Dosing & Uses
Dosage Forms & Strengths
oral powder for suspension
- 1g/packet
- 8.4g/packet
- 16.8g/packet
- 25.2g/packet
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 intervals, in increments of 8.4 g
Note: Doses exceeding 50.4 g/day have not been tested; excessive doses may result in hypokalemia; restore serum potassium if hypokalemia occurs
Dosage Modifications
Renal impairment
- No dosing adjustments are needed
- In clinical studies, 93% of the 666 adults had chronic kidney disease
Dosing Considerations
Limitation of use: Do not use as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action
Dosage Forms & Strengths
oral powder for suspension
- 1g/packet
- 8.4g/packet
- 16.8g/packet
- 25.2g/packet
Hyperkalemia
Indicated for hyperkalemia in patients aged ≥12 years
<12 years
- Safety and efficacy not established
12-17 years
- Initial: 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 4 g
- Note: Doses exceeding 50.4 g/day vave not been tested; excessive doses may result in hypokalemia; restore serum potassium if hypokalemia occurs
Dosage Modifications
Renal impairment
- No dosing adjustments are needed
- All pediatric patients treated in clinical studies had chronic kidney disease
Dosing Considerations
Limitation of use: Do not use as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (10)
- bisoprolol
patiromer will decrease the level or effect of bisoprolol by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- carvedilol
patiromer will decrease the level or effect of carvedilol by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- ciprofloxacin
patiromer will decrease the level or effect of ciprofloxacin by drug binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- levothyroxine
patiromer will decrease the level or effect of levothyroxine by drug binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- metformin
patiromer will decrease the level or effect of metformin by drug binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- mycophenolate
patiromer will decrease the level or effect of mycophenolate by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- nebivolol
patiromer will decrease the level or effect of nebivolol by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- quinidine
patiromer will decrease the level or effect of quinidine by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- telmisartan
patiromer will decrease the level or effect of telmisartan by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
- thiamine
patiromer will decrease the level or effect of thiamine by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate administration by at least 3 hr from patiromer
Minor (31)
- amoxicillin
patiromer, amoxicillin. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- azilsartan
patiromer, azilsartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- benazepril
patiromer, benazepril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- bumetanide
patiromer, bumetanide. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- canagliflozin
patiromer, canagliflozin. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- candesartan
patiromer, candesartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- captopril
patiromer, captopril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- cephalexin
patiromer, cephalexin. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- dapagliflozin
patiromer, dapagliflozin. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- empagliflozin
patiromer, empagliflozin. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- enalapril
patiromer, enalapril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- eplerenone
patiromer, eplerenone. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- eprosartan
patiromer, eprosartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- finerenone
patiromer, finerenone. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- fosinopril
patiromer, fosinopril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- furosemide
patiromer, furosemide. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- irbesartan
patiromer, irbesartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- lisinopril
patiromer, lisinopril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- losartan
patiromer, losartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- metoprolol
patiromer, metoprolol. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- moexipril
patiromer, moexipril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- olmesartan
patiromer, olmesartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- perindopril
patiromer, perindopril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- quinapril
patiromer, quinapril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- ramipril
patiromer, ramipril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- sacubitril/valsartan
patiromer, sacubitril/valsartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- spironolactone
patiromer, spironolactone. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- torsemide
patiromer, torsemide. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- trandolapril
patiromer, trandolapril. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- trimethoprim
patiromer, trimethoprim. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- valsartan
patiromer, valsartan. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
Adverse Effects
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%)
Warnings
Contraindications
Hypersensitivity to patiromer or its components
Cautions
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
Drug interaction overview
- Patiromer may potentially bind to some oral co-administered medications, which could decrease their GI absorption and efficacy
- Binding to other oral medications not listed below may occur if taken too close to patiromer
- Administer other oral medications at least 3 hr before or after patiromer administration
-
Clinically important interactions
- Separate administration by at least 3 hr
- Angiotensin II blockers (ARBs; ie, telmisartan only)
- Beta-blockers (ie, bisoprolol, carvedilol, nebivolol)
- Antibiotics (ie, ciprofloxacin only)
- Levothyroxine
- Metformin
- Mycophenolate mofetil
- Quinidine
- Thiamine
-
No observed clinically important interactions
- No separation of dosing is required for these drugs
- Angiotensin-converting enzyme (ACE) inhibitors (ie, benazepril, captopril, enalapril, fosinopril, lisinopril, perindopril, quinapril, ramipril, trandolapril)
- ARBs (ie, azilsartan, candesartan, irbesartan, losartan, olmesartan, valsartan)
- Beta-blockers (ie, metoprolol)
- Loop diuretics (ie, furosemide, bumetanide, torsemide)
- Antibiotics (ie, trimethoprim, amoxicillin, cephalexin)
- Mineralocorticoid receptor antagonists (ie, eplerenone, finerenone, spironolactone)
- Neprilysin inhibitors (ie, sacubitril)
- SGLT2 inhibitors (ie, canagliflozin, dapagliflozin, empagliflozin)
Pregnancy
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
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
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
Absorption
Not systemically absorbed
Quantitative whole-body autoradiography analysis in rats demonstrated that radioactivity was limited to the GI tract, with no detectable level of radioactivity in any other tissues or organs
Elimination
Excretion: Feces
Administration
Oral Suspension Preparation
Prepare each dose immediately before administering
Measure 1/3 cup of water and pour half of water into a glass; empty the entire contents of the packet(s) into the glass and stir
Add remaining half of water and stir the mixture thoroughly
Powder will not dissolve and mixture will look cloudy; add more water to mixture as needed for desired consistency
Drink 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
Other beverages or soft foods (eg, applesauce, yogurt, pudding) may be use instead of water to prepare mixture by following the above steps
Consider the potassium content of liquids or soft foods used to prepare the mixture as part of the dietary recommendations on potassium intake for each patient
Oral Administration
Prepare oral suspension (see above) and drink immediately after preparation
Do not heat (eg, microwave) or add to heated foods or liquids
Do not take in its dry form
May decrease absorption of some oral coadministered medications, which could decrease their GI absorption; separate administration by at least 3 hr (see Drug Interactions)
Storage
Unopened packets
- Refrigerate at 2-8ºC (36-46ºF)
- If stored at room temperature (25ºC [77ºF]), use within 3 months of being taken out of the refrigerator
- Avoid exposure to excessive heat >40ºC (>104ºF)
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Veltassa oral - | 25.2 gram powder | ![]() | |
Veltassa oral - | 16.8 gram powder | ![]() | |
Veltassa oral - | 8.4 gram powder | ![]() | |
Veltassa oral - | 8.4 gram powder | ![]() | |
Veltassa oral - | 8.4 gram powder | ![]() |
Copyright © 2010 First DataBank, Inc.
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