Potassium Binder
Pregnancy: N/A — limited data
Patiromer
Brand names: Veltassa
Adult dose
Dose: 8.4g once daily
Route: Oral
Frequency: Once daily with food
Can increase to 16.8g or 25.2g daily. Not for emergency hyperkalaemia — onset 7–12 hours.
Clinical pearls
- Calcium-based ion exchange resin — exchanges calcium for potassium in colon
- Takes 7–12 hours for onset — NOT for acute emergency hyperkalaemia
- May allow continuation of RAAS inhibitors in CKD patients with hyperkalaemia
- Sodium zirconium cyclosilicate (Lokelma) is faster-acting alternative (1–2 hours)
Contraindications
- Emergency hyperkalaemia requiring immediate treatment
- Bowel obstruction
Side effects
- Constipation
- Hypomagnesaemia
- Hypokalaemia (over-correction)
- Nausea
Interactions
- Most oral medications — take 3 hours apart (reduces absorption of other drugs)
- Metformin — separate by 3 hours
Monitoring
- Serum potassium (within 1 week, then monthly)
- Serum magnesium
Reference: OPAL-HK and AMETHYST-DN trials. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators