patiromer (Rx)

Brand and Other Names:Veltassa
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral powder for suspension

  • 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 or longer 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

Also see Administration

Dosage Modifications

Renal impairment

  • No dosing adjustments are needed
  • Of the 666 patients treated with patiromer in clinical studies, 93% had chronic kidney disease

Dosing Considerations

Limitations of use: Should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action

Safety and efficacy not established

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Interactions

Interaction Checker

and patiromer

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            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%)

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            Warnings

            Contraindications

            Hypersensitivity to patiromer or its components

            Cautions

            Patiromer binds many orally administered medications, which could decrease their GI absorption and lead to reduced efficacy (see Administration)

            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

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            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.

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            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

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            Administration

            Oral suspension preparation

            Prepare each dose immediately prior to administration following the steps below

            • 1: Measure 1/3 cup of water and pour half of water into a glass
            • 2: Empty the entire contents of the packet(s) into the glass or cup and stir
            • 3: Add the remaining half of water and stir the mixture thoroughly
            • 4: The powder will not dissolve and the mixture will look cloudy; add more water to the mixture as needed for desired consistency
            • 5: Drink the 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

            Oral administration

            Prepare oral suspension (see above) and drink immediately after preparation

            Do not heat patiromer (eg, microwave) or add to heated foods or liquids

            Do not take patiromer in its dry form

            Patiromer may decrease absorption other oral medications

            • Administer patiromer at least 3 hr before or 3 hr after other oral medications

            Storage

            Stored refrigerated at 2-8°C (36-46°F)

            If stored at room temperature (25°C [77°F]), patiromer must be used within 3 months of being taken out of the refrigerator

            For either storage condition, do not use after the expiration date printed on the packet

            Avoid exposure to excessive heat >40°C (>104°F)

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.