Download Veltassa

Veltassa / patiromer
Pharmacology
Manufacturer
Approval Date
Indications
Contraindications
Black Box Warnings
Warnings/Precautions
Pregnancy/Lactation
Pharmacokinetics
Drug Interactions –
Object Drugs
Drug Interactions –
Precipitant drugs
Adverse Effects /
Lab Abnormalities
Monitoring Efficacy
Monitoring Toxicity
Dosing – Initial
Dosing – Max
Renal Adjustment
Hepatic Adjustment
A cation exchange polymer that increases fecal potassium excretion
through binding of potassium in the lumen of the gastrointestinal tract,
resulting in a reduction of serum potassium levels.
Relypsa Inc.
10/21/15
Indicated for the treatment of hyperkalemia. Not to be used as an
emergency treatment for life-threatening hyperkalemia because of its
delayed onset of action.
 Hypersensitivity to patiromer sorbitex calcium or xanthan gum
 Patiromer binds to many orally administered medications, which could
decrease their absorption and reduce their effectiveness. Administer
other oral medications at least 6 hours before or 6 hours after
patiromer. Choose patiromer or the other oral medication if adequate
dosing separation is not possible.
 GI effects: Avoid use in patients with severe constipation, bowel
obstruction or impaction as patiromer may worsen GI conditions.
 Hypomagnesemia: Patiromer binds to magnesium in the colon, which
can lead to hypomagnesemia. Monitor serum magnesium and consider
supplementation if hypomagnesemia develops.
 Patiromer is not absorbed systemically following oral administration
 Maternal use is not expected to result in fetal risk
 Breastfeeding is not expected to result in fetal risk
Patiromer is not systemically absorbed and is excreted in the feces.
There are no known significant interactions. Refer to black box warning.
There are no known significant interactions. Refer to black box warning.
Hypomagnesemia <1.4mg/dL (9%) Diarrhea (4.8%)
Constipation (7.2%)
Hypokalemia <3.5mEq/L (4.7%)
Hypomagnesemia (5.3%)
Nausea (2.3%)
Decrease in serum potassium level, dose may be adjusted in 8.4 g
increments in > 1 week intervals.
Monitor serum potassium and serum magnesium levels
8.4 g by mouth daily. Administer with food. Mix the powder with water and
make sure all of the powder is consumed. The powder should be
refrigerated. Once the packet has been out of the refrigerator, it is good at
room temperature up to 3 months.
25.2 g by mouth daily
 No dosage adjustment necessary.
 There are no dosage adjustments provided in the manufacturer’s
labeling.
Cost: Source: UpToDate.com – accessed 3/13/15
Dose(s)
Brand – Generic
8.4 g powder for oral suspension
Veltassa – patiromer
16.8 g powder for oral suspension
25.2 g powder for oral suspension
$ (30 days)
$1071
$714
$714
Summary
 Veltassa, patiromer, is a potassium binder indicated to treat hyperkalemia. It is not to be used as
emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.
 Black box warning for patiromer binding to other oral medications. The administration of other oral
medications should be given 6 hours before or 6 hours after the administration of patiromer.
 Patiromer has 3 different doses (8.4 g, 16.8 g, 25.2 g once daily) that can be adjusted at > 1 week
intervals based on the patient’s serum potassium levels.
 Most common adverse drug effects include: constipation, hypomagnesemia, diarrhea, and
nausea.
 Patiromer does not have any dosage adjustments for hepatic or renal impaired patients.
References:
1. https://www.veltassa.com
2. Veltassa package insert. Relypsa Inc. Oct. 2015.
3. Bakris, GL et al. Effect of patiromer on serum potassium level in patients with hyperkalemia
and diabetic kidney disease: The AMETHYST-DN Randomized Clinical Trial. JAMA. 2015 Jul
14;314(2):151-61.
4. Weir, MR et al. Patiromer in patients with kidney disease and hyperkalemia receiving RAAS
inhibitors. N Engl J Med. 2015 Jan 15;372(3):211-21.
Date Prepared: 03/23/2016
Editor: Peter G. Koval, Pharm.D., BCPS
Author: Dylan Wagoner, Pharm.D. Candidate, UNC Eshelman School of Pharmacy