The potassium binder Veltassa (patiromer), approved by the FDA in October 2015 for the treatment of hyperkalemia, is now available via prescription.

Patients prescribed Veltassa will receive the medication via mail order directly from specialty pharmacies managed by ACS (affiliated with CVS) or Walgreens. The medication is also available in hospitals through authorized distributors.

Patiromer is in powder form and needs to be mixed with a total of 3 ounces of water before being taken with food. Before use, the medication should be stored in the refrigerator at 36°F to 46°F.

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The drug comes with a boxed warning that patiromer binds to many other oral medications, which could decrease their absorption or effectiveness. Instruct patients to take other oral medication 6 hours before or after taking patiromer. 

The drug binds potassium in exchange for calcium, mainly in the colon, and allows potassium to be excreted normally. No special dosing adjustments are needed for patients with renal impairment.

Due to its delayed onset of action, patiromer should not be used as an emergency treatment for life-threatening hyperkalemia.

Certain patients should avoid the medication, including those with severe constipation, bowel obstruction or impaction, including post-operative bowel motility disorders, as patiromer may worsen gastrointestinal conditions.

Among the adverse reactions, 9% of patients in clinical trials developed hypomagnesemia with a serum magnesium value less than 1.4 mg/dL. Clinicians need to check the magnesium levels in patients’ blood during treatment and may consider prescribing a magnesium supplement. Other common side effects include constipation, diarrhea, nausea, abdominal discomfort and flatulence.

Veltassa is manufactured by Relypsa Inc. located in Redwood City, Calif. Visit for more information.