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patiromer (Veltassa)

Indications: - hyperkalemia (FDA-approved Oct 2015) - useful in patients with chronic renal failure on ACE inhibitors, ARBs or other RAAS Inhibitor (spironolactone) Contraindications: - not appropriate for rapid correction of severe hyperkalemia [2] Adverse effects: - constipation - diarrhea - nausea - abdominal discomfort - flatulence - hypomagnesemia [2] Mechanism of action: - nonabsorbed polymer that binds K+ in the GI tract

General

metabolic agent (metabolic modifier) gastrointestinal agent polymer

References

  1. Weir MR et al Patiromer in Patients with Kidney Disease and Hyperkalemia Receiving RAAS Inhibitors. N Engl J Med. Nov 21, 2014 PMID: 25415805 http://www.nejm.org/doi/full/10.1056/NEJMoa1410853 - Ingelfinger JR A New Era for the Treatment of Hyperkalemia? N Engl J Med. Nov 21, 2014 PMID: 25415806 http://www.nejm.org/doi/full/10.1056/NEJMe1414112
  2. Stiles S FDA Approves Potassium-Binder Patiromer (Veltassa), New Option for Patients on RAAS Inhibitor-Treated Patients Medscape Oncology. October 21, 2015 http://www.medscape.com/viewarticle/853049 - FDA News Release. October 21, 2015 FDA approves new drug to treat hyperkalemia http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm468546.htm
  3. Lou N Patiromer Helps CKD Patients Stay on Spironolactone - Now the question is: Can outcomes can be improved? MedPage Today. September 15, 2019 https://www.medpagetoday.com/cardiology/hypertension/82166 - Agarwal R, Rossignol P, Romero A et al Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): A phase 2, randomised, double-blind, placebo-controlled trial. Lancet 2019. Sept 15 PMID: 31533906 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32135-X/fulltext - Agarwal R, Rossignol P, Garza D et a; Patiromer to Enable Spironolactone Use in the Treatment of Patients with Resistant Hypertension and Chronic Kidney Disease: Rationale and Design of the AMBER Study. Am J Nephrol. 2018;48(3):172-180. PMID: 30176673 Free PMC Article
  4. Di Palo K, Sinnett MJ, Goriacko P Assessment of Patiromer Monotherapy for Hyperkalemia in an Acute Care Setting. JAMA Netw Open. 2022;5(1):e2145236 PMID: 35080601 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788445