Sodium Polystyrene Sulfonate

SOURCE FLAG: no UK SPC (eMC) posology was fetched for this product — the entire entry comes from US labelling (Sodium Polystyrene Sulfonate for suspension, Bryant Ranch Prepack, label date 2024-04-12, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=929068a8-), which may differ from the UK product. Verify against the current UK SPC before use. SEPARATION FROM OTHER DRUGS: administer at least 3 hours before or 3 hours after other oral medications; patients with gastroparesis may require a 6 hour separation. PREPARATION: prepare the suspension fresh and use within 24 hours; do NOT heat it, as this could alter the exchange properties of the resin. One level teaspoon contains approximately 3.5 g of sodium polystyrene sulfonate and 15 mEq of SODIUM — relevant to sodium loading in renal patients. ORAL ADMINISTRATION: suspend each dose in a small quantity of water or syrup, approximately 3 to 4 mL of liquid per gram of resin, and administer with the patient in an upright position (risk of aspiration). ENEMA ADMINISTRATION: after an initial cleansing enema, insert a soft, large size (French 28) rubber tube into the rectum for a distance of about 20 cm with the tip well into the sigmoid colon and tape in place; administer as a warm (body temperature) emulsion in 100 mL of aqueous vehicle and flush with 50 to 100 mL of fluid; a somewhat thicker suspension may be used but do not form a paste; agitate the emulsion gently during administration; retain the resin for as long as possible and follow with a cleansing enema using a NON-SODIUM containing solution, ensuring an adequate volume of cleansing solution (up to 2 litres) is used. SAFETY: cases of intestinal necrosis, some fatal, and other serious gastrointestinal adverse events (bleeding, ischaemic colitis, perforation) have been reported; the majority of cases reported concomitant use of SORBITOL, which is not recommended. Risk factors present in many cases included prematurity, history of intestinal disease or surgery, hypovolaemia, and RENAL INSUFFICIENCY AND FAILURE. Use only in patients who have normal bowel function; avoid in patients who have not had a bowel movement post-surgery and in those at risk of constipation or impaction (history of impaction, chronic constipation, inflammatory bowel disease, ischaemic colitis, vascular disease). Severe hypokalaemia can occur, and patients sensitive to sodium intake should be monitored for signs of FLUID OVERLOAD. No paediatric per-kg dose is stated in the source, so paedDose is null — the label contraindicates use in neonates with reduced gut motility; verify any paediatric use against a children's formulary. §5 and §7 were truncated at the source-fetch limit; no §4.6-equivalent pregnancy section and no renal dose-adjustment statement were retrieved.