SPS Patiromer ZS9
Mechanism of action Cation-exchange resin, exchanges sodium for H+ in stomach, then exchange for H+ for other cations in large intestine Nonabsorbed organic polymer, binds potassium in the colon Inorganic polymer; negative charge to framework enables cation exchange
Dosing
Oral: 15 g 1 to 4 times daily Rectal: 30 to 50 g every 6 hours
Oral: Initial: 8.4 g once daily; adjust dose at ≥1-week intervals in increments of 8.4 g; maximum dose: 25.2 g/day
Oral: Initial: 10 g 3 times daily for up to 48 hours; maintenance: 10 g once daily (range: 5 g every other day to 15 g once daily); maximum maintenance dose: 15 g/day
Onset of action Variable 7 hours 1 hour
Efficacy Reduces serum potassium concentration by 0.82 and 1.14 mmol/L Mean reduction in serum potassium concentration at week 4: −1.01 mmol/L Mean initial reduction in serum potassium (48 hr) −0.46 to −1.1; 98% achieved normokalemia within 48 hr
Safety Risk of acute bowel necrosis, diarrhea, and gastrointestinal intolerance Constipation and hypomagnesemia Hypokalemia and edema