Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Polystyrene sulphonic acid

Generic name
Polystyrene sulphonic acid
Brand name
ATC Code
V03AE01

Pharmacokinetics in children

Polystyrene resins are insoluble and are not absorbed.

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

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Available formulations

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Dosages

Hyperkaliaemia; Prevention of hyperkaliaemia in chemotherapy
  • Oral
    • 1 month up to 18 years
      • 0.5 - 1 g/kg/day in 3 doses. Max: 60 g/day. Max single dose: 20 g/dose.
      • Directions for administration:

        For oral administration, suspend the powder in a glass of water, tea or soft drink and drink in a sitting or standing position. Do not suspend it in fruit drinks because they contain a high level of potassium.

      • Depending on the potassium intake.

  • Rectal
    • 0 years up to 18 years
      • 0.5 - 1 g/kg/day in 3 doses. Max: 120 g/day. Max single dose: 40 g/dose.
      • Special care is required when administering rectally to children, as excessive dosage or inadequate dilution results in impaction of the resin. After retention of each enema, irrigate the colon well to remove the resin properly.

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Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Constipation. After rectal administration, especially in children: obstruction of the ileus due to clumping of the resin, and of haematochezia in premature babies and neonates with a low birthweight.

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications in children

  • Oral use in neonates
  • Oral and rectal use in premature neonates < 28 weeks GA or in neonates with decreased intestinal activity.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Determine the plasma concentrations of sodium, potassium and calcium regularly. Be aware of the possibility of obstipation. Special care is required when administering rectally to children and neonates, as excessive dosage or inadequate dilution results in impaction of the resin; there is a risk of local haemorrhage or necrosis in premature babies or neonates with low birthweights. After retention of each enema, irrigate the colon well to remove the resin properly. For rectal administration, suspend the powder in 150 ml of a 5% glucose solution; apply a cleansing enema before insertion.

When sodium restriction is indicated, the calcium salt is preferred.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Antidotes
V03AB27
V03AB16
V03AB24
V03AB25
V03AB33
V03AB17
V03AB15
V03AB13
V03AB19
V03AB14
V03AB06
V03AB35
Iron chelating agents
V03AC03
V03AC02
V03AC01
Drugs for treatment of hyperkalemia and hyperphosphatemia
V03AE07
V03AE02
V03AE01
Detoxifying agents for antineoplastic treatment
V03AF03
V03AF01
V03AF07
Drugs for treatment of hypoglycemia
V03AH01
Other therapeutic products
V03AX03
DETOXIFYING AGENTS FOR ANTINEOPLASTIC TREATMENT
V03AF03
V03AF01
V03AF07
OTHER THERAPEUTIC PRODUCTS
V03AX03

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References

  1. Fresenius Medical Care Deutschland GmbH, SPC Sorbisterit (RVG 10261) 13-03-2020, www.geneesmiddeleninformatiebank.nl
  2. Kamps WA et al, Guidance Supportive Care Pediatric Oncology, VU Uitgeverij,, 2005
  3. Sanofi-Aventis Netherlands BV, SPC Resonium A (RVG 08071) 26-11-2018, www.geneesmiddeleninformatiebank.nl
  4. Kamps WA et al, Guidance Supportive Care Pediatric Oncology, VU Uitgeverij,, 2005

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Changes

Changes