Kalimate® [Calcium polystyrene sulfonate]

The standard daily dose is 15-30 g, which should be divided into 2-3 doses. The drug is diluted in a small amount of water (30-50 ml) or 3-4 ml of sweet food or liquid (except for juice rich in potassium - orange, pineapple, grape, tomato) for 1 g of powder. If necessary, the prepared suspension can be introduced using a gastric probe with a thickness of 2-3 mm. When preparing the suspension, inhalation of the drug should be avoided due to the risk of developing acute bronchitis (see the “Adverse Effects” section).

The above dose is average, and can be individually adjusted depending on the levels of electrolytes in a particular patient. The use of calcium polystyrenesulfonate should be discontinued with a decrease in the level of potassium below 5 mmol / l.

Elderly patients (over 65 years)

Since elderly patients often have a decrease in the activity of physiological processes, when prescribing calcium polystyrene sulfonate, elderly patients are advised to perform more careful medical observation and use lower doses of the drug.

Adverse reactions

The frequency of side effects is indicated according to the classification of indicators recommended by the World Health Organization (WHO):

Very often:> 1/10;Often: 1/100; Infrequently: 1/1000; Seldom: 1/10000; Very rarely: 

Metabolic and nutritional disorders

Often: hypokalemia, anorexia

Infrequently: hypercalcemia

Rarely: hypomagnesemia

Disorders of the gastrointestinal tract

Often: constipation, nausea, stomach discomfort, anorexia

Infrequently: vomiting, diarrhea.

Rarely: intestinal perforation, ischemic colitis or intestinal necrosis, intestinal obstruction. It was reported about the formation of calculus (bezoar) in the gastrointestinal tract after the use of the drug.

Disorders of the respiratory system, organs of the chest and mediastinum

Seldom: cases of the development of acute bronchitis and / or bronchopneumonia associated with the inhalation of polystyrenesulfonate calcium particles have been reported.

Violations of the skin and subcutaneous tissue

Seldom: rash

Contraindications

When aggravation of these side effects or the emergence of new, not described in the instructions, the patient should inform the doctor.

1) Intestinal obstruction;

2) Hypersensitivity to polystyrene sulfonate in history;

3) Conditions associated with hypercalcemia (for example, hyperparathyroidism, multiple myeloma, sarcoidosis, metastatic carcinoma);

4) The level of potassium in the plasma is below 5 mmol / l;

5) Kalimate® is not recommended for use in children under the age of 18 years due to insufficient data on efficacy and safety;

6) Combined use with sorbitol.

Carefully:

1) In patients prone to constipation (risk of intestinal obstruction or perforation);

2) In patients with intestinal stenosis (intestinal obstruction or perforation is possible);

3) In patients with gastrointestinal ulcers (possibly exacerbation of symptoms).

Drug interactions

Combined use of the drug with sorbitol is not recommended, as cases of intestinal necrosis have been reported with this use.

Cation exchange drugs can reduce the efficiency of potassium ion binding with Kalimeit.

With the combined use of cation-exchange resins and cation-containing antacid and laxative preparations (magnesium hydroxide, aluminum hydroxide, calcium carbonate, etc.), systemic alkalosis can develop and concretions of aluminum hydroxide are formed.

When used together with digitalis preparations (eg, digoxin), in the case of hypokalemia and / or hypercalcemia, the toxic effect of digitalis preparations on the heart may increase, especially the onset of ventricular arrhythmias and oppression of the atrioventricular node.

When combined with lithium preparations, a decrease in lithium absorption is possible.

When combined with thyroxine may decrease the absorption of thyroxin.

Calcium polystyrenesulfonate may impair the absorption of fat-soluble vitamins.

Pregnancy and Lactation

Special instructions

Overdosage