Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (2024)

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Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (3)

Generic Kayexalate

Used for Hyperkalemia

Used for Hyperkalemia

Sodium polystyrene sulfonate (more commonly known by its brand name, Kayexalate) is a medication used to treat high potassium levels (hyperkalemia). Sodium polystyrene sulfonate (SPS) is available as a liquid suspension that's given orally (by mouth) or as an enema. It also comes as a powder that needs to be mixed into a suspension. Sodium polystyrene sulfonate (SPS) is typically taken 1 to 4 times a day, but make sure to follow your provider's instructions. This medication can cause low appetite and stomach-related side effects (e.g., nausea, vomiting, constipation or diarrhea).

Reviewed by:

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (4)

Robert Chad Hakim, PharmD, BCCCP

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (5)

Allison Gourley, PharmD

Last reviewed on August 27, 2023

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Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (6)

What is Sodium polystyrene sulfonate (SPS)?

What is Sodium polystyrene sulfonate (SPS) used for?

  • High potassium levels (hyperkalemia)

How Sodium polystyrene sulfonate (SPS) works

Sodium polystyrene sulfonate (SPS) is a potassium binder. It works by binding (attaching) to potassium in your stomach and intestines (gut) so that your body can't absorb it. It's then passed through your stool, which lowers the levels of potassium in your blood.

Drug Facts

Common BrandsKayexalate (brand name no longer available), Kionex, SPS (branded generics)

Drug ClassPotassium binder

Controlled Substance ClassificationNot a controlled medication

Generic StatusLower-cost generic available

AvailabilityPrescription only

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (7)

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$182.40

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Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (8)

What are the side effects of Sodium polystyrene sulfonate (SPS)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Low appetite
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea

Other Side Effects

  • Gut irritations
  • Blockage in the gut

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

  • Intestinal necrosis (low blood flow to the stomach and intestines): bleeding in stool, nausea, vomiting, constipation or diarrhea, fever, stomach pain
  • Low electrolyte levels: muscle cramps, muscle pain, numbness or tingling, nausea, vomiting, weakness, shortness of breath, or confusion

Source:DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare

Bloody vomit

chest pain

cough

cough producing mucus

difficulty with breathing

fever or chills

severe stomach pain

sneezing

sore throat

tightness in the chest

troubled breathing

Incidence not known

Confusion

constipation

decrease in the amount of urine

diarrhea

dry mouth

increased thirst

irregular heartbeat

loss of appetite

muscle cramps in the hands, arms, feet, legs, or face

nausea or vomiting

noisy, rattling breathing

numbness and tingling around the mouth, fingertips, or feet

seizures

severe constipation

swelling of the fingers, hands, feet, or lower legs

stomach cramps or pain

tremor

troubled breathing at rest

unusual tiredness or weakness

weight gain

weight loss

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Dizziness

drowsiness

fainting

fast, slow, or irregular heartbeat

lightheadedness

muscle spasms (tetany) or twitching

pounding or rapid pulse

trembling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (9)

Pros and cons of Sodium polystyrene sulfonate (SPS)

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (10)

Pros

Option for taking by mouth or as an enema

Powder form can be stored at room temperature

Available in a lower-cost, generic form

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (11)

Cons

Not a first-choice option for lowering potassium levels

Must space out at least 3 hours from other oral (by mouth) medications

Not a good choice for people with gut-movement problems

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (12)

Pharmacist tips for Sodium polystyrene sulfonate (SPS)

Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (13)

  • Make sure to tell your provider about all of the medications you're taking before starting sodium polystyrene sulfonate (SPS), especially if you're taking medications that can change your potassium levels, certain laxatives, or antacids. Don't start any new medications while taking sodium polystyrene sulfonate (SPS) without speaking to your provider or pharmacist.

    • It's important to follow a low-sodium diet while taking sodium polystyrene sulfonate (SPS) to avoid swelling. This is because this medication contains sodium. If you get swelling or puffiness in your arms or legs, shortness of breath, need to sleep with multiple pillows, or have gained a lot of weight in a short amount of time, contact your provider.

      • Let your provider know if you feel sick (e.g., diarrhea, lower appetite) because this might put you at high risk for low potassium levels. Your provider might need to adjust your dose of sodium polystyrene sulfonate (SPS) during this time.

        • Make sure to take other oral medications at least 3 hours before or 3 hours after you take your sodium polystyrene sulfonate (SPS) dose. This is because it can lower how much your body absorbs other medications, which can affect how well they work. Additionally, if you have a condition called gastroparesis (slow digestion), you might have to separate your medications from sodium polystyrene sulfonate (SPS) by at least 6 hours.

          • Take sodium polystyrene sulfonate (SPS) while sitting in an upright position to prevent choking. Don't heat sodium polystyrene sulfonate (SPS) before taking it.

            • You can mix sodium polystyrene sulfonate (SPS) into food or juice to improve the taste. But don't mix it with food or drinks that contain potassium, such as bananas and orange juice, because sodium polystyrene sulfonate (SPS) is trying to lower your potassium level.

              • If your provider prescribed sodium polystyrene sulfonate (SPS) as an enema, make sure you know how to give yourself the medication correctly. Ask your provider or pharmacist if you have any questions.

                More tips for sodium polystyrene sulfonate (SPS) oral suspension:

                • Each 60 mL contains 15 g of sodium polystyrene sulfonate (SPS). Make sure you know what your dose is so that you're taking the correct amount of medication.

                  • Shake the bottle well before measuring out each dose. Make sure to only use an oral dosing syringe from the pharmacy to measure out your dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.

                    • Storage of sodium polystyrene sulfonate (SPS) suspension will depend on how it's dispensed to you from the pharmacy. Check the medication label carefully to see if you need to store it in the refrigerator for up to 14 days or at room temperature. Throw away the bottle after the expiration date, even if there's still some medication left.

                      More tips for sodium polystyrene sulfonate (SPS) powder:

                      • Each level teaspoon of sodium polystyrene sulfonate (SPS) powder contains about 3.5 g of sodium polystyrene sulfonate (SPS). Each gram of sodium polystyrene sulfonate (SPS) powder should be mixed with about 3 to 4 mL (about one and a half teaspoonfuls) of water. Make sure you know your dose of sodium polystyrene sulfonate (SPS) so you mix and take the correct amount of powder.

                        Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (14)

                        Frequently asked questions about Sodium polystyrene sulfonate (SPS)

                        How do I mix sodium polystyrene sulfonate (SPS) powder?

                        expand_more

                        Each gram of sodium polystyrene sulfonate (SPS) powder should be mixed with about 3 mL to 4 mL of water. So if your dose is 15 grams, then you'll measure 4 level teaspoonfuls of sodium polystyrene sulfonate (SPS) powder and mix it with about 45 mL to 60 mL of water. The dose should be prepared and used within 24 hours of mixing. Don't heat up the sodium polystyrene sulfonate (SPS) powder or mixture because this could damage the medication.

                        How do you know if sodium polystyrene sulfonate (SPS) is effective?

                        expand_more

                        You'll know if sodium polystyrene sulfonate (SPS) is working for you if you no longer feel symptoms of high potassium levels (e.g., tired or weak, nausea, muscle cramps or pain, chest pain). Additionally, you and your provider will know if sodium polystyrene sulfonate (SPS) is working for you by drawing your blood potassium level regularly during treatment. Make sure to mark your calendar with your appointments to see your provider and get any bloodwork done so sodium polystyrene sulfonate (SPS) is as safe for you as possible.

                        How long does sodium polystyrene sulfonate (SPS) take to work?

                        expand_more

                        It can take 2 to 24 hours to start working to lower potassium. The effects can last for up to 4 to 6 hours.

                        Does sodium polystyrene sulfonate (SPS) cause diarrhea?

                        expand_more

                        Yes, sodium polystyrene sulfonate (SPS) can cause diarrhea and other stomach side effects. If you experience diarrhea, you can try following the BRAT diet for a short while to help with your stomach upset. Ask your provider if it's safe for you to take over-the-counter diarrhea medications.

                        Is sodium polystyrene sulfonate (SPS) a sulfate?

                        expand_more

                        No, sodium polystyrene sulfonate (SPS) is a sulfonate, which is a little different. People with sulfa allergies can likely safely take sodium polystyrene sulfonate (SPS), but it might depend in your reaction to sulfa. To be safe, tell your provider if you're allergic to sulfa.

                        Will sodium polystyrene sulfonate (SPS) raise my sodium level?

                        expand_more

                        Yes, sodium polystyrene sulfonate (SPS) can raise your sodium level. Let your healthcare provider know if need to limit your sodium intake because of certain medical conditions, such as heart failure or high blood pressure. Higher sodium intake can cause your body to hold onto more fluid, so you and your healthcare provider might need to adjust the amount of sodium from your diet while taking sodium polystyrene sulfonate (SPS).

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                        What are the risks and warnings for Sodium polystyrene sulfonate (SPS)?

                        Sodium polystyrene sulfonate (SPS) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                        Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (20)

                        Serious stomach and intestinal side effects (intestinal necrosis)

                        • Risk factors: Using sorbitol | Premature birth | History of intestine problems or surgery | Low blood volume (hypovolemia) | Kidney problems | Constipation

                          Although rare, there have been cases of a serious stomach and intestinal problem called bowel or intestinal necrosis. This happens when blood isn't flowing through your gut and it can cause potentially life-threatening damage. Taking sodium polystyrene sulfonate (SPS) at the same time as sorbitol (a sweetener that's also used as a laxative) can raise your risk of these side effects. Avoid using sorbitol when taking sodium polystyrene sulfonate (SPS). Only take this medication if you have normal bowel movements. Talk to your healthcare provider if you notice blood in your stool, nausea, vomiting, constipation or diarrhea, fever, or stomach pain, while taking sodium polystyrene sulfonate (SPS), because they might have you stop the medication.

                          Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (21)

                          Low potassium, magnesium, and calcium levels

                          • Risk factors: Stomach symptoms (e.g., vomiting, diarrhea) | Low appetite | People on hemodialysis | Taking medications that lower potassium, magnesium, or calcium

                            Taking sodium polystyrene sulfonate (SPS) raises your risk for low electrolyte (e.g., potassium, magnesium, calcium) levels. Your provider might monitor your electrolytes regularly throughout treatment. Make sure to tell your provider about all of your medications before starting sodium polystyrene sulfonate (SPS). Don't start any new medications while taking sodium polystyrene sulfonate (SPS) without talking to your provider first. Some medications (e.g., loop diuretics) can also lower your electrolyte levels. If you get sick (e.g., vomiting, diarrhea) and aren't eating as much while taking sodium polystyrene sulfonate (SPS), contact your provider because they might lower your dose of sodium polystyrene sulfonate (SPS) or get lab work to check your potassium level. Let your provider know if you feel any muscle cramps, muscle pain, numbness or tingling, nausea, vomiting, weakness, shortness of breath, or confusion. These might be signs that certain electrolytes are low.

                            Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (22)

                            Swelling

                            • Risk factors: Heart failure | Kidney problems | Eating or drinking too much sodium | Taking high doses of sodium polystyrene sulfonate (SPS)

                              Taking sodium polystyrene sulfonate (SPS) can lead to swelling in your arms, legs, or other places in your body. This is because this medication contains salt, which causes your body to hold on to more water. While the swelling is typically mild or moderate, it can be dangerous for people who have medical conditions, such as heart failure and kidney problems, who need to limit how much salt they take in. If you get any swelling or puffiness in your arms or legs, feel short of breath, need to sleep with multiple pillows, or have gained a lot of weight in a short amount of time, contact your provider.

                              Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (23)

                              Separate from other medications

                              Sodium polystyrene sulfonate (SPS) can lower how much your body absorbs other medications, which can cause them to not work as well for you. Make sure to take other oral medications at least 3 hours before or 3 hours after you take sodium polystyrene sulfonate (SPS). If you have a condition called gastroparesis (slow digestion), you might have to separate your medications from sodium polystyrene sulfonate (SPS) by at least 6 hours.

                              Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (24)

                              Choking risk

                              • Risk factors: Impaired gag reflex | People who aren't conscious | People who are prone to spitting up

                                Some people have reported choking after inhaling the sodium polystyrene sulfonate (SPS) powder. You'll want to make sure you mix sodium polystyrene sulfonate (SPS) well in water, and only take it while sitting in an upright position to prevent choking.

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (25)

                                Sodium polystyrene sulfonate (SPS) dosage forms

                                The average cost for 1 can of 454g of Sodium polystyrene sulfonate (SPS) is $39.95 with a free GoodRx coupon. This is 78.1% off the average retail price of $182.40.

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (26)

                                Bottle of powder

                                DosageQuantityPrice as low asPrice per unit
                                15g1 bottle$5.18$5.18
                                454g1 bottle$39.95$39.95

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (27)

                                Can of powder

                                DosageQuantityPrice as low asPrice per unit
                                454g1 can$39.95$39.95

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (28)

                                Ml of oral suspension

                                DosageQuantityPrice as low asPrice per unit
                                15g/60ml30 ml$6.88$0.23

                                Typical dosing for Sodium polystyrene sulfonate (SPS)

                                Sodium polystyrene sulfonate (SPS) is available as a powder containing 3.5 g per level teaspoon and a 15 g/60 mL liquid (suspension). The dose is the same for both the powder and the suspension.

                                Your dose of sodium polystyrene sulfonate (SPS) will depend on how high your potassium levels are, how well you're responding to the medication, and if you're having side effects.

                                • Adults

                                  • Oral: The typical dose is 15 grams by mouth 1 to 4 times per day.

                                  • Rectal: The typical dose is 30 grams to 50 grams inserted into the rectum every 6 hours as an enema.

                                • Children

                                  • Your child's provider will determine if sodium polystyrene sulfonate (SPS) is safe for your child. If so, the dose of sodium polystyrene sulfonate (SPS) is calculated based on blood potassium levels.

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (29)

                                Interactions between Sodium polystyrene sulfonate (SPS) and other drugs

                                Sodium polystyrene sulfonate (SPS) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Sodium polystyrene sulfonate (SPS). Please note that only the generic name of each medication is listed below.

                                Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                                Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                • Meloxicam
                                • Sorbitol

                                Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                • Liothyronine

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (30)

                                How much does Sodium polystyrene sulfonate (SPS) cost?

                                To access savings, use a GoodRx coupon and pay just a fraction of the retail price.

                                Sodium polystyrene sulfonate (SPS) (generic)

                                savings_outlinedGoodRx lowest price$39.95(save 78.10%)

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (31)

                                Sodium polystyrene sulfonate (SPS) contraindications

                                Contraindications are specific health conditions or situations in which a person shouldnot take a medication due to safety concerns. If you have any of the following conditionsor if any of the following apply to you, let your healthcare provider know because Sodium polystyrene sulfonate (SPS) will not be safe for you to take.

                                • Low potassium

                                • Conditions where your bowel is blocked

                                • Newborns with gut-movement problems

                                Sodium Polystyrene Sulfonate (SPS): Uses, Side Effects, Dosage & More - GoodRx (32)

                                What are alternatives to Sodium polystyrene sulfonate (SPS)?

                                There are a number of medications that your doctor can prescribe in place of Sodium polystyrene sulfonate (SPS). Compare a few possible alternatives below.

                                Sodium polystyrene sulfonate (SPS)

                                Used for:

                                • High potassium levels (hyperkalemia)

                                $39.95 Lowest GoodRx priceView Prices

                                Lokelma

                                Used for:

                                • Treatment of high potassium levels (hyperkalemia) in adults

                                $803.23 Lowest GoodRx priceView Prices

                                Veltassa (patiromer)

                                Used for:

                                • Treatment of high potassium levels (hyperkalemia) in adults

                                $999.88 Lowest GoodRx priceView Prices

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                                Sodium polystyrene sulfonate (SPS) images

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                                This medicine is Brown Can Of Powder.brown - Sodium Polystyrene Sulfonate 454g Powder for Suspension

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                                This medicine is Brown Can Of Powder.brown - Sodium Polystyrene Sulfonate 454g Powder for Suspension

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                                References

                                starsBest studies we found

                                American Academy of Allergy, Asthma and Immunology. (n.d.). Sulfite and sulfa drugs.

                                Campbell, E. A., et al. (2023). Bowel necrosis. StatPearls.

                                Centers for Disease Control and Prevention. (2020). Spoons are for soup, milliliters are for medicine.

                                View All References (9)

                                expand_more

                                Chartwell RX, LLC. (2023). Sodium polystyrene sulfonate powder, for suspension [package insert]. DailyMed.

                                CMP Pharma, Inc. (2021). Sodium polystyrene sulfonate- sodium polystyrene sulfonate suspension [package insert]. DailyMed.

                                Geri-Care Pharmaceuticals, Corp. (2020). Gericare sorbitol solution- sorbitol liquid [package insert]. DailyMed.

                                Lewis, J. L., III. (2023). Hypokalemia (low level of potassium in the blood). Merck Manual Consumer Version.

                                PuraCap Laboratories, LLC. (2022). Sodium polystyrene sulfonate powder, for suspension [package insert]. DailyMed.

                                Rahman, S., et al. (2023). Sodium polystyrene sulfonate. StatPearls.

                                Shahar-Nissan, K., et al. (2019). The ice cream challenge: A favourable extemporaneous Kayexalate formulation improves compliance in paediatric patients. British Journal of Clinical Pharmacology.

                                Viera, A. J., et al. (2015). Potassium disorders: Hypokalemia and hyperkalemia. American Family Physician.

                                Wu, Y. H., et al. (2021). Adverse gastrointestinal effects with Kayexalate or Kalimate: A comprehensive review. Clinical and Experimental Gastroenterology.

                                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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