Hyperkalaemia

Sodium Polystyrene Sulfonate

Brand names: Resonium A

Sodium polystyrene sulfonate is a cation-exchange resin used to treat hyperkalaemia, including in patients with renal impairment.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It exchanges sodium for potassium ions within the gut, binding potassium and increasing its faecal elimination.

Prescribing in practice

Avoid in patients with bowel obstruction or reduced gut motility, as the resin has been associated with serious gastrointestinal injury including intestinal necrosis.
Onset is slow, so it is unsuitable as sole therapy for severe or life-threatening hyperkalaemia.
The added sodium load and potential for hypokalaemia, hypocalcaemia and hypomagnesaemia should be considered, particularly in renal and cardiac patients.

Monitoring

Monitor serum potassium and other electrolytes regularly during treatment, alongside bowel function.

Counselling the patient

Report any abdominal pain, constipation or vomiting promptly.
Take this medicine as directed and keep your blood-test appointments to check potassium.

Evidence & guidelines

Use is informed by long-standing clinical experience and MHRA advice highlighting the risk of serious gastrointestinal adverse effects.

Reference: NICE NG35 (Acute Hyperkalaemia); SPC Resonium A; FDA Advisory (Sorbitol + SPS Intestinal Necrosis); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways