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A cream to light brown, fine powder with orange flavor filled into a sachet.
Each sachet (5.066 g) contains Calcium Polystyrene Sulfonate 5 grams.
Excipients/Inactive Ingredients: Sodium saccharin, Orange flavor.

Pharmacology: Pharmacodynamics: Calcium polystyrene sulfonate, the calcium salt of sulfonate styrene polymer, is a cation-exchange resin that exchanges calcium ions for potassium ion and other cations in the gastrointestinal tract. It is used to enhance potassium excretion in the treatment of hyperkalaemia and may be preferred to the sodium resin in patients who cannot tolerate an increase in their sodium load.
Pharmacokinetics: After administration of calcium polystyrene sulfonate via oral or rectal route, calcium ion of calcium polystyrene sulfonate is exchanged for the potassium ion in the intestinal tract, particularly around the colon, and the drug is excreted as unchanged polystyrene sulfonate resin into the feces without digestion and absorption. In consequence, potassium in the intestinal tracts excreted outside the body.

Treatment of hyperkalemia associated with anuria and severe oliguria and due to acute and chronic renal failure.

Adults: Oral: 15 g, divided into three or four times a day. The resin given by mouth as a suspension in a small amount of water (3 to 4 ml per g of resin), or it may be mixed with some sweetened vehicle (but not fruit juices, which contain potassium).
Rectal: In case of vomiting or upper gastro-intestinal problems, including paralytic ileus. The resin may be given rectally as a suspension of 30 g of resin in 150 ml of water or 10 percent dextrose in water, as a daily retention edema.
The enema should, if possible, be retained for at least 9 hours following which the colon should be irrigated to remove the resin.
If both routes are used initially, it is probably unnecessary to continue rectal administration once the oral resin has reached the rectum.
Children: Oral: Lower dose should be used; 1 mmol potassium per g of resin.
Initial dose: 1 g per kg of body weight daily in 3-4 divided doses.
Maintenance dose: 0.5 g per kg of body weight daily in 3-4 divided doses.
Rectal: Resin may be given rectally using a dose at least as great as that which would be given orally, diluted in the same ratio as described for adults.
Neonate: Should not be given by the oral route.
Rectal: 0.5 to 1 g per kg of body weight would be employed.

Overdose and Treatment: Overdosage may give rise to clinical signs and symptoms of hypokalemia, including irritability, confusion, delayed thought process, muscle weakness, hyporeflexia, and eventually frank paralysis. Apnea may be a serious consequence of this progression. Cardiac arrhythmia may occur. Appropriate measures should be taken to correct serum electrolytes (potassium, calcium). The resin should be removed from the gastrointestinal tract by appropriate use of laxatives or enema.

It is contraindicated in patients with obstructive bowel disease and conditions associated with hypercalcemia (e.g. hyperparathyroidism, multiple myeloma, sarcoidosis or metastatic carcinoma).

It may cause gastric irritation, anorexia, nausea, vomiting, fecal impaction, intestinal obstruction, hypokalemia, and hypercalcemia.
Caution should be exercised when it is to be used concomitantly with aluminium hydroxide and digoxin.

In the event of clinically significant constipation, treatment should be discontinued until normal bowel movement has resumed. Magnesium containing laxatives should not be used.
With oral administration, care should be taken to avoid aspiration, which may lead to bronchopulmonary complication.
Since effective lowering of serum potassium with calcium resin may take hours to days, treatment with this drug alone may be insufficient to rapidly correct severe hyperkalemia.
Patient monitoring: The following are recommended: 1. Serum calcium level, to detect the early development of hypercalcemia, weekly intervals.
The dose of resin is adjusted to prevent hypercalcemia and hypokalemia.
2. Serum magnesium levels, to detect hypomagnesemia.
Additional information: Treatment with calcium polystyrene sulfonate may be discontinued when the serum potassium concentrations have been reduced to 5 mEq (mmol) per litre.

Calcium polystyrene sulfonate is not absorbed from the gastrointestinal tract. No data are available about the use of calcium polystyrene sulfonate in pregnancy and lactation. Drug is only recommended for use when benefit outweighs risk.

Calcium overloading and hypercalcaemia may occur. It should therefore be avoided in patients with conditions such as hyperparathyroidism, multiple myeloma, sarcoidosis, or metastatic carcinoma who may present with renal failure and hypercalcaemia.

Calcium ions are released from the resin in the gastrointestinal tract and this may reduced the absorption of oral tetracycline.

Store below 30°C in a dry place, away from direct sunlight.

Antidotes & Detoxifying Agents

A07XA03 - calcium compounds ; Belongs to the class of other antidiarrheals.
V03AE01 - polystyrene sulfonate ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.
A12AA - Calcium ; Used as dietary supplements.

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