BNF for Children (BNFC) 2018-2019

lCONTRA-INDICATIONSHyperparathyroidism.metastatic
carcinoma.multiple myeloma.obstructive bowel disease.
reduced gut motility (in neonates).sarcoidosis

lCAUTIONSImpaction of resin with excessive dosage or
inadequate dilution

lINTERACTIONS→Appendix 1 : polystyrene sulfonate

lSIDE-EFFECTSAppetite decreased.constipation
(discontinue—avoid magnesium-containing laxatives).
diarrhoea.electrolyte imbalance.epigastric discomfort.
gastrointestinal disorders.gastrointestinal necrosis (in
combination with sorbitol).hypercalcaemia (in dialysed
patients and occasionally in those with renal impairment).
increased risk of infection.nausea.vomiting

lPREGNANCYManufacturers advise use only if potential
benefit outweighs risk—no information available.

lBREAST FEEDINGManufacturers advise use only if
potential benefit outweighs risk—no information
available.
lMONITORING REQUIREMENTSMonitor for electrolyte
disturbances (stop if plasma-potassium concentration
below 5 mmol/litre).
lDIRECTIONS FOR ADMINISTRATION
▶With rectal useMix each 1 g of resin with 5 mL of water or
10 % glucose.

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: enema
Powder
CAUTIONARY AND ADVISORY LABELS 13
EXCIPIENTS:May contain Sucrose
▶Calcium Resonium(Sanofi)
Calcium polystyrene sulfonate 999.34 mg per 1 gramCalcium
Resonium powder sugar-free| 300 gramp£ 82. 16

Sodium polystyrene sulfonate

lINDICATIONS AND DOSE

Hyperkalaemia associated with anuria or severe oliguria,

and in dialysis patients

▶BY MOUTH

▶Child: 0. 5 – 1 g/kg daily in divided doses; maximum 60 g

per day

▶BY RECTUM

▶Neonate: 0. 5 – 1 g/kg daily, irrigate colon to remove resin

after 8 – 12 hours.

▶Child: 0. 5 – 1 g/kg daily, irrigate colon to remove resin

after 8 – 12 hours; maximum 30 g per day

lCONTRA-INDICATIONSObstructive bowel disease.reduced
gut motility (in neonates)

lCAUTIONSCongestive heart failure.hypertension.
impaction of resin with excessive dosage or inadequate
dilution.oedema

lINTERACTIONS→Appendix 1 : polystyrene sulfonate

lSIDE-EFFECTSAppetite decreased.bezoar.constipation
(discontinue—avoid magnesium-containing laxatives).
diarrhoea.electrolyte imbalance.epigastric discomfort.
gastrointestinal disorders.increased risk of infection.
nausea.necrosis (in combination with sorbitol).vomiting
lPREGNANCYManufacturers advise use only if potential
benefit outweighs risk—no information available.

lBREAST FEEDINGManufacturers advise use only if
potential benefit outweighs risk—no information
available.

lRENAL IMPAIRMENTUse with caution.

lMONITORING REQUIREMENTSMonitor for electrolyte

disturbances (stop if plasma-potassium concentration

below 5 mmol/litre).

lDIRECTIONS FOR ADMINISTRATION

▶With rectal useMix each 1 g of resin with 5 mL of water or

10 % glucose.

▶With oral useAdminister dose (powder) in a small amount

of water or honey—do not give with fruit juice or squash,

which have a high potassium content.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug. Forms available from special-order

manufacturers include: oral suspension

Powder

CAUTIONARY AND ADVISORY LABELS 13

▶Resonium A(Sanofi)

Sodium polystyrene sulfonate 999.34 mg per 1 gramResonium A

powder sugar-free| 454 gramp£ 81. 11

2.5bHypokalaemia

ELECTROLYTES AND MINERALS›POTASSIUM

Potassium bicarbonate with

potassium acid tartrate

lINDICATIONS AND DOSE

Hyperchloraemic acidosis associated with potassium

deficiency (as in some renal tubular and gastro-

intestinal disorders)

▶BY MOUTH

▶Child:(consult product literature)

lCONTRA-INDICATIONSHypochloraemia.plasma-

potassium concentration above 5 mmol/litre

lCAUTIONSCardiac disease

lSIDE-EFFECTSAbdominal pain.diarrhoea.flatulence.

nausea.vomiting

lRENAL IMPAIRMENTAvoid in severe impairment.

MonitoringClose monitoring required in renal

impairment—high risk of hyperkalaemia.

lDIRECTIONS FOR ADMINISTRATIONTo be dissolved in

water before administration.

lPRESCRIBING AND DISPENSING INFORMATIONThese

tablets do not contain chloride.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Effervescent tablet

CAUTIONARY AND ADVISORY LABELS13, 21

▶Potassium bicarbonate with potassium acid tartrate (Non-

proprietary)

Potassium acid tartrate 300 mg, Potassium bicarbonate

500 mgPotassium (potassium 6. 5 mmol) effervescent tablets BPC

1968 | 56 tabletG£ 77. 77 – £ 93. 33 DT = £ 88. 15

Potassium chloride

lINDICATIONS AND DOSE

Prevention of hypokalaemia (patients with normal diet)

▶BY MOUTH

▶Child: 1 – 2 mmol/kg daily; Usual maximum 50 mmol

Electrolyte imbalance

▶BY INTRAVENOUS INFUSION

▶Neonate: 1 – 2 mmol/kg daily, dose dependent on deficit

or the daily maintenance requirements.

continued→

BNFC 2018 – 2019 Hypokalaemia 601

Blood and nutrition

9