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Sodium Polystyrene Sulfonate is used to treat hyperkalemia. The most common cause of hyperkalemia is Acute or Chronic Kidney Disease. It can also come from Liver failure or Adrenal insufciency, from taking certain drugs such as ARB, ACE inhibitors or Beta blockers, or from excessive use of Potassium supplements.
Pharmacology
Sodium Polystyrene Sulfonate is a cation exchange resin. In the stomach it gives up sodium ions and takes hydrogen ions in their place. When the resin reaches the large intestine, the hydrogen ions are swapped for free potassium ions, and the resin then leaves the body in the feces. So less potassium is available to be absorbed into the blood, and more of it is passed out through the feces. The end result is a fall in potassium levels in the body.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adults (including the elderly): The average daily oral dose of Sodium Polystyrene Sulfonate for an adult is 15 gm to 60 gm, which is 1 sachet taken 1 to 4 times daily. If a patient can't take the medicine by mouth, it can be given rectally as an enema. The rectal dose is 30 gm to 50 gm of resin once or twice daily, at intervals of 6 hours. Each dose is given as a warm emulsion (at body temperature) in 150 ml to 200 ml of aqueous vehicle, such as plain water, 10% dextrose in water, or equal parts of water and 2% Methylcellulose suspension. The emulsion should be agitated gently while it is being given. The enema should be retained for as long as possible, and a cleansing enema should follow it.
Children: By mouth, smaller children and infants should get correspondingly lower doses. In acute hyperkalemia, a suitable initial dose is 1 gm/kg body weight daily in divided doses. For maintenance therapy, the dose may be reduced to 0.5 gm/kg body weight daily. If the child refuses it by mouth, the resin may be given rectally, using a dose at least as much as the oral dose would have been. The resin should be suspended in a proportional amount of 10% Dextrose in water. Once the enema has been retained, the colon should be irrigated so the resin is removed properly.
Neonates: The oral route is not advised for neonates, so only rectal administration should be considered. Use the minimum effective dose within the range of 0.5 to 1 gm/kg of resin. The suspension that results should be diluted as it is for adults. After the resin has been given, the colon should be irrigated well so the resin is recovered.
Side Effects
Sodium Polystyrene Sulfonate can irritate the stomach to some degree. Loss of appetite, nausea, vomiting and constipation may occur, especially when high doses are given. Low blood potassium (hypokalemia), low blood calcium (hypocalcemia) and marked sodium retention can also develop, along with the clinical features that go with them. Diarrhea sometimes occurs. In elderly people, large doses may cause fecal impaction. Colonic necrosis has been reported, though rarely. Intestinal obstruction caused by concretions of aluminum hydroxide has also been reported when it is used together with this kind of resin.
Cautions & Contraindications
Warnings & Precautions
Take care when giving Sodium Polystyrene Sulfonate to patients who can't tolerate even a small rise in sodium load, such as those with severe congestive heart failure, severe hypertension or marked edema. In these cases, sodium intake from other sources may need to be restricted to make up for it. If clinically significant constipation develops, stop Sodium Polystyrene Sulfonate until normal bowel motion returns. Magnesium-containing laxatives or sorbitol should not be used.
Contraindications
Sodium Polystyrene Sulfonate should not be given to patients with hypokalemia, or to those with a history of hypersensitivity to polystyrene sulfonate resins. It is also contraindicated in obstructive bowel disease. In neonates, it must not be used when gut motility is reduced (either after surgery or because of a medicine), and it must not be given by mouth to neonates at all.
Pregnancy & Breastfeeding
Sodium Polystyrene Sulfonate is Pregnancy Category C. No animal reproduction studies have been done with it, so nobody knows whether it can harm the baby when given to a pregnant woman, or whether it affects the ability to reproduce. A pregnant woman should receive it only if it is clearly needed.
It is also not known whether Sodium Polystyrene Sulfonate passes into human milk. Many drugs do pass into breast milk, so caution is needed when this medicine is given to a nursing mother.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Use in Children: Sodium Polystyrene Sulfonate has not been shown to work in children. It should not be given by mouth to neonates. Take particular care in premature infants and in infants with low birth weight, because there is a risk of digestive hemorrhage or colonic necrosis.
Overdose
Taking too much Sodium Polystyrene Sulfonate can upset the body's electrolytes. The levels of potassium, calcium and magnesium in the blood may fall, which are called hypokalemia, hypocalcemia and hypomagnesemia.
These biochemical changes can produce the signs and symptoms of hypokalemia. They include irritability, confusion, delayed thought processes, muscle weakness and hyporeflexia, and these may progress to frank paralysis and/or apnea.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Sodium Polystyrene Sulfonate below 30°C and out of the reach of children. If you prepare a suspension of Sodium Polystyrene Sulfonate, make it fresh each time and don't store it for more than 24 hours.
Drug Interactions
Common questions about Normo-K 15 gm
What is Normo-K 15 gm Oral Powder?
Normo-K 15 gm Oral Powder is a medicine that contains Sodium Polystyrene Sulfonate. It is made by Square Pharmaceuticals PLC, Pabna. It belongs to the Calcium Regulator group of medicines.
What is Normo-K used for?
Sodium Polystyrene Sulfonate is used to treat hyperkalemia. The most common cause of hyperkalemia is Acute or Chronic Kidney Disease.
What are the side effects of Normo-K?
Sodium Polystyrene Sulfonate can irritate the stomach to some degree. Loss of appetite, nausea, vomiting and constipation may occur, especially when high doses are given.
Can I take Normo-K during pregnancy or while breastfeeding?
Sodium Polystyrene Sulfonate is Pregnancy Category C. No animal reproduction studies have been done with it, so nobody knows whether it can harm the baby when given to a pregnant woman, or whether it affects the ability to reproduce. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Normo-K?
Taking too much Sodium Polystyrene Sulfonate can upset the body's electrolytes. The levels of potassium, calcium and magnesium in the blood may fall, which are called hypokalemia, hypocalcemia and hypomagnesemia. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Normo-K?
Keep Sodium Polystyrene Sulfonate below 30°C and out of the reach of children. If you prepare a suspension of Sodium Polystyrene Sulfonate, make it fresh each time and don't store it for more than 24 hours.
Can I take other medicines with Normo-K?
Some medicines can interact with Sodium Polystyrene Sulfonate, for example: Magnesium Oxide, Levothyroxine Sodium. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Normo-K?
Normo-K is a prescription (Rx) medicine. Take it as your doctor advises.