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DRUG IMAGES
SPS 15 GM/60 ML SUSPENSION
SPS 30 GM/120 ML ENEMA SUSP
The following indications for SPS (sodium polystyrene sulfonate) have been approved by the FDA:
Indications:
Hyperkalemia
Professional Synonyms:
Hyperpotassemia
Indications:
Hyperkalemia
Professional Synonyms:
Hyperpotassemia
The following dosing information is available for SPS (sodium polystyrene sulfonate):
No enhanced Dosing information available for this drug.
No enhanced Administration information available for this drug.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| SPS 15 GM/60 ML SUSPENSION | Maintenance | Adults take 60 milliliters (15 gram) by oral route 1-4 times daily |
| SPS 30 GM/120 ML ENEMA SUSP | Maintenance | Adults insert 120 milliliters (30 gram) by rectal route every 6 hours |
No generic dosing information available.
The following drug interaction information is available for SPS (sodium polystyrene sulfonate):
There are 0 contraindications.
There are 2 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Potassium Supplements/Potassium Binders SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Patiromer, sodium polystyrene sulfonate and sodium zirconium cyclosilicate bind to potassium.(1-3) CLINICAL EFFECTS: Concurrent use of potassium supplements and patiromer, sodium polystyrene sulfonate or sodium zirconium cyclosilicate may decrease the effectiveness of both agents. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients should normally not receive potassium supplements and patiromer, sodium polystyrene sulfonate or sodium zirconium cyclosilicate concurrently.(1-3) Patiromer, sodium polystyrene sulfonate or sodium zirconium cyclosilicate are indicated for management of hyperkalemia. Consider discontinuing or holding potassium supplements in patients who develop hyperkalemia requiring treatment. DISCUSSION: Patiromer, sodium polystyrene sulfonate and sodium zirconium cyclosilicate are indicated for hyperkalemia. Consider discontinuing or holding potassium supplements in patients receiving sodium polystyrene sulfonate or sodium zirconium cyclosilicate. |
DEXTROSE 5%-ELECTROLYTE #48, EFFER-K, K-PHOS NO.2, K-PHOS ORIGINAL, KCL-D5W-0.2% NACL, KCL-D5W-0.225% NACL, KCL-D5W-0.45% NACL, KCL-D5W-0.9% NACL, KLOR-CON, KLOR-CON 10, KLOR-CON 8, KLOR-CON M10, KLOR-CON M15, KLOR-CON M20, KLOR-CON-EF, POKONZA, POTASSIUM ACETATE, POTASSIUM CHLORIDE, POTASSIUM CHLORIDE IN D5LR, POTASSIUM CHLORIDE-0.45% NACL, POTASSIUM CHLORIDE-0.9% NACL, POTASSIUM CHLORIDE-DEXTROSE 5%, POTASSIUM CHLORIDE-WATER, POTASSIUM CL-LIDOCAINE-NS, POTASSIUM PHOSPHATE, POTASSIUM PHOSPHATE-0.9% NACL, POTASSIUM PHOSPHATES |
| Sorbitol/Lamivudine SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Sorbitol increases the osmotic pressure in the intestine, resulting in accelerated small intestinal transit time and decreased absorption and bioavailability of lamivudine. CLINICAL EFFECTS: Concurrent administration of sorbitol and lamivudine may result in decreased clinical efficacy of lamivudine.(1) Reduction in lamivudine exposure is sorbitol dose-dependent. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of lamivudine states that the concurrent use of lamivudine and sorbitol should be avoided.(1) Consider more frequent monitoring of HBV viral load when chronic coadministration cannot be avoided. DISCUSSION: In an open label, randomized sequence, 4-period, crossover trial in 16 healthy adults, coadministration of a single dose of lamivudine (300 mg) with sorbitol (3.2 grams) resulted in a dose-dependent decrease of lamivudine's area-under-the-curve (AUC(0-24), AUC infinity) and maximum concentration (Cmax) of 20%, 28%, and 28%. A single dose of lamivudine with sorbitol (10.2 grams) resulted in a decrease of lamivudine's AUC and Cmax of 39%, 52%, and 52%. A single dose of lamivudine with sorbitol (13.4 grams) resulted in a decrease of lamivudine's AUC and Cmax of 36%, 55%, and 55%.(1) |
ABACAVIR-LAMIVUDINE, CIMDUO, DELSTRIGO, DOVATO, EFAVIRENZ-LAMIVU-TENOFOV DISOP, EPIVIR, LAMIVUDINE, LAMIVUDINE HBV, LAMIVUDINE-ZIDOVUDINE, SYMFI, TRIUMEQ, TRIUMEQ PD |
There are 3 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Slt Cation-Donating Antacids/Polystyrene Sulfonate SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Polystyrene sulfonate may bind the cation from the antacid, resulting in increased intestinal absorption of non-neutralized bicarbonate, which may result in systemic alkalosis and decreased potassium binding by polystyrene sulfonate. Intestinal obstruction has occurred with aluminum hydroxide because of concretion. CLINICAL EFFECTS: Simultaneous oral use may result in metabolic alkalosis and a decrease in the potassium lowering effect of polystyrene sulfonate. Intestinal obstruction has been reported with aluminum hydroxide. PREDISPOSING FACTORS: Patients with renal failure may be at a higher risk of systemic alkalosis. PATIENT MANAGEMENT: Consider the use of alternative agents to cation-donating antacids in patients receiving oral polystyrene sulfonate when possible. If concurrent use is required, separate the dosing by several hours.(1) Some vitamin preparations may contain sufficient quantities of calcium and/or magnesium salts with antacid properties to interact as well. DISCUSSION: In a study in 11 patients with decreased renal function, the administration of magnesium hydroxide and sodium polystyrene sulfonate produced moderate to moderately severe metabolic alkalosis.(2) There are case reports documenting this affect as well.(3-7) Intestinal obstruction has been reported with aluminum hydroxide and sodium polystyrene sulfonate.(8) If the polystyrene sulfonate is administered rectally, a clinically significant interaction is not likely to occur. |
ALUMINUM HYDROXIDE, CALCIUM ACETATE, CALCIUM CHLORIDE, CALCIUM GLUCONATE, CALCIUM GLUCONATE MONOHYDRATE, CLENPIQ, MAGNESIUM OXIDE |
| Thyroid Preparations/Polystyrene Sulfonate SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Polystyrene sulfonate may bind and delay or prevent the absorption of thyroid preparations from the gastrointestinal tract.(1) CLINICAL EFFECTS: Simultaneous administration of polystyrene sulfonate may result in decreased levels of and effectiveness from thyroid preparations.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of levothyroxine states that levothyroxine should be administered at least 4 hours apart from polystyrene sulfonate.(1) DISCUSSION: Because polystyrene sulfonate may bind and delay or prevent the absorption of levothyroxine from the gastrointestinal tract, the US manufacturer of levothyroxine states that levothyroxine should be administered at least 4 hours apart from polystyrene sulfonate.(1) |
ADTHYZA, ARMOUR THYROID, CYTOMEL, ERMEZA, EUTHYROX, LEVO-T, LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM DILUTION, LEVOXYL, LIOTHYRONINE SODIUM, NIVA THYROID, NP THYROID, PCCA T3 SODIUM DILUTION, PCCA T4 SODIUM DILUTION, RENTHYROID, SYNTHROID, THYQUIDITY, THYROID, TIROSINT, TIROSINT-SOL, UNITHROID |
| Lithium/Polystyrene Sulfonate SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Polystyrene sulfonate may bind and delay or prevent the absorption of lithium from the gastrointestinal tract.(1) CLINICAL EFFECTS: Simultaneous administration of polystyrene sulfonate may result in decreased levels of and effectiveness from lithium.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of sodium polystyrene sulfonate states that oral medications should be administered at least 3 hours apart from polystyrene sulfonate. Patients with gastroparesis may require a 6 hour separation. If concurrent therapy is warranted, consider monitoring lithium levels and clinical response.(1) DISCUSSION: Because polystyrene sulfonate may bind and delay or prevent the absorption of lithium from the gastrointestinal tract, the US manufacturer of sodium polystyrene sulfonate states that lithium should be administered at least 3 hours apart from polystyrene sulfonate.(1) |
LITHIUM CARBONATE, LITHIUM CARBONATE ER, LITHIUM CITRATE, LITHIUM CITRATE TETRAHYDRATE, LITHOBID |
The following contraindication information is available for SPS (sodium polystyrene sulfonate):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 9 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Chronic idiopathic constipation |
| Colonic necrosis |
| Fecal impaction |
| Gastrointestinal hypomotility |
| Gastrointestinal obstruction |
| Hypokalemia |
| Ileus |
| Inflammatory bowel disease |
| Ischemic colitis |
There are 5 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Absence of bowel sounds |
| Alkalosis |
| Gastrointestinal hemorrhage |
| Gastrointestinal tract surgery |
| Prolonged QT interval |
There are 8 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Cardiac arrhythmia |
| Edema |
| Hypocalcemia |
| Hypomagnesemia |
| Hypovolemia |
| Kidney disease with reduction in glomerular filtration rate (GFr) |
| Severe chronic heart failure |
| Severe uncontrolled hypertension |
The following adverse reaction information is available for SPS (sodium polystyrene sulfonate):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 11 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Fecal impaction Hypocalcemia Hypokalemia |
| Rare/Very Rare |
|---|
|
Alkalosis Bronchitis Gastrointestinal concretion Gastrointestinal hemorrhage Gastrointestinal perforation Gastrointestinal ulcer Intestinal ischemic necrosis Ischemic colitis |
There are 5 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Anorexia Constipation Nausea Vomiting |
None. |
| Rare/Very Rare |
|---|
|
Diarrhea |
The following precautions are available for SPS (sodium polystyrene sulfonate):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for SPS (sodium polystyrene sulfonate):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for SPS (sodium polystyrene sulfonate)'s list of indications:
| Hyperkalemia | |
| E87.5 | Hyperkalemia |
Formulary Reference Tool