The Basics
What is Sodium Polystyrene Sulfonate?
Used to treat hyperkalemia (increased amounts of potassium in the body).
Brand names for Sodium Polystyrene Sulfonate
Kionex
How Sodium Polystyrene Sulfonate is classified
Cation Exchange Resins, Chelating Agents
Sodium Polystyrene Sulfonate During Pregnancy
Sodium Polystyrene Sulfonate pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Sodium Polystyrene Sulfonate while pregnant
Animal reproduction studies have not been conducted with sodium polystyrene sulfonate. It is also not known whether sodium polystyrene sulfonate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium polystyrene sulfonate should be given to a pregnant woman only if clearly needed.
Taking Sodium Polystyrene Sulfonate While Breastfeeding
What are recommendations for lactation if you're taking Sodium Polystyrene Sulfonate?
Because sodium polystyrene sulfonate is not orally absorbed, it is unlikely to reach the breastmilk or adversely affect the breastfed infant after maternal administration. No special precautions are required. A suspension of sodium polystyrene sulfonate has been added directly to breastmilk to lower the potassium concentration of milk for use in infants with renal impairment. In addition to lowering average potassium content by 65%, the calcium content of breastmilk was reduced by 84%.[1] Infants given either expressed breastmilk, formula or a combination of both had their average serum potassium levels decreased by 24% from 6.3 to 4.8 mEq/L. Serum calcium and creatinine also decreased slightly. The infants had no clinically noticeable side effects.[2] Addition of large amounts of sodium polystyrene sulfonate to artificial formula also lowers the calcium, copper, manganese, phosphorus, sulfur and zinc concentrations; whereas the iron, sodium and sulfur content of formulas are increased.[3] Similar changes might occur with breastmilk.
Maternal / infant drug levels
Because sodium polystyrene sulfonate is not orally absorbed, it is unlikely to reach the breastmilk or adversely affect the breastfed infant after maternal administration. No special precautions are required. A suspension of sodium polystyrene sulfonate has been added directly to breastmilk to lower the potassium concentration of milk for use in infants with renal impairment. In addition to lowering average potassium content by 65%, the calcium content of breastmilk was reduced by 84%.[1] Infants given either expressed breastmilk, formula or a combination of both had their average serum potassium levels decreased by 24% from 6.3 to 4.8 mEq/L. Serum calcium and creatinine also decreased slightly. The infants had no clinically noticeable side effects.[2] Addition of large amounts of sodium polystyrene sulfonate to artificial formula also lowers the calcium, copper, manganese, phosphorus, sulfur and zinc concentrations; whereas the iron, sodium and sulfur content of formulas are increased.[3] Similar changes might occur with breastmilk.
Possible effects of Sodium Polystyrene Sulfonate on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Sodium Polystyrene Sulfonate
Patiromer.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Bonnet L, Goudable J, Accominotti M et al. [Effect of polystyrene sulfonate resins on milk ionic concentration]. Nephrologie. 1997;18:287-9. PMID: 9496569
2. Thompson K, Flynn J, Okamura D et al. Pretreatment of formula or expressed breast milk with sodium polystyrene sulfonate (Kayexalate(R)) as a treatment for hyperkalemia in infants with acute or chronic renal insufficiency. J Ren Nutr. 2013;23:333-9. PMID: 23707305
3. Taylor JM, Oladitan L, Carlson S et al. Renal formulas pretreated with medications alters the nutrient profile. Pediatr Nephrol. 2015;30:1815-23. PMID: 25930981
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.