Cation-exchange resin
Calcium polystyrene sulfonate
Brand names: Calcium Resonium
Adult dose
Dose: Oral: 15g TDS–QDS; PR: 30g BD
Route: Oral / PR
Frequency: TDS–QDS
Clinical pearls
- UK Renal Association hyperkalaemia guideline: chronic management of hyperkalaemia in CKD
- MHRA warning re intestinal necrosis — co-administer with laxative (lactulose), avoid concurrent sorbitol
- Patiromer / sodium zirconium cyclosilicate increasingly preferred per NICE TA599/TA623
Contraindications
- Hypercalcaemia
- Plasma K+ <5
- Obstructive bowel disease
- Neonates
- Hypersensitivity
Side effects
- Hypercalcaemia
- Hypokalaemia (over-correction)
- Constipation / faecal impaction
- GI necrosis (rare — MHRA warning, particularly with sorbitol)
- Bezoar formation
Interactions
- Aluminium / magnesium-containing antacids (alkalosis with Ca-resonium)
- Digoxin
- Lithium
Monitoring
- Potassium
- Calcium
- GI symptoms
Reference: BNF; UK Renal Association; MHRA Drug Safety Update; NICE TA599; NICE TA623; https://bnf.nice.org.uk/drugs/calcium-polystyrene-sulfonate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Hyperkalaemia Management Algorithm · Electrolyte Disorders
- PLASMIC Score for TTP · Haematological Diagnosis
- Sickle Cell Exchange Transfusion Volume · Transfusion Medicine
- Blood Volume Calculation (Nadler Formula) · Haematology
- Hour-Specific Bilirubin Risk Assessment (Bhutani Nomogram) · Neonatal Jaundice
- Neonatal Partial Exchange Transfusion for Polycythaemia · Neonatal Haematology
Pathways
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019