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Calcium Polystyrene Sulfonate (K-Nor) is used for patients with hyperkalemia who also have anuria or severe oliguria. The medicine lowers the level of potassium in the serum and removes the extra potassium from the body. It is indicated in all states of hyperkalemia due to acute and chronic renal failure, abortion, complicated labor, incompatible blood transfusion, crush injury, prostectomy, severe burns, surgical shock, and cases of severe glomerulonephritis and pyelonephritis. Patients who need dialysis can also benefit, and the medicine can be used during the period of under dialysis to control blood potassium levels.
Pharmacology
Calcium Polystyrene Sulfonate works gradually along the whole gastrointestinal tract, where it removes potassium ions that are then passed out in the feces. As it moves through the colon, it meets fluids that contain higher amounts of potassium. Potassium is taken up in increasing amounts in exchange for calcium ions.
How long Calcium Polystyrene Sulfonate stays in the body is a decisive factor in how well it works. That is why giving it by mouth is more effective than giving it rectally.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Calcium Polystyrene Sulfonate is for oral or rectal use only. Start treatment with the resin as soon as the serum potassium level rises above 6 mmol/L.
Adults (including the elderly). Oral: the usual adult dose is 15 g, 3 or 4 times a day. Give the resin by mouth as a suspension in a little water. For a better taste, it can be made into a paste with some sweetened vehicle, but not with orange juice or other fruit juices, because these are known to contain potassium. The amount of fluid usually ranges from 3 to 4 ml per gram of resin. Rectal: if oral use isn't possible, Calcium Polystyrene Sulfonate may be given rectally as a daily retention enema. The suspension is 30 g of resin in 100 ml of 2% methylcellulose and 100 ml of water.
Children. Oral: in acute hyperkalemia, give 1 g/kg body weight daily in divided doses. For maintenance therapy the dose may be reduced to 0.5 g/kg body weight daily in divided doses. Rectal: the resin can be given rectally, suspended in a proportional amount of 10% dextrose in water. After the enema has been retained, irrigate the colon so that the resin is properly removed.
Neonates. Oral use of Calcium Polystyrene Sulfonate is contraindicated in neonates, so only the rectal route should be considered. Give the minimum effective dose within the range of 0.5 g/kg to 1 g/kg, diluted as for adults, and irrigate well so that the resin is recovered.
Side Effects
Calcium Polystyrene Sulfonate can cause nausea, vomiting, gastric irritation, loss of appetite (anorexia) and constipation. Diarrhoea happens occasionally. Other effects include fecal impaction, gastrointestinal stenosis and intestinal obstruction, gastrointestinal ischemia, ischemic colitis, rectal haemorrhage, and ulceration or necrosis of the gastrointestinal tract. Hypomagnesemia and hypercalcemia can also occur, among others. Some cases of acute bronchitis and bronchopneumonia have been reported.
Cautions & Contraindications
Warnings & Precautions
While you are on Calcium Polystyrene Sulfonate, think about the risk of severe potassium depletion. To prevent serious hypokalemia, stop the resin as soon as the serum potassium level falls to 5 mmol/L. Hypomagnesemia and hypercalcemia may also occur, so patients should be monitored for all electrolyte disturbances. If clinically significant constipation develops, stop the resin until normal bowel motions return. Magnesium-containing laxatives should not be used. Take care with the patient's position when the resin is swallowed, because aspiration can lead to bronchopulmonary complications. Children and neonates: Calcium Polystyrene Sulfonate should not be given by the oral route. In both children and neonates, take particular care with rectal administration.
Contraindications
Calcium Polystyrene Sulfonate should not be given to patients whose serum potassium is below 5 mmol/L. It should also not be given where there is a condition linked with hypercalcaemia, such as hyperparathyroidism, multiple myeloma, sarcoidosis or metastatic carcinoma. Patients with a history of hypersensitivity to polystyrene sulfonate resins, and those with obstructive bowel disease, should not receive it either. Giving Calcium Polystyrene Sulfonate by mouth is contraindicated in neonates.
Pregnancy & Breastfeeding
Calcium Polystyrene Sulfonate isn't absorbed from the gastrointestinal tract. There are no data on its use in human pregnancy or during breastfeeding.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
An overdose of Calcium Polystyrene Sulfonate can cause the signs of hypokalemia. These include irritability, confusion, slowed thinking, muscle weakness and reduced reflexes (hyporeflexia), and in the end complete paralysis. Apnea can be a serious result as this progresses. The ECG may show changes that fit with hypokalemia or hypercalcemia, and cardiac arrhythmia may occur.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Calcium Polystyrene Sulfonate below 30°C, in a dry place and away from light. Keep it out of reach of children.
Drug Interactions
Common questions about K-Nor 99.934%
What is K-Nor 99.934% Powder For Suspension?
K-Nor 99.934% Powder For Suspension is a medicine that contains Calcium Polystyrene Sulfonate. It is made by Popular Pharmaceuticals PLC. It belongs to the Hyperkalaemia Products group of medicines.
What is K-Nor used for?
Calcium Polystyrene Sulfonate (K-Nor) is used for patients with hyperkalemia who also have anuria or severe oliguria. The medicine lowers the level of potassium in the serum and removes the extra potassium from the body.
What are the side effects of K-Nor?
Calcium Polystyrene Sulfonate can cause nausea, vomiting, gastric irritation, loss of appetite (anorexia) and constipation. Diarrhoea happens occasionally.
Can I take K-Nor during pregnancy or while breastfeeding?
Calcium Polystyrene Sulfonate isn't absorbed from the gastrointestinal tract. There are no data on its use in human pregnancy or during breastfeeding. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much K-Nor?
An overdose of Calcium Polystyrene Sulfonate can cause the signs of hypokalemia. These include irritability, confusion, slowed thinking, muscle weakness and reduced reflexes (hyporeflexia), and in the end complete paralysis. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store K-Nor?
Keep Calcium Polystyrene Sulfonate below 30°C, in a dry place and away from light. Keep it out of reach of children.
Can I take other medicines with K-Nor?
Some medicines can interact with Calcium Polystyrene Sulfonate, for example: Levothyroxine Sodium. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for K-Nor?
K-Nor is a prescription (Rx) medicine. Take it as your doctor advises.