Kayexalate (sodium polystyrene sulfonate): Drug Safety Communication - FDA Recommends Separating Dosing
AUDIENCE: Internal Medicine, Nephrology, Cardiology, Pharmacy
ISSUE: FDA is recommending that patients avoid taking the potassium-lowering drug sodium polystyrene sulfonate (Kayexalate) at the same time as other medicines taken by mouth. A study found that sodium polystyrene sulfonate binds to many commonly prescribed oral medicines, decreasing the absorption and therefore effectiveness of those oral medicines. To reduce this likelihood, we recommend separating the dosing of sodium polystyrene sulfonate from other orally administered medicines by at least 3 hours. We are updating the sodium polystyrene sulfonate drug labels to include information about this dosing separation.
BACKGROUND: Sodium polystyrene sulfonate is used to treat hyperkalemia, a serious condition in which the amount of potassium in the blood is too high. It works by binding with potassium in the intestines so it can be removed from the body. Potassium is a mineral that helps the body function properly. Too much potassium in the blood can cause problems with heart rhythm, which in rare cases can be fatal. Sodium polystyrene sulfonate is available as the brand name Kayexalate, as generic brands, and also as non-branded generics.
RECOMMENDATION: Patients should take orally administered prescription and over-the-counter (OTC) medicines at least 3 hours before or 3 hours after taking sodium polystyrene sulfonate. Patients should not stop taking their potassium-lowering medicines without talking to their health care professional first. If you have questions or concerns, including about how to take sodium polystyrene sulfonate with other medicines, talk to a pharmacist or other health care professional.
When prescribing sodium polystyrene sulfonate, health care professionals should advise patients to separate dosing from other orally administered medicines by at least 3 hours. That time should be increased to 6 hours for patients with gastroparesis or other conditions resulting in delayed emptying of food from the stomach into the small intestine.
Read the MedWatch safety alert, including a link to the Drug Safety Communication, at:
https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm574763.htm
Sodium polystyrene sulfonate為治療高血鉀藥品，其機轉主要是藉由和腸道中的鉀離子結合，而將鉀離子移出體外。鉀離子可維持身體的正常機能，但高血鉀會導致心律不整，嚴重的話可能致命。一研究發現sodium polystyrene sulfonate會與多種常見口服藥物結合，降低吸收，使得其他口服藥品之效果下降。為了減少藥品交互作用發生的可能性，美國FDA建議病人應避免於同一時間點使用降血鉀藥品sodium polystyrene sulfonate (Kayexalate)以及其他口服藥品，使用sodium polystyrene sulfonate應與其他口服藥物前後間隔至少3小時。同時美國FDA也要求藥品仿單需加註此相關資訊。
Sodium polystyrene sulfonate 目前於美國除了有商品名為Kayexalate之產品外，亦有可能有其他商品名之學名藥於市面上販售。
病人使用其他口服藥品，需與sodium polystyrene sulfonate前後至少間隔3小時。不可以在未經醫療專業人員指示下，自行停用降血鉀藥品。若病人對於如何使用sodium polystyrene sulfonate有疑問或疑慮，請與醫療專業人員聯繫。
醫療專業人員處方sodium polystyrene sulfonate，也需告知病人此藥品應與其他口服藥品間隔3小時以上，若病人有其他狀況導致腸胃蠕動差或延遲胃排空之時間，其服藥之間隔更需超過6小時以上。
相關訊息與連結請參考FDA網址：
https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm574763.htm
[Posted 09/06/2017]
資料來源：美國FDA之藥物安全警訊
資料提供：台大醫院藥劑部
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