Orally administered drug for the treatment of hyperkalemia.

Patiromer, sold under the brand name Veltassa,

It is taken by mouth.

Bioavailability-Not absorbed


It is a non-absorbed polymer that binds potassium throughout the G.I. tract, therefore increasing fecal excretion of potassium and lowering serum potassium levels

Consists of smooth, spherical beads approximately 100 µm in diameter that do not swell appreciably on exposure to liquids.

Among patients with hyperkalemia and diabetic kidney disease patiromer at doses of 4.2-16.8 g b.i.d. results in significant decreases in serum potassium levels after four weeks of treatment, lasting through 52 weeks Bakris GL et al).

After 4 weeks of treatment 76% of patients reach their target lower potassium values.

Onset of action 7 hrs

Duration of action 24 hrs


Common side effects: constipation, low blood magnesium, and abdominal pain.

Side effects include: constipation, and hypomagnesemia.

It binds potassium in the gut.

It is used for the treatment of hyperkalemia, but not as an emergency treatment for life-threatening hyperkalemia, as it acts relatively slowly.

Typical reasons for hyperkalemia are chronic kidney disease and application of drugs that inhibit the renin–angiotensin–aldosterone system (RAAS): ACE inhibitors, angiotensin II receptor antagonists, or potassium-sparing diuretics, or that interfere with renal function in general, such as nonsteroidal anti-inflammatory drugs.

It interacts  with many drugs, and could reduce their availability and effectiveness.

Patients should take patiromer at least three hours before or three hours after other oral medications.

Patiromer works by binding free potassium ions in the gastrointestinal tract and releasing calcium ions for exchange. 

It lowers the amount of potassium available for absorption and increases the amount that is excreted via the feces. 

Lowering of potassium levels is detectable 7 hours after administration. 

Levels continue to decrease for at least 48 hours if treatment is continued, and remain stable for 24 hours after administration of the last dose. 

Patiromer is not absorbed from the gut, is not metabolized, and is excreted in unchanged form with the feces.

In a Phase III multicenter clinical trial including 237 patients with hyperkalemia under RAAS inhibitor treatment, 76% of participants reached normal serum potassium levels within four weeks. 

In responders continuing  patiromer treatment vs. placebo group, re-occurrence of hyperkalemia was 15% versus 60%, respectively.

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