Sodium polystyrene sulfonate interactions

Sodium polystyrene sulfonate (Kayexalate, Kionex, SPS), a potassium supplement has 50 documented interactions across the FDA labels and fact sheets we index: 5 major, 40 moderate, 5 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (5)

  • Amiloridepotassium-sparing diureticMajor

    Potassium supplementation in the form of medication, potassium-containing salt substitutes or a potassium-rich diet should not be used with amiloride HCl except in severe and/or refractory cases of hypokalemia. (Amiloride label, Contraindications)

  • Cation-Donating Antacids The simultaneous oral administration of Sodium Polystyrene Sulfonate Powder, for Suspension with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability and increase the risk of systemic alkalosis 7.3 Sorbitol Sorbitol may contribute to the risk of intestinal necrosis [ see Warnings and… (Sodium polystyrene sulfonate label, Drug interactions)

  • Eplerenonealdosterone antagonistMajor

    …with: • type 2 diabetes with microalbuminuria, • serum creatinine > 2.0 mg/dL in males or >1.8 mg/dL in females, • creatinine clearance < 50 mL/min, or • concomitant administration of potassium supplements or potassium-sparing diuretics (e.g., amiloride, spironolactone, or triamterene) [see Warnings and Precautions (5.1) , Adverse Reactions (6.2) , Drug Interactions… (Eplerenone label, Contraindications)

  • GlycopyrrolateanticholinergicMajor

    • GI Toxicity with Solid Oral Dosage Forms of Potassium Chloride : Concomitant use is not recommended. (Glycopyrrolate label, Drug interactions)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

Moderate interactions (40)

  • AliskirenantihypertensiveModerate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes, combination use with ARBs or ACEIs [see Contraindications ( 4 ), Warnings and Precautions ( 5.2 ), and Clinical Studies ( 14.3 )] , NSAIDs, or potassium supplements or potassium sparing diuretics. (Aliskiren label, Warnings and precautions)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerModerate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes. (Amlodipine and benazepril label, Warnings and precautions)

  • Amlodipine and valsartandihydropyridine calcium channel blockerModerate

    …Serum Potassium: Concomitant use of valsartan with other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart… (Amlodipine and valsartan label, Drug interactions)

  • BenazeprilACE inhibitorModerate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes [see Drug Interactions (7.1) ] . (Benazepril label, Warnings and precautions)

  • BisacodyllaxativeModerate

    Cation-Donating Antacids The simultaneous oral administration of Sodium Polystyrene Sulfonate Powder, for Suspension with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability and increase the risk of systemic alkalosis 7.3 Sorbitol Sorbitol may contribute to the risk of intestinal necrosis [ see Warnings and… (Sodium polystyrene sulfonate label, Drug interactions)

  • Candesartanangiotensin II receptor blocker (ARB)Moderate

    Agents Increasing Serum Potassium Co-administration of candesartan cilexetil with potassium sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia. (Candesartan label, Drug interactions)

  • Candesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Co-administration of candesartan cilexetil and hydrochlorothiazide tablets with potassium sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia. (Candesartan and hydrochlorothiazide label, Drug interactions)

  • CaptoprilACE inhibitorModerate

    Potassium-sparing diuretics such as spironolactone, triamterene, or amiloride, or potassium supplements should be given only for documented hypokalemia, and then with caution, since they may lead to a significant increase of serum potassium. (Captopril label, Drug interactions)

  • CyclosporineimmunosuppressantModerate

    Caution is also required when cyclosporine is coadministered with potassium sparing drugs (e.g., angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists), potassium-containing drugs as well as in patients on a potassium rich diet. (Cyclosporine label, Drug interactions)

  • DocusatelaxativeModerate

    Cation-Donating Antacids The simultaneous oral administration of Sodium Polystyrene Sulfonate Powder, for Suspension with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability and increase the risk of systemic alkalosis 7.3 Sorbitol Sorbitol may contribute to the risk of intestinal necrosis [ see Warnings and… (Sodium polystyrene sulfonate label, Drug interactions)

  • EnalaprilACE inhibitorModerate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes [see Drug Interactions ( 7.3 )]. (Enalapril label, Warnings and precautions)

  • Potassium-sparing diuretics (e.g., spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. (Enalapril and hydrochlorothiazide label, Drug interactions)

  • EnalaprilatACE inhibitorModerate

    Potassium-sparing diuretics (e.g., spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. (Enalaprilat label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Monitor serum potassium levels; use potassium supplements if necessary. (Fludrocortisone label, Drug interactions)

  • FosinoprilACE inhibitorModerate

    Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia. (Fosinopril label, Drug interactions)

  • Drug Interactions Potassium supplements and potassium-sparing diuretics As noted above (“Derangements of Serum Electrolytes”), the net effect of fosinopril sodium and hydrochlorothiazide may be to elevate a patient’s serum potassium, to reduce it, or to leave it unchanged. (Fosinopril and hydrochlorothiazide label, Drug interactions)

  • Irbesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Coadministration of AVALIDE with potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia, sometimes severe. (Irbesartan and hydrochlorothiazide label, Warnings and precautions)

  • LactuloselaxativeModerate

    Cation-Donating Antacids The simultaneous oral administration of Sodium Polystyrene Sulfonate Powder, for Suspension with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability and increase the risk of systemic alkalosis 7.3 Sorbitol Sorbitol may contribute to the risk of intestinal necrosis [ see Warnings and… (Sodium polystyrene sulfonate label, Drug interactions)

  • Liothyroninethyroid hormoneModerate

    Drug or Drug Class Effect Bile Acid Sequestrants -Colesevelam -Cholestyramine -Colestipol Ion Exchange Resins -Kayexalate -Sevelamer Bile acid sequestrants and ion exchange resins are known to decrease thyroid hormones absorption. (Liothyronine label, Drug interactions)

  • LisinoprilACE inhibitorModerate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes [see Drug Interactions (7.1) ] . (Lisinopril label, Warnings and precautions)

  • Use of lisinopril with potassium-sparing diuretics (e.g., spironolactone, eplerenone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. (Lisinopril and hydrochlorothiazide label, Drug interactions)

  • Lithiumserotonergic drugModerate

    Decreased absorption of lithium and thyroxine have also been reported with co-administration of Sodium Polystyrene Sulfonate Powder, for Suspension. (Sodium polystyrene sulfonate label, Drug interactions)

  • MoexiprilACE inhibitorModerate

    Potassium Supplements and Potassium-Sparing Diuretics: Moexipril hydrochloride can increase serum potassium because it decreases aldosterone secretion. (Moexipril label, Drug interactions)

  • Olmesartanangiotensin II receptor blocker (ARB)Moderate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes [see Drug Interactions (7.3) ] . (Olmesartan label, Warnings and precautions)

  • Omeprazole and sodium bicarbonateproton pump inhibitorModerate

    Cation-Donating Antacids: may reduce the resin’s potassium exchange capability and increase risk of systemic alkalosis ( 7.2 ). (Sodium polystyrene sulfonate label, Drug interactions)

  • PerindoprilACE inhibitorModerate

    Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus and the concomitant use of agents such as potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes [see Drug Interactions (7.2) ] . (Perindopril label, Warnings and precautions)

  • Polyethylene glycol 3350laxativeModerate

    Cation-Donating Antacids The simultaneous oral administration of Sodium Polystyrene Sulfonate Powder, for Suspension with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability and increase the risk of systemic alkalosis 7.3 Sorbitol Sorbitol may contribute to the risk of intestinal necrosis [ see Warnings and… (Sodium polystyrene sulfonate label, Drug interactions)

  • Concurrent use with potassium-containing medications, potassium-sparing diuretics and angiotensin-converting enzyme inhibitors (ACE inhibitors) may result in hyperkalemia and cardiac arrhythmias or cardiac arrest. (Potassium iodide label, Drug interactions)

  • Sacubitril and valsartanangiotensin II receptor blocker (ARB)Moderate

    Potassium-Sparing Diuretics As with other drugs that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium [see Warnings and Precautions (5.5)] . (Sacubitril and valsartan label, Drug interactions)

  • Senna (sennosides)laxativeModerate

    Cation-Donating Antacids The simultaneous oral administration of Sodium Polystyrene Sulfonate Powder, for Suspension with nonabsorbable cation-donating antacids and laxatives may reduce the resin's potassium exchange capability and increase the risk of systemic alkalosis 7.3 Sorbitol Sorbitol may contribute to the risk of intestinal necrosis [ see Warnings and… (Sodium polystyrene sulfonate label, Drug interactions)

  • Sodium bicarbonateantacidModerate

    Cation-Donating Antacids: may reduce the resin’s potassium exchange capability and increase risk of systemic alkalosis ( 7.2 ). (Sodium polystyrene sulfonate label, Drug interactions)

  • Spironolactonealdosterone antagonistModerate

    This risk is increased by impaired renal function or concomitant potassium supplementation, potassium-containing salt substitutes or drugs that increase potassium, such as angiotensin converting enzyme inhibitors and angiotensin receptor blockers [see Drug Interactions ( 7.1 )] . (Spironolactone label, Warnings and precautions)

  • Telmisartanangiotensin II receptor blocker (ARB)Moderate

    Hyperkalemia Hyperkalemia may occur in patients on ARBs, particularly in patients with advanced renal impairment, heart failure, on renal replacement therapy, or on potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes or other drugs that increase potassium levels. (Telmisartan label, Warnings and precautions)

  • Telmisartan and amlodipineangiotensin II receptor blocker (ARB)Moderate

    Hyperkalemia Telmisartan Hyperkalemia may occur in patients on ARBs, particularly in patients with advanced renal impairment, heart failure, on renal replacement therapy, or on potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes or other drugs that increase potassium levels. (Telmisartan and amlodipine label, Warnings and precautions)

  • TenapanorModerate

    Sodium Polystyrene Sulfonate (SPS): Separate administration by at least three hours ( 7.2 ). (Tenapanor label, Drug interactions)

  • TrandolaprilACE inhibitorModerate

    Use of potassium-sparing diuretics (spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes concomitantly with ACE inhibitors can increase the risk of hyperkalemia. (Trandolapril label, Drug interactions)

  • Triamterenepotassium-sparing diureticModerate

    Sodium polystyrene sulfonate may be administered to enhance the excretion of excess potassium. (Triamterene label, Warnings and precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate

    Exchange resins, such as sodium polystyrene sulfonate, whether administered orally or rectally, reduce serum potassium levels by sodium replacement of the potassium; fluid retention may occur in some patients because of the increased sodium intake. (Triamterene and hydrochlorothiazide label, Drug interactions)

  • Valsartanangiotensin II receptor blocker (ARB)Moderate

    Potassium-sparing diuretics, potassium supplements or salt substitutes may lead to increases in serum potassium, and in heart failure patients, increases in serum creatinine ( 7.1 ) (Valsartan label, Drug interactions)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …Serum Potassium: Concomitant use of valsartan with other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart… (Valsartan and hydrochlorothiazide label, Drug interactions)

Minor mentions (5)

  • Interactions Common for Both Benazepril and Hydrochlorothiazide Potassium Supplements and Potassium -Sparing Diuretics: Concomitant use with Lotensin HCT may effect potassium levels. (Benazepril and hydrochlorothiazide label, Drug interactions)

  • Bumetanideloop diureticMinor

    Supplemental potassium and/or spironolactone may prevent hypokalemia and metabolic alkalosis in these patients. (Bumetanide label, Warnings)

  • DobutaminesympathomimeticMinor

    Drug Interactions There was no evidence of drug interactions in clinical studies in which dobutamine was administered concurrently with other drugs, including digitalis preparations, furosemide, spironolactone, lidocaine, glyceryl trinitrate, isosorbide dinitrate, morphine, atropine, heparin, protamine, potassium chloride, folic acid, and acetaminophen. (Dobutamine label, Drug interactions)

  • HyoscyamineanticholinergicMinor

    Drug interactions may occur when anticholinergics are used with the following medications: antacids, antidiarrheals (adsorbent), other anticholinergics, antimyasthenics, cyclopropane, haloperidol, ketoconazole, metoclopramide, opioid (narcotic) analgesics, and potassium chloride. (Hyoscyamine label, Drug interactions)

  • MilrinonePDE3 inhibitorMinor

    …been observed in limited experience with patients in whom milrinone was used concurrently with the following drugs: digitalis glycosides; lidocaine, quinidine; hydralazine, prazosin; isosorbide dinitrate, nitroglycerin; chlorthalidone, furosemide, hydrochlorothiazide, spironolactone; captopril; heparin, warfarin, diazepam, insulin; and potassium supplements. (Milrinone label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.