Calimet, 5 g 21 pcs.

Hyperkalemia caused by acute or chronic renal failure.

Active ingredient

Calcium polystyrene sulfonate

Interaction

Co-administration of the drug with sorbitol is not recommended, since cases of intestinal necrosis have been reported with such use.

Cation-exchange drugs may reduce the efficiency of binding of potassium ions by the drug Kalimeit. When co-administration of cation-exchange resins and cation-containing antacids and laxatives (magnesium hydroxide, aluminum hydroxide, calcium carbonate, etc.) systemic alkalosis and formation of aluminum hydroxide concretions may develop.

When coadministered with digitalis preparations (e.g. digoxin), in case of hypokalemia and/or hypercalcemia the toxic effect of digitalis preparations on the heart may increase, especially the occurrence of ventricular arrhythmias and atrioventricular node suppression.

When used concomitantly with lithium preparations the absorption of lithium may be decreased. When coadministration with thyroxine, absorption of thyroxine may decrease. Calcium polystyrene sulfonate may impair absorption of fat-soluble vitamins.

Directions for use

Adult patients

Standard daily dose is 15-30 g, which should be divided into 2-3 doses. The drug is diluted in a small amount of water (30-50 ml) or 3-4 ml of sweet food or liquid (except for juices rich in potassium – orange, pineapple, grape, tomato) per 1 g of powder.

If necessary, the prepared suspension may be administered using a 2-3 mm gastric tube. When preparing the suspension it is necessary to avoid inhalation of the drug due to the risk of acute bronchitis (see section “Side effects”).

The above dose is an average and may be individually adjusted depending on the electrolyte levels of the particular patient. Calcium polystyrene sulfonate should be discontinued when potassium levels fall below 5 mmol/l.

Elderly patients (over 65 years)

Since elderly patients often have decreased activity of physiological processes, when prescribing calcium polystyrene sulfonate to elderly patients it is recommended to perform closer medical supervision and use smaller doses of the drug.

Special Instructions

Cases of intestinal obstruction and intestinal perforation have been reported with sodium and calcium polystyrene sulfonates. In case of such phenomena as severe constipation, prolonged abdominal pain, vomiting, it is necessary to stop using the drug and take appropriate therapeutic measures.

Contraindications

1) Intestinal obstruction;
2) Hypersensitivity to polystyrene sulfonate in history;
3) Conditions accompanied by hypercalcemia (e.g., hyperparathyroidism, multiple myeloma, sarcoidosis, metastatic carcinoma);
4) Plasma potassium levels below 5 mmol/L;
5) Kalimeit is not recommended for use in children under 18 years of age due to insufficient efficacy and safety data;
6) Concomitant use with sorbitol.

With caution:
1) In patients with constipation (risk of bowel obstruction or perforation);
2) In patients with bowel stenosis (possible bowel obstruction or perforation);
3) In patients with gastrointestinal ulcers (possible exacerbation of symptoms).

Side effects

The frequency of side effects is according to the indicator classification recommended by the World Health Organization (WHO): Very common: >1/10; Frequent: 1/100; Infrequent: 1/1000; Rare: 1/10000; Very rare:

Overdose

Biochemical disorders in overdose may cause clinical manifestation of symptoms of hypokalemia (irritability, confusion, slow thinking, muscle weakness, hyporeflexia, paralysis).

With the progression of the condition respiratory arrest may develop. Electrocardiographic changes may correspond to those characteristic of hypokalemia or hypercalcemia; arrhythmias may develop. Adequate measures should be taken to correct plasma electrolyte levels and to remove the drug from the digestive tract with laxatives and enemas.

Pregnancy use

No special safety studies of calcium polystyrene sulfonate in pregnancy have been conducted.