Calcium Polystyrene Sulfonate

(BANM, rINNM)
Calcium Polystyrene Sulfonate Chemical formula

💊 Chemical information

Calcium Polystyrene Sulphonate; Poliestirenosulfonato cálcico; Polistiren Sülfonat Kalsiyum.
CAS — 37286-92-3.
ATC — V03AE01.
ATC Vet — QV03AE01.

Pharmacopoeias.

In Br. and Jpn.

BP 2008

(Calcium Polystyrene Sulphonate). A cream to light brown, fine powder. The calcium content is not less than 6.5% and not more than 9.5%, calculated with reference to the dried substance. Each g exchanges not less than 1.3 mmol and not more than 2.0 mmol of potassium, calculated with reference to the dried substance. Practically insoluble in water and in alcohol. Store in airtight containers.

💊 Adverse Effects and Precautions

As for Sodium Polystyrene Sulfonate. Sodium overloading is not a problem with calcium polystyrene sulfonate, but calcium overloading and hypercalcaemia may occur. It should therefore be avoided in patients with conditions such as hyperparathyroidism, multiple myeloma, sarcoidosis, or metastatic carcinoma who may present with renal failure together with hypercalcaemia. Patients should be monitored for electrolyte disturbances, especially hypokalaemia and hypercalcaemia.

Effects on the lungs.

An elderly man who died from cardiac arrest was found at autopsy to have bronchopneumonia associated with inhalation of calcium polystyrene sulfonate;1 the resin had been given by mouth to treat hyperkalaemia.
1. Chaplin AJ, Millard PR. Calcium polystyrene sulphonate: an unusual cause of inhalation pneumonia. BMJ 1975; 3: 77–8.

💊 Interactions

As for Sodium Polystyrene Sulfonate. Calcium ions are released from the resin in the gastrointestinal tract and this may reduce the absorption of tetracycline given by mouth.

💊 Uses and Administration

Calcium polystyrene sulfonate, the calcium salt of sulfonated styrene polymer, is a cation-exchange resin that exchanges calcium ions for potassium ions and other cations in the gastrointestinal tract. It is used similarly to sodium polystyrene sulfonate to enhance potassium excretion in the treatment of hyperkalaemia and may be preferred to the sodium resin in patients who cannot tolerate an increase in their sodium load. It is estimated that 1 g of calcium polystyrene sulfonate could bind 1.3 to 2 mmol of potassium but it is unlikely that such figures could be achieved in practice. It is given orally, in a dose of 15 g three or four times daily, as a suspension in water or syrup or as a sweetened paste. It should not be given in fruit juices that have a high potassium content. A dose for children is 1 g/kg daily in divided doses for acute hyperkalaemia, reduced to a maintenance dose of 500 mg/kg daily in divided doses; the oral route is not recommended for neonates. When oral administration is difficult, calcium polystyrene sulfonate may be given rectally as an enema. The usual daily dose is 30 g given as a suspension in 100 mL of 2% methylcellulose ‘450’ and 100 mL of water and retained, if possible, for at least 9 hours. Initial therapy may involve both oral and rectal routes. Following retention of the enema the colon should be irrigated to remove the resin. Children and neonates may be given rectal doses similar to the oral doses suggested for children.

💊 Preparations

Proprietary Preparations

Arg.: Resincalcio; RIC Calcio†; Austral.: Calcium Resonium; Austria: CPS Pulver; Sorbisterit; Belg.: Kayexalate; Braz.: Sorcal; Canad.: Resonium Calcium; Chile: Sorbisterit; Cz.: Calcium Resonium; Resical; Sorbisterit†; Denm.: Resonium Calcium; Ger.: Anti-Kalium; Calcium Resonium; CPS Pulver; Elutit-Calcium; Sorbisterit; Gr.: Calcium Resonium†; Hong Kong: Calcium Resonium; Indon.: Kalitake; Irl.: Calcium Resonium; Jpn: Kalimate; Malaysia: Kalimate; Neth.: Sorbisterit; Norw.: Resonium Calcium; NZ: Calcium Resonium; Philipp.: Kalimate; Pol.: Calcium Resonium; Port.: Resical; Spain: Resincalcio; Swed.: Resonium Calcium; Switz.: Sorbisterit; Thai.: Kalimate; Resincalcio; Turk.: Anti-potasium; UK: Calcium Resonium.
Published October 22, 2018.