As kidney function deteriorates, patients often suffer elevated levels of potassium (K) that can lead to cardiac rhythm disturbances and other bad things. For years we have prescribed sodium polystyrene sulfonate (Kayexalate), a resin that exchanges sodium (Na) for K in the gut. While it's good to then poop out the K, the patient can absorb more Na, a problem for those with kidney disease. Also, this drug is so old (how old is it?) that it was not subjected to the current level of FDA safety and efficacy studies.
Our pharmaceutical companies have provided an alternative. Patiromer (Veltassa) is a polymer that binds K without releasing Na. So far, so good. It does reduce K levels in patients. Unfortunately, it cannot be taken with other medications because it can bind them and prevent their absorption into the body. Kidney disease patients generally require a whole bunch of drugs, so this is a bit of an issue.
I have a patient who requires some Kayexalate every day to keep blood levels normal, and it works well. However, the texture is gritty. I want to know if patiromer also has a gritty texture. I know it is more expensive, but if it annoys patients less it could be worth the money.
Have you taken patiromir or prescribed it? Let me know what you or your patients think in the comments please!