammation of the lining of the stomach or belly (e.g., abdominal pain, bloating, fever, nausea and vomiting, loss of appetite, diarrhea, thirst, cannot pass stool or gas, fatigue, confusion, decreased urine production)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of an allergic reaction (such as difficulty breathing, hives, swelling of the face or throat)  
• signs of bleeding in the stomach (e.g., vomit that looks like coffee grounds; black, bloody or tarry stools)
• symptoms of a blocked intestine (e.g., abdominal pain, abdominal swelling, vomiting)
• symptoms of fecal impaction (e.g., leaking liquid stool, stomach pain, feeling the need to push, nausea, vomiting, loss of appetite)
• symptoms of a tear of the intestine (e.g., abdominal pain, nausea, vomiting, fever)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Gastrointestinal problems: Sodium polystyrene sulfonate can cause a number of problems in the digestive system. Intestinal perforation is a serious and sometimes fatal condition in which a hole develops somewhere along the digestive system, resulting in inflammation of the abdomen. If you experience fever or chills with severe abdominal pain, nausea or vomiting, seek immediate medical attention.

Sodium polystyrene sulfonate can also cause narrowing in the digestive tract, decreased blood flow to the digestive tract, inflammation, and ulcers. Get immediate medical attention if you experience signs of bleeding in the stomach or intestines, such as vomiting blood or material that looks like coffee grounds, or stools that are black and tarry.

Increase in sodium levels: Sodium polystyrene sulfonate can cause an increase in sodium levels. If you have congestive heart failure, high blood pressure, kidney problems, or swelling of the ankles, feet, lower legs, or hands, discuss with your doctor how this medication may affect your medical condition and whether special monitoring is required.

Low potassium levels: Sodium polystyrene sulfonate can cause low potassium levels. Tell your doctor if you experience symptoms of low potassium, such as confusion, irregular heartbeat, and muscle weakness or cramping.

Pregnancy: The safety and effectiveness of using this medication during pregnancy have not been established.

Breast-feeding: The safety and effectiveness of using this medication while breast-feeding have not been established.

Children and infants: Newborns should not be given sodium polystyrene sulfonate by mouth. This medication should also not be given to any newborns who have digestive systems that are not working properly.

There may be an interaction between sodium polystyrene sulfonate and any of the following:

• aluminum hydroxide
• certain antacids (e.g., magnesium hydroxide, calcium carbonate)
• lithium
• magnesium supplements (e.g., magnesium citrate, magnesium oxide)
• magnesium containing laxatives (e.g., magnesium hydroxide)
• meloxicam
• potassium bicarbonate
• quetiapine
• sodium bicarbonate
• sorbitol
• thyroid replacements (e.g., desiccated thyroid, levothyroxine, liothyronine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.