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Patiromer acetate is a nonabsorbable cation exchange polymer that has been approved for management of hyperkalaemia
Patiromer acetate
NICE suggest that (3):
It was noted onset of action for patiromer is 4 to 7 hours and patiromer should not replace emergency treatment for life-threatening hyperkalaemia. The NICE committee noted that patiromer could have a role in treating life-threatening hyperkalaemia alongside usual care
In a study to investigate the impact of patiromer on serum potassium level and its ability to enable specified target doses of renin-angiotensin-aldosterone system inhibitor (RAASi) use in patients with heart failure and reduced ejection fraction (HFrEF) it was found that concurrent use of patiromer and high-dose mineralocorticoid receptor antagonist (50mg spironolactone/eplerenone) reduced risk of recurrent hyperkalaemia vs placebo (at median 27 weeks, mean change potassium +0.03 mmol/L vs +0.13 mmol/L; respectively; p<0.001) (4)
The respective Summary of Product Characteristics should be consulted before prescribing this drug.
Reference:
(1) BhattaraiS et al. Patiromer Acetate Induced Hypercalcemia: An Unreported Adverse Effect. Case Rep Nephrol. 2019; 2019: 3507407
(3) NICE (February 2020). Patiromer for treating hyperkalaemia
(4) Butler J et al. Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial, European Heart Journal, 2022;, ehac401,
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