Sodium Polystyrene Sulfonate (Kayexalate)


  • Electrolyte and water


  • Electrolyte and renal agent


  • Hyperkalemia


  • Hypokalemia

  • Hypocalcemia


  • Pregnancy category A

  • Pregnacy

  • Sodium restriction

Adverse Reactions (Side Effects):

  • anorexia, bowel necrosis, bowel obstruction, constipation, diarrhea

  • hypocalcemia, hypokalemia, nausea, vomiting

  • sodium retention


Administered orally, rectally: Dose individualized depending on the daily assessment of total body potassium

  • Adult: 

    • PO 15g (about 4 teaspoonsful of the powder or 60 ml of the commercially available suspension) 1-4 times daily

  • Child: 

    • PO 1 g/kg every 6 hours as needed

  • Note: Each dose of the powdered resin is usually given PO as a suspension in water or in a syrup such as sorbitol.  The amount of fluid may range 20-100 ml, depending upon the dose, or 3-4 ml per gram of resin.  Suspensions should be freshly prepared and not stored longer than 24 hours.  The powder should not be mixed with liquids that contain large amounts of potassium, such as orange juice.

  • Adult: 

    • PR 30-50 grams as retention enema every 1-2 hours initially as needed and then every 6 hours

  • Child: 

    • PR 1 g/kg every 2-6 hours as required

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