Patiromer

The daily dose may be increased or decreased by 8.4 g as necessary to reach the desired target range, adjusted at intervals of one week or longer based on serum potassium. Multiple sachets may be used to achieve the dose. Onset of action is 4-7 hours after administration — Veltassa must NOT replace emergency treatment for life-threatening hyperkalaemia. Administration should be separated by 3 hours from other oral medicinal products. If serum potassium falls below the desired range, reduce or discontinue the dose; on discontinuation serum potassium may rise as early as 2 days after the last dose. Missed dose: take as soon as possible the same day; do not take with the next dose. Duration of treatment individualised by the treating physician. ADOLESCENTS 12 TO 17 YEARS (not a per-kg regimen, so not captured as a structured paediatric dose): recommended starting dose 4 g patiromer once daily, adjusted on serum potassium up to a maximum of 25.2 g daily; switch to 8.4 g sachets if doses above 7 g are needed; data limited to 6 months exposure, so treatment beyond 6 months should be done with caution. Safety and efficacy in children under 12 years have not been established. Elderly: no special dose and administration guidelines. Preparation volumes are dose-dependent — source lists 1 g:10 mL, 2 g:20 mL, 3 g:30 mL, 4 g:40 mL and a further '4 g: 80 mL' entry that appears to be a source transcription error (verify against the SPC); for NG/PEG administration use 160 mL for doses above 8.4 g up to 16.8 g and 240 mL for doses above 16.8 g up to 25.2 g. Take within 1 hour of initial suspension; do not heat, do not add to heated food or liquid, do not take in dry form. Limited experience in patients with serum potassium above 6.5 mmol/L.