Drug Action
Patiromer is a non-absorbed cation- exchange polymer that acts as a potassium binder in the gastro-intestinal tract.
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Drug reference
Patiromer is a non-absorbed cation- exchange polymer that acts as a potassium binder in the gastro-intestinal tract.
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Hyperkalaemia ▶BY MOUTH ▶Adult: Initially 8.4 g once daily; adjusted in steps of 8.4 g as required, dose adjustments should be made at intervals of at least one week; maximum 25.2 g per day
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▶Onset of action 4–7 hours.
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Risk factors for hypercalcaemia (calcium partially released from counterion complex). severe gastro-intestinal disorders (ischaemia, necrosis, and intestinal perforation reported with other potassium binders)
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NICE decisions ▶Patiromer for treating hyperkalaemia (February 2020) NICE TA623 Patiromer (Veltassa ®) is recommended as an option for treating hyperkalaemia in adults only if used: . in emergency care for acute life-threatening hyperkalaemia alongside standard care, or . for people with persistent hyperkalaemia and stages 3b to 5 chronic kidney disease or heart failure, if they: . have a confirmed serum potassium level of at least 6.0 mmol/litre, and . are not taking, or are taking a reduced dosage of, a renin-angiotensin-aldosterone system (RAAS) inhibitor because of hyperkalaemia, and . are not on dialysis. Stop patiromer if RAAS inhibitors are no longer suitable. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding Blood and nutrition arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta623 Scottish Medicines Consortium (SMC) decisions SMC No. SMC2084 The Scottish Medicines Consortium has advised (August 2018) that patiromer calcium (Veltassa ®) is not recommended for use within NHS Scotland for the treatment of hyperkalaemia in adults as the economic case was not demonstrated.
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→Appendix 1: patiromer
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▶Common or very common Abdominal pain. constipation. diarrhoea. flatulence. hypomagnesaemia ▶Uncommon Nausea. vomiting
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid—no information available (although no effects on the infant are anticipated).
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Manufacturer advises monitor for electrolyte disturbances, particularly plasma- potassium (as clinically indicated) and plasma-magnesium (continue to monitor for at least 1 month after initiation of treatment).
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Manufacturer advises Veltassa ® should be mixed with approx. 40 mL of water, then stirred and mixed with a further approx. 40 mL of water; the powder will not dissolve. More water may be added as needed. The mixture should be taken within 1 hour of preparation. Apple juice or cranberry juice may be used instead of water, other liquids should be avoided as they may contain high amounts of potassium. l HANDLING AND STORAGE Store in a refrigerator (2–8°C) prior to dispensing; once dispensed, patient may store below 25°C for up to 6 months.
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There can be variation in the licensing of different medicines containing the same drug. Powder CAUTIONARY AND ADVISORY LABELS 13, 21 A ▶Veltassa (Vifor Fresenius Medical Care Renal Pharma UK Ltd) Patiromer calcium (as Patiromer sorbitex calcium) 8.4 gram Veltassa 8.4g oral powder sachets | 30 sachet P £172.50 DT = £172.50 Patiromer calcium (as Patiromer sorbitex calcium) 16.8 gram Veltassa 16.8g oral powder sachets | 30 sachet P £172.50 DT = £172.50
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Initially 8.4 g once daily; adjusted in steps of
First-line fragment. Read the complete Indications and Dose section above.
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