FDA-filed SPL labeling · retrieved through openFDA

Sodium Polystyrene Sulfonate

Sodium polystyrene sulfonate is a potassium-binding resin used to treat hyperkalemia (high potassium levels in the blood).

Brand names KalexateKayexalateKionexSps
Drug class Potassium Binder
Rx Forms 3 Routes Oral; Rectal · Oral, Rectal · Oral
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 14 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveAug 15, 2021
Clinical labels in scope 14
AvailabilityRx
Earliest approval/marketing year 1958
FDA-listed product records 43
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Sodium Polystyrene Sulfonate at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Sodium polystyrene sulfonate is a prescription resin that lowers high potassium levels by binding potassium in the gut and removing it in stool. It works slowly — over hours to days — so it is not meant for emergencies. Careful monitoring of potassium, calcium, magnesium, and sodium is essential during treatment.

📖 Sodium Polystyrene Sulfonate: Patient Information Guide

A plain-language walkthrough of Sodium Polystyrene Sulfonate — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Sodium polystyrene sulfonate is a potassium binder used to treat hyperkalemia (high potassium in the blood). All supported products share this single indication.

  • Kionex Suspension (oral suspension): indicated for the treatment of hyperkalemia
  • Sodium Polystyrene Sulfonate oral suspension, powder for suspension, and enema forms: indicated for the treatment of hyperkalemia
  • Important limitation (all products): Not appropriate as emergency treatment for life-threatening hyperkalemia — it takes hours to days to lower potassium, so faster interventions (including dialysis) may be needed in severe cases
⚙️How it works

Sodium polystyrene sulfonate is a resin — a substance that exchanges ions (electrically charged particles). As it travels through your intestines, it releases sodium and picks up potassium in return. The potassium-loaded resin then passes out of the body in stool, lowering the amount of potassium in your blood. Most of this exchange happens in the large intestine. The medication is not absorbed into your bloodstream at all — it works entirely inside the gut.

The exchange process is limited and somewhat unpredictable in how well it works from person to person. Potassium reduction can take anywhere from several hours to a few days, which is why this medication is not used in emergencies.

💊How it's taken

This medication can be taken by mouth or given rectally as an enema, depending on the product form and your clinical situation. The oral form is generally taken one to four times a day; the rectal form is typically given every six hours. Always take it in an upright position.

  • Separate this medication from all other oral medicines by at least 3 hours before or after — or 6 hours if you have slow stomach emptying (gastroparesis)
  • The powder for suspension should be prepared fresh and used within 24 hours; never heat it
  • Your prescriber will determine the dose and duration based on how high your potassium is and how your body responds
🤒Side effects — in detail

The most common side effects involve the digestive system, but changes in blood electrolytes are also possible and important to watch for.

  • Nausea, vomiting, or loss of appetite
  • Constipation (especially at higher doses)
  • Diarrhea
  • Stomach irritation
  • Fecal impaction (bowel blockage) — more common in elderly patients and with rectal use in children
  • Low potassium (hypokalemia) — can cause muscle weakness, confusion, or irregular heartbeat
  • Low calcium (hypocalcemia) or low magnesium (hypomagnesemia)
  • Fluid retention or swelling from the sodium content of the medication

If you develop severe stomach pain, bloody stools, muscle weakness, or a fast or irregular heartbeat, get medical help right away — these can be signs of serious complications.

⚠️Warnings & precautions
  • Intestinal necrosis (bowel tissue death): Rare but potentially fatal cases have been reported, especially when this drug was combined with sorbitol. People with recent bowel surgery, bowel disease, low blood volume, or kidney failure are at greatest risk. Stop the medication and seek care if you develop severe abdominal pain or bloody stools.
  • Dangerously low potassium (hypokalemia): Potassium can drop too far during treatment, causing heart rhythm problems, muscle weakness, or even paralysis. Blood tests are needed regularly.
  • Other electrolyte losses: Calcium and magnesium levels can also fall. All electrolytes should be monitored.
  • Sodium load and fluid overload: Each dose contains significant sodium. People with heart failure, high blood pressure, or edema need careful monitoring for swelling or worsening symptoms.
  • Aspiration risk: Inhaling particles of this medication has caused lung inflammation (bronchitis or pneumonia). Always take the oral suspension sitting upright. Patients with swallowing difficulties are at higher risk.
  • Not for emergencies: This medication acts slowly and should not be the only treatment when potassium is at a life-threatening level.
🔀What it interacts with

Sodium polystyrene sulfonate can interact with several medications — either by reducing their absorption or by changing how they affect your body.

  • Sorbitol: Combining with this laxative has been linked to fatal intestinal necrosis — avoid this combination
  • Magnesium hydroxide and similar antacids/laxatives: Can cause a dangerous rise in blood pH (alkalosis) and reduce the resin's effectiveness — magnesium hydroxide should not be used together with this medication
  • Aluminum hydroxide: Combined use has caused bowel blockages from hardened concretions
  • Digoxin (digitalis): Low potassium caused by this medication amplifies digoxin's toxic effects on the heart
  • Lithium: Absorption of lithium may be reduced
  • Thyroid hormone (thyroxine): Absorption may be reduced if taken at the same time
  • Warfarin, metoprolol, phenytoin, furosemide, amlodipine, amoxicillin: Lab studies show the resin can bind these drugs — space all oral medications at least 3 hours apart from this medication

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Do not take this medication if you have an allergy to polystyrene sulfonate resins
  • Do not take it if you have an obstructive bowel disease (a blockage in your intestine)
  • Neonates with reduced gut motility should not receive this medication at all
  • Tell your doctor if you have a history of constipation, impaction, inflammatory bowel disease, ischemic colitis, bowel resection, or bowel obstruction
  • Tell your doctor if you have not had a bowel movement since surgery
  • People with heart failure, high blood pressure, or edema should be monitored carefully because of the sodium content in each dose
  • Patients with swallowing problems or who are prone to reflux should be managed carefully to avoid inhaling the medication
  • Pregnancy: The medication is not absorbed systemically, so fetal risk is not expected; use only under medical supervision
  • Breastfeeding: Not absorbed systemically, so risk to the infant is not expected; discuss with your provider
  • Children and neonates: Safety and efficacy have not been formally established; oral use is not appropriate for neonates; rectal use in children and neonates requires careful dosing to avoid impaction; premature and low-birth-weight infants face higher risk of serious gut complications
🚑If you take too much

Too much sodium polystyrene sulfonate can cause dangerous drops in potassium, calcium, and magnesium. Signs of overdose may include irritability, confusion, slow thinking, muscle weakness, loss of reflexes, difficulty breathing, or an irregular heartbeat. If these occur, seek emergency care immediately. Treatment focuses on restoring normal electrolyte levels and removing the resin from the gut using laxatives or enemas.

📡Pharmacodynamics — effects in the body

Sodium polystyrene sulfonate lowers the level of potassium in the blood by pulling potassium out through the stool. This effect does not happen quickly — meaningful reduction in serum (blood) potassium can take several hours to a few days after dosing begins. Because of this delayed onset, it is not suitable for treating a potassium emergency on its own.

🔬Pharmacokinetics — how your body processes it

Sodium polystyrene sulfonate is not absorbed into the bloodstream — it stays entirely within the gastrointestinal tract. As it moves through the intestines, it exchanges sodium for potassium; approximately one-third of its sodium content is ultimately delivered to the body in this process. Because it is not absorbed systemically, it does not undergo typical drug metabolism or kidney/liver clearance; it exits the body in the stool along with the potassium it has captured.

📦How to store it

Store at 20° - 25° C (68° - 77° F); excursions permitted to 15° – 30° C (59° – 86° F)

📄 Written from Sodium Polystyrene Sulfonate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Sodium Polystyrene Sulfonate — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is sodium polystyrene sulfonate doing in my body?
Think of it as a tiny sponge that travels through your intestines. It grabs onto extra potassium in your gut and carries it out of your body in your stool — it never actually enters your bloodstream. This slowly brings your blood potassium level down to a safer range. Because it works gradually, your doctor will likely monitor your blood levels regularly while you're on it.
How long does it take to work, and do I need to take it long-term?
It can take anywhere from several hours to a few days to meaningfully lower your potassium levels — so it's definitely not a quick fix. If your potassium is dangerously high right now, your doctor may use other faster treatments alongside it. How long you take it depends on what's causing your high potassium and how your levels respond, so follow your prescriber's guidance on duration.
Can I take my other medications at the same time as this one?
You need to be careful here — this resin can stick to other oral medications and prevent them from being absorbed properly. The general rule is to take your other medicines at least 3 hours before or 3 hours after sodium polystyrene sulfonate. If your stomach empties slowly (a condition called gastroparesis), your doctor may tell you to wait 6 hours. This applies to common drugs like blood thinners, blood pressure pills, antibiotics, and thyroid medication, among others — so make sure your pharmacist reviews your full medication list.
What side effects should I expect, and when should I call my doctor?
The most common side effects are digestive: nausea, vomiting, constipation, and stomach discomfort. Constipation is worth reporting to your doctor promptly — if it develops, you may need to stop the medication. More serious warning signs include severe stomach pain, bloody stools, muscle weakness, confusion, or an irregular heartbeat. Those symptoms need medical attention right away, as they can signal that your potassium (or other electrolytes) has dropped too low, or in rare cases, a serious bowel complication.
I have heart failure — is it safe for me to take this?
It can be used, but your doctor needs to monitor you carefully. Each dose of this medication contains a meaningful amount of sodium (salt), which can cause your body to retain fluid — something that's a real concern if you already have heart failure, high blood pressure, or swelling. Your care team will keep a close eye on your sodium intake from all sources and watch for signs of fluid buildup. Always make sure all your providers know you're taking this.
Is this medication safe during pregnancy or while breastfeeding?
Based on how the medication works — it stays entirely in your gut and is never absorbed into your bloodstream — it is not expected to reach your baby during pregnancy or through breast milk. That said, you should always let your doctor know you're pregnant or breastfeeding so they can weigh the benefits and risks and make the best decision for you and your baby.
Is Sodium Polystyrene Sulfonate available over the counter?
Sodium Polystyrene Sulfonate is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Sodium Polystyrene Sulfonate first available?
Sodium Polystyrene Sulfonate has been available in the United States since at least 1958, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Sodium Polystyrene Sulfonate?
Sodium Polystyrene Sulfonate is supplied by 18 manufacturers listed in the FDA NDC Directory, including Bryant Ranch Prepack, Atlantic Biologicals Corp., Purolite LLC.

💬 Answers drafted from Sodium Polystyrene Sulfonate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Sodium Polystyrene Sulfonate comes

Sodium Polystyrene Sulfonate is available in 3 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Enema

By mouth · Rectal
How this form is used
What it may be used for
  • Sodium Polystyrene Sulfonate enema is used rectally to treat hyperkalemia, though rectal administration produces less effective results than oral use
Important instructions
  • The rectal enema form is typically administered every six hours for adults; follow your prescriber's instructions
  • In children and neonates, use extra caution with rectal administration — excessive doses or inadequate dilution can cause resin impaction
  • Sodium Polystyrene Sulfonate enema should be given with the patient in an upright or appropriate position as directed by your care team
Available strengths 3 strengths
29 FDA-listed product records

Oral suspension

By mouth
Brands Kionex
How this form is used
What it may be used for
  • Kionex Suspension is indicated to treat hyperkalemia (high blood potassium)
  • Sodium Polystyrene Sulfonate oral suspension is indicated to treat hyperkalemia
Important instructions
  • Kionex Suspension is typically taken one to four times daily; follow your prescriber's schedule
  • Kionex Suspension should be taken with the patient sitting upright — do not lie down while taking it
  • Administer Kionex Suspension at least 3 hours before or after other oral medications (6 hours if you have slow stomach emptying)
  • Sodium Polystyrene Sulfonate oral suspension should be prepared fresh and used within 24 hours; do not heat it
Available strengths 2 strengths
7 FDA-listed product records

Rectal powder

By mouth · Rectal
How this form is used
What it may be used for
  • Sodium polystyrene sulfonate powder for suspension is indicated for the treatment of hyperkalemia and can be administered orally or rectally
Important instructions
  • Prepare the suspension fresh and use within 24 hours; do not heat the powder as this can alter how it works
  • Administer at least 3 hours before or after other oral medications; allow 6 hours if you have slow stomach emptying
  • Do not use this medication as emergency treatment for life-threatening hyperkalemia — it takes hours to days to work
Available strengths 1 strength
2 FDA-listed product records

📊 Sodium Polystyrene Sulfonate across the U.S. market

How Sodium Polystyrene Sulfonate appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

3
Dose forms
18
Manufacturers
2
Brand names
43
FDA-listed product records
1958
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (5) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Bryant Ranch Prepack30%
Atlantic Biologicals Corp.7%
Purolite LLC7%
Belcher Pharmaceuticals, LLC5%
Burel Pharmaceuticals, LLC5%
Cardinal Health 107, LLC5%
Other makers42%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Sodium Polystyrene Sulfonate is used

A general measure of how commonly Sodium Polystyrene Sulfonate is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Sodium Polystyrene Sulfonate is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

16,195
Medicaid prescriptions filled (Q1–Q4 2025)
$1.9M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Sodium Polystyrene Sulfonate prescribed? Of the 1,596 medications we measure, Sodium Polystyrene Sulfonate ranks #837 by Medicaid prescriptions — more than 48% of them.

Where Sodium Polystyrene Sulfonate ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Sodium Polystyrene Sulfonate product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 15000 mg powder for oral suspension is the most-dispensed Sodium Polystyrene Sulfonate product — about 31% of these Medicaid prescriptions.

sodium polystyrene sulfonate 15000 MG Powder for Oral Suspension Most dispensed

5,081 Medicaid prescriptions (Q1–Q4 2025) 31% of Sodium Polystyrene Sulfonate prescriptions shown $298,468 gross reimbursement (before rebates) ≈ $59 per prescription (gross)

Summed across the 7 of 29 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2101899

sodium polystyrene sulfonate 250 MG/ML Oral Suspension

1,560 Medicaid prescriptions (Q1–Q4 2025) 10% of Sodium Polystyrene Sulfonate prescriptions shown $170,291 gross reimbursement (before rebates) ≈ $109 per prescription (gross)

Summed across the 1 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 313072

Other Sodium Polystyrene Sulfonate products — combination packs and listings not yet matched to a specific clinical product (kept visible so every prescription is accounted for)

9,554 Medicaid prescriptions (Q1–Q4 2025) 59% of Sodium Polystyrene Sulfonate prescriptions shown $1.4M gross reimbursement (before rebates) ≈ $145 per prescription (gross)

Summed across the 3 of 14 listed NDC products with Medicaid activity.

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Sodium Polystyrene Sulfonate, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 11 of 52 listed Sodium Polystyrene Sulfonate NDCs with Medicaid activity.

🔍 Compare Sodium Polystyrene Sulfonate products

A representative set of FDA-listed product records for Sodium Polystyrene Sulfonate — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 43 of 43 products — FDA National Drug Code Directory. See every product, package size and price: browse all 43 Sodium Polystyrene Sulfonate NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Sodium Polystyrene Sulfonate RxCUI 56512 2 dose forms · 2 strengths
  1. Dose form (SCDF) Oral Suspension RxCUI 375287 In current FDA listings
    Clinical drug / strength (SCD) 250 MG/ML RxCUI 313072
  2. Dose form (SCDF) Powder for Oral Suspension RxCUI 2101898 In current FDA listings
    Clinical drug / strength (SCD) 15000 MG RxCUI 2101899

Look up RxCUI 56512 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Kalexate Kayexalate Kionex Sps

🏭 Manufacturers & labelers

Bryant Ranch Prepack 13 Atlantic Biologicals Corp. 3 Purolite LLC 3 Belcher Pharmaceuticals, LLC 2 Burel Pharmaceuticals, LLC 2 Cardinal Health 107, LLC 2 Chartwell RX, LLC 2 CMP Pharma, Inc. 2 PuraCap Laboratories, LLC 2 Epic Pharma, LLC 2 Marlex Pharmaceuticals Inc 2 KVK-Tech, Inc. 2 Sunrise Pharmaceutical, Inc. 1 ANI Pharmaceuticals, Inc. 1 Ion Exchange India Limited 1 ECI Pharmaceuticals, LLC 1 Dsp 1 Cardinal Health 1

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Aug 15, 2021
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Sodium Polystyrene Sulfonate.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Sodium Polystyrene Sulfonate after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
14
NDC products indexed
43
Distinct labelers/manufacturers represented
18
Linked representative label
CMP Pharma, Inc.
Linked label effective
Aug 15, 2021
Composite sections available
22
Linked SPL Set ID
12d48dcf-07bd-4b06-bd6c-7543f1be8357
Linked SPL Document ID
233303fe-cee1-420f-bf82-aaeb7850b01f
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 14 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. CMP Pharma, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.