Loading…
PMS-SODIUM POLYSTYRENE SULFONATE is a brand name for Sodium Polystyrene Sulfonate, supplied as a powder for suspension. The medicine, its uses, side effects and dosage are the same regardless of brand.
Verbatim from this product's HC label. Tap a section to expand.
Gastrointestinal disorders pms-SODIUM POLYSTYRENE SULFONATE (sodium polystyrene sulfonate) may cause some degree of gastric irritation. Anorexia, nausea, vomiting and constipation may occur especially if high doses are given. Occasionally diarrhea develops.
Large doses in elderly individuals may cause fecal impaction. These effects may be obviated through usage of the resin in enemas as described under DOSAGE AND ADMINISTRATION. Fecal impaction following rectal administration particularly in children and gastrointestinal concretions (bezoars) following oral administration have been reported.
Gastrointestinal stenosis and intestinal obstruction have also been reported, possibly due to co-existing pathology or inadequate dilution of the resin. Intestinal obstruction due to concretions of aluminum hydroxide has been reported when aluminum hydroxide was used in combination with sodium polystyrene sulfonate.
Gastrointestinal ischemia, ischemic colitis, rectal haemorrhage, gastrointestinal tract ulceration or necrosis which could lead to intestinal perforation have been reported, which is sometimes fatal. The majority of cases have been reported with concomitant use of sorbitol (see WARNINGS AND PRECAUTIONS and DRUG INTERACTIONS).
Metabolism and nutrition disorders In accordance with its pharmacological actions, the resin may give rise to sodium retention, hypokalemia and hypocalcemia, and their related clinical manifestations (see WARNINGS AND PRECAUTIONS and OVERDOSAGE).
Cases of hypomagnesemia have been reported. Respiratory, thoracic and mediastinal disorders Some cases of acute bronchitis and/or bronchopneumonia associated with inhalation of particles of sodium polystyrene sulfonate have been described.
DOSAGE AND ADMINISTRATION pms-SODIUM POLYSTYRENE SULFONATE (sodium polystyrene sulfonate) is for oral or rectal administration only. The dosage recommendations given below are approximate. The precise requirements for each individual patient should be determined on the basis of regular clinical and biochemical assessments.
Prescribing Information - pms-SODIUM POLYSTYRENE SULFONATE Page 8 of 14 Powder for Suspension Suspensions of pms-SODIUM POLYSTYRENE SULFONATE should be freshly prepared and not stored beyond 24 hours. pms-SODIUM POLYSTYRENE SULFONATE powder should not be heated as heating may alter the exchange properties of the resin.
pms-SODIUM POLYSTYRENE SULFONATE (sodium polystyrene sulfonate) should not be administered to patients with the following conditions: serum potassium <5 mmol/L history of hypersensitivity to polystyrene sulfonate resins obstructive bowel disease pms-SODIUM POLYSTYRENE SULFONATE should not be administered orally to neonates or in neonates with reduced gut motility (postoperatively or drug induced).
g. burns and renal failure). In such instances, some form of dialysis (peritoneal or hemo-) may be imperative. g. 5 mmol/liter), immediate treatment with intravenous glucose and insulin, or intravenous sodium bicarbonate may be necessary as a temporary measure to lower serum potassium, while other long-term potassium lowering therapy is initiated.
Binding to other orally administered medications:
When administered orally, pms-SODIUM POLYSTYRENE SULFONATE may bind to other orally administered medications, which could decrease their gastrointestinal absorption and efficacy. Avoid co-administration of pms- SODIUM POLYSTYRENE SULFONATE with other orally administered medications.
Administer pms-SODIUM POLYSTYRENE SULFONATE at least 3 hours before or 3 hours after administration of other oral medications. For patients with gastroparesis, a 6-hour separation should be considered (see DRUG INTERACTIONS and DOSAGE AND ADMINISTRATION, Powder for Suspension).
Gastrointestinal injuries:
Cases of gastrointestinal stenosis, intestinal ischemia, ischemic colitis, rectal haemorrhage, gastrointestinal necrosis and intestinal perforation with fatal outcomes have been reported in association with sodium polystyrene sulfonate use.
The majority of these cases reported the concomitant use of sorbitol. Risk factors for gastrointestinal adverse events were present in many of the cases including prematurity, history of intestinal disease or surgery, hypovolemia, immunosuppressant therapy, severe burns, and renal insufficiency and failure.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Sodium Polystyrene Sulfonate in Canada.
Know a brand we are missing in Canada? Suggest a brand →
Brand names are compiled from public regulatory records for active-ingredient mapping only. Drugvu is not affiliated with any manufacturer. This is not medical advice.
Adults, Including the Elderly Oral:
The average daily adult dose of the resin is 15 to 60 grams. This is provided by administering 15 grams (approximately 4 level teaspoons) of pms-SODIUM POLYSTYRENE SULFONATE one to four times daily. 5 grams of pms-SODIUM POLYSTYRENE SULFONATE powder and 15 mmol of sodium.
A heaping teaspoon may contain as much as 10-12 grams of pms-SODIUM POLYSTYRENE SULFONATE powder. Since the in vivo efficiency of sodium-potassium exchange resins is approximately 33 per cent, about one third of the resin’s actual sodium content is being delivered to the body.
Each dose should be given as a suspension in a small quantity of water or, for greater palatability, in syrup, but not in orange juice or other fruit juices that are known to contain potassium. The amount of fluid usually ranges from 20 to 100 mL, depending on the dose.
It may be simply determined by allowing 3 to 4 mL per gram of resin. Administer pms-SODIUM POLYSTYRENE SULFONATE at least 3 hours before or 3 hours after other oral medications. For patients with gastroparesis, a 6-hour separation should be considered (see WARNINGS AND PRECAUTIONS and DRUG INTERACTIONS).
The resin may be introduced into the stomach through a plastic tube. If desired, it may be mixed with a diet appropriate for a patient in renal failure.
Rectal:
For adults, the resin may also be given, although with less effective results, in a daily enema. Thirty (30) to 50 g of resin is given once or twice daily (at intervals of six hours). Each dose is administered as a warm emulsion (at body temperature) in 150 to 200 mL of aqueous vehicle (such as plain water, 10 per cent dextrose in water or equal parts of water and 2 per cent methylcellulose suspension).
The emulsion should be agitated gently during administration. The enema should be retained for as long as possible and should be followed by a cleansing enema. After the initial cleansing enema, insert a soft, large size (French 28) rubber tube into the rectum for a distance of about 20 cm, with the tip well into the sigmoid colon.
Then tape the tube in place. Suspend the resin in the appropriate amount of water or 10 percent dextrose in water at body temperature. While constantly stirring to keep the particles in suspension, introduce the suspension into the colon by gravitational flow.
The suspension should be flushed with 50 or 100 mL of saline solution, following which the tube is clamped and left in place. If back leakage occurs, the hips may be elevated on pillows or a temporary knee-chest position may be taken.
A somewhat thicker suspension may be used, but care should be taken that no paste is formed. Paste formation has a greatly reduced exchange surface and is particularly ineffective, if Prescribing Information - pms-SODIUM POLYSTYRENE SULFONATE Page 9 of 14 deposited in the rectal ampulla.
If possible, keep the suspension in the sigmoid colon for several hours. In order to remove the resin, irrigate the colon with non-sodium containing solution at body temperature. Two quarts of flushing solution may be necessary. The returns should be drained constantly through a Y tube connection.
While the use of sorbitol is not recommended, particular attention should be paid to the cleansing enema whenever sorbitol has been used. It should be noted that the rectal route of administration should be reserved for patients who are vomiting or who have upper gastrointestinal tract problems, including paralytic ileus.
The rectal route may […]
Concomitant administration of sorbitol is not recommended (see DRUG INTERACTIONS and ADVERSE REACTIONS). Prescribing Information - pms-SODIUM POLYSTYRENE SULFONATE Page 4 of 14 Hypokalemia: pms-SODIUM POLYSTYRENE SULFONATE therapy can precipitate serious potassium deficiency and the possibility of severe potassium depletion should be considered.
It is therefore imperative to determine serum potassium levels at least daily and more frequently when indicated. Adequate clinical and biochemical control is essential during treatment especially in patients on digitalis. Therapy should be discontinued as soon as serum potassium falls below 5 mmol/L (see DRUG INTERACTIONS).
Since intracellular potassium deficiency is not always reflected by serum potassium levels, the level at which treatment with pms- SODIUM POLYSTYRENE SULFONATE should be discontinued must be determined individually for each patient.
The patient's clinical condition and electrocardiogram are important in making this determination. Early clinical signs of severe hypokalemia include a pattern of irritability, confusion and delayed thought processes. Severe hypokalemia is often associated with a lengthened Q-T interval, widening, flattening or inversion of the T wave, and the appearance of U waves on the electrocardiogram (ECG).
Cardiac arrhythmias such as premature atrial, nodal and ventricular contractions, and supraventricular and ventricular tachycardias may also occur. Marked hypokalemia can also be manifested by severe muscle weakness, at times extending into frank paralysis.
The toxic effects of digitalis on the heart, especially various ventricular arrhythmia and A-V nodal dissociation, are likely to be exaggerated by hypokalemia. These effects can occur even though serum digoxin concentration is within the ‘normal range’.
Other electrolytes disturbances:
Like all cation-exchange resins, sodium polystyrene sulfonate is not totally selective (for potassium) in its actions, and small amounts of other cations such as magnesium and calcium can also be lost during treatment. Patients receiving pms-SODIUM POLYSTYRENE SULFONATE should be monitored for all applicable electrolyte disturbances.
Other risks:
In the event of clinically significant constipation, treatment with the resin should be discontinued until normal bowel motion is resumed. Magnesium-containing laxatives should not be used (see DRUG INTERACTIONS). The patient should be positioned carefully when ingesting the resin, in order to avoid aspiration, which could lead to bronchopulmonary complications.
Special Populations Children and neonates:
In neonates, pms-SODIUM POLYSTYRENE SULFONATE should not be given by the oral route. In both children and neonates, particular care should be observed with rectal administration. Excessive dosage or inadequate dilution could result in impaction of the resin.
Due to the risk of gastrointestinal tract hemorrhage, colonic necrosis, or sodium overload, particular care should be observed in premature infants or low birth weight infants.
Patients at risk from an increase in sodium load:
During the resin’s action in the intestinal tract, sodium is released mole for mole with potassium uptake. A single dose of sodium polystyrene sulfonate (15 grams) contains approximately 60 mmol of sodium. e. severe congestive […]