patiromer (Rx)

Brand and Other Names:Veltassa
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral powder for suspension

  • 8.4g/packet
  • 16.8g/packet
  • 25.2g/packet

Hyperkalemia

Indicated for hyperkalemia

Initial: 8.4 g PO qDay

Monitor serum potassium and adjust dose based on the serum potassium level and the desired target range

May increase or decrease dose as necessary; not to exceed 25.2 g qDay

May titrate upward at 1-week or longer intervals, in increments of 8.4 g

Note: Doses exceeding 50.4 g/day have not been tested; excessive doses may result in hypokalemia; restore serum potassium if hypokalemia occurs

Also see Administration

Dosage Modifications

Renal impairment

  • No dosing adjustments are needed
  • Of the 666 patients treated with patiromer in clinical studies, 93% had chronic kidney disease

Dosing Considerations

Limitations of use: Should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and patiromer

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (3)

                • ciprofloxacin

                  patiromer will decrease the level or effect of ciprofloxacin by drug binding in GI tract. Use Caution/Monitor. May administer 3 hours apart

                • levothyroxine

                  patiromer will decrease the level or effect of levothyroxine by drug binding in GI tract. Use Caution/Monitor. May administer 3 hours apart

                • metformin

                  patiromer will decrease the level or effect of metformin by drug binding in GI tract. Use Caution/Monitor. May administer 3 hours apart

                Minor (0)

                  Previous
                  Next:

                  Adverse Effects

                  1-10%

                  Constipation (7.2%)

                  Hypomagnesemia (5.3%)

                  Diarrhea (4.8%)

                  Hypokalemia, <3.5 mEq/L (4.7%)

                  Nausea (2.3%)

                  Abdominal discomfort (2%)

                  Flatulence (2%)

                  Previous
                  Next:

                  Warnings

                  Contraindications

                  Hypersensitivity to patiromer or its components

                  Cautions

                  Patiromer binds many orally administered medications, which could decrease their GI absorption and lead to reduced efficacy (see Administration)

                  Avoid use with severe constipation, bowel obstruction, or impaction, including abnormal postoperative bowel motility disorders; patiromer may be ineffective with these conditions present and may worsen GI conditions

                  Patients with a history of bowel obstruction or major GI surgery, severe GI disorders, or swallowing disorders were not included in clinical trials

                  Binds to magnesium in the colon, which can lead to hypomagnesemia; monitor serum magnesium; consider magnesium supplementation if low serum magnesium levels observed

                  Previous
                  Next:

                  Pregnancy

                  Pregnancy

                  Not absorbed systemically following oral administration, and maternal use is not expected to result in fetal risk

                  Lactation

                  Not absorbed systemically by the mother, so breastfeeding is not expected to result in risk to the infant

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

                  Previous
                  Next:

                  Pharmacology

                  Mechanism of Action

                  Binds and removes potassium from the GI tract, particularly the colon

                  Patiromer is a nonabsorbed, cation exchange polymer that contains a calcium-sorbitol counterion

                  Absorption

                  Not systemically absorbed

                  Quantitative whole-body autoradiography analysis in rats demonstrated that radioactivity was limited to the GI tract, with no detectable level of radioactivity in any other tissues or organs

                  Elimination

                  Excretion: Feces

                  Previous
                  Next:

                  Administration

                  Oral suspension preparation

                  Prepare each dose immediately prior to administration following the steps below

                  • 1: Measure 1/3 cup of water and pour half of water into a glass
                  • 2: Empty the entire contents of the packet(s) into the glass or cup and stir
                  • 3: Add the remaining half of water and stir the mixture thoroughly
                  • 4: The powder will not dissolve and the mixture will look cloudy; add more water to the mixture as needed for desired consistency
                  • 5: Drink the mixture immediately; if some powder remains in the glass after drinking, add more water, stir and drink immediately; repeat as needed to ensure the entire dose is administered

                  Oral administration

                  Prepare oral suspension (see above) and drink immediately after preparation

                  Do not heat patiromer (eg, microwave) or add to heated foods or liquids

                  Do not take patiromer in its dry form

                  Patiromer may decrease absorption other oral medications

                  • Administer patiromer at least 3 hr before or 3 hr after other oral medications

                  Storage

                  Stored refrigerated at 2-8°C (36-46°F)

                  If stored at room temperature (25°C [77°F]), patiromer must be used within 3 months of being taken out of the refrigerator

                  For either storage condition, do not use after the expiration date printed on the packet

                  Avoid exposure to excessive heat >40°C (>104°F)

                  Previous
                  Next:

                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  Veltassa oral
                  -
                  16.8 gram powder
                  Veltassa oral
                  -
                  8.4 gram powder
                  Veltassa oral
                  -
                  8.4 gram powder
                  Veltassa oral
                  -
                  25.2 gram powder

                  Copyright © 2010 First DataBank, Inc.

                  Previous
                  Next:

                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
                  Previous
                  Next:

                  Formulary

                  FormularyPatient Discounts

                  Adding plans allows you to compare formulary status to other drugs in the same class.

                  To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                  Adding plans allows you to:

                  • View the formulary and any restrictions for each plan.
                  • Manage and view all your plans together – even plans in different states.
                  • Compare formulary status to other drugs in the same class.
                  • Access your plan list on any device – mobile or desktop.

                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
                  Additional Offers
                  Email to Patient

                  From:

                  To:

                  The recipient will receive more details and instructions to access this offer.

                  By clicking send, you acknowledge that you have permission to email the recipient with this information.

                  Email Forms to Patient

                  From:

                  To:

                  The recipient will receive more details and instructions to access this offer.

                  By clicking send, you acknowledge that you have permission to email the recipient with this information.

                  Previous
                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.