Sps (WITH SORBITOL) (sodium polystyrene sulfonate/sorbitol solution)
Potassium-Removing Resins Rectal Enema (ML)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Sodium polystyrene sulfonate is a sulfonated cation-exchange resin that is used for the removal of excess potassium.
USES: This medication is used to treat a high level of potassium in your blood. Too much potassium in your blood can sometimes cause heart rhythm problems. Sodium polystyrene sulfonate works by helping your body get rid of extra potassium.
Generic name: sodium polystyrene sulfonate/sorbitol solution
Pronunciation: (SOE-dee-um POL-ee-STYE-reen SUL-foe-nate)
Drug class: Potassium-Removing Resins
Therapeutic class: Electrolyte Balance-Nutritional Products
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Sps (WITH SORBITOL)
Indications
The following indications are listed for Sps (WITH SORBITOL):
- Hyperkalemia
Also known as: Hyperpotassemia.
Dosing
No dosing information is available for this tab.
No dosing information is available for this tab.
| Drug label | Dosing type | Instructions |
|---|---|---|
| Sps 30 Gm/120 Ml Enema Susp | Maintenance | Insert 120 milliliters (30 gram) by rectal route every 6 hours. |
No dosing information is available for this tab.
Drug interactions
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There are no contraindication interactions for this drug.
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Bile Acid Sequestrants And Ion Exchange Resins/Tiratricol
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Bile acid sequestrants and ion exchange resins may decrease the gastrointestinal absorption of tiratricol.(1,2)
CLINICAL EFFECTS: Simultaneous administration of a bile acid sequestrants and ion exchange resins may result in decreased absorption and effectiveness of tiratricol.(1,2)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of tiratricol states concurrent use of bile acid sequestrants and ion exchange resins with tiratricol should be avoided.(1) The UK manufacturer of tiratricol states use of antacids, charcoal, calcium, cationic resins (e.g. cholestyramine), iron, sucralfate, and other gastrointestinal agents may interfere with the gastrointestinal absorption of tiratricol should be taken before or after tiratricol (more than 2 hours before or after if possible). For cholestyramine, tiratricol should be taken 1 hour before or 4 hours after the resin dose. Adjustment of the tiratricol dose may be required to obtain the desired effect.(2)
DISCUSSION: Bile acid sequestrants and ion exchange resins decrease thyroid hormone exposure by binding and delaying or preventing absorption.(1,2)
Potassium Binders/Potassium Supplements
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.
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)
Moderate Interaction: Assess the risk to the patient and take action as needed.
Polystyrene Sulfonate/Lithium
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)
Polystyrene Sulfonate/Thyroid Preparations
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)
Contraindications
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- Chronic idiopathic constipation
- Colonic necrosis
- Fecal impaction
- Gastrointestinal hypomotility
- Gastrointestinal obstruction
- Hypokalemia
- Ileus
- Inflammatory bowel disease
- Ischemic colitis
- Absence of bowel sounds
- Alkalosis
- Gastrointestinal hemorrhage
- Gastrointestinal tract surgery
- Prolonged QT interval
- Cardiac arrhythmia
- Edema
- Hypocalcemia
- Hypomagnesemia
- Hypovolemia
- Kidney disease with reduction in glomerular filtration rate (GFr)
- Severe chronic heart failure
- Severe uncontrolled hypertension
Adverse reactions
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Less Frequent
- Fecal impaction
- Hypocalcemia
- Hypokalemia
Rare or Very Rare
- Alkalosis
- Bronchitis
- Gastrointestinal concretion
- Gastrointestinal hemorrhage
- Gastrointestinal perforation
- Gastrointestinal ulcer
- Intestinal ischemic necrosis
- Ischemic colitis
More Frequent
- Anorexia
- Constipation
- Nausea
- Vomiting
Rare or Very Rare
- Diarrhea
Precautions
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No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Hyperkalemia | ||
| E87.5 | ICD10CM | Hyperkalemia |
ICD code information from First Databank (FDB).
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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