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Generic name: patiromer systemic

Brand names: Veltassa

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Packet, Oral:

Veltassa: 8.4 g (1 ea, 4 ea, 30 ea); 16.8 g (1 ea, 30 ea); 25.2 g (1 ea, 30 ea)


Mechanism of Action

Patiromer, a non-absorbed, cation exchange polymer that contains a calcium-sorbitol counterion, increases fecal potassium excretion through binding of potassium in the lumen of the gastrointestinal tract, resulting in a reduction of serum potassium levels.



Not systemically absorbed


Feces (unchanged)

Onset of Action

7 hours (Bushinsky 2015)

Duration of Action

24 hours (Bushinsky 2015)

Use: Labeled Indications

Hyperkalemia: Treatment of hyperkalemia

Limitations of use: Patiromer should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.


Hypersensitivity to patiromer or any component of the formulation

Dosage and Administration

Dosing: Adult

Hyperkalemia: Oral: Initial: 8.4 g once daily; adjust dose at ≥1-week intervals in increments of 8.4 g (maximum dose: 25.2 g/day)

Dosing: Geriatric

Refer to adult dosing.


Immediately prior to administration, measure 1/3 cup of water and pour half into an empty glass; empty entire contents of the packet(s) into the glass and stir. Add the remaining water to the mixture; stir thoroughly (powder will not dissolve and the mixture will look cloudy). Add more water as needed for desired consistency.


Administer without regard to food. Do not administer patiromer in its dry form. Following reconstitution, drink mixture immediately. If powder remains in the glass after drinking, add more water, stir, and drink immediately; repeat as needed to ensure the entire dose is administered. Do not heat patiromer (eg, microwave) or add to heated foods or liquids. Administer other oral medications at least 3 hours before or 3 hours after patiromer.


Store at 2°C to 8°C (36°F to 46°F). If stored at room temperature (25°C ± 2°C [77°F ± 4°F]), use within 3 months of being taken out of the refrigerator. Avoid exposure to excessive heat above 40°C (104°F).

Drug Interactions

Ciprofloxacin (Systemic): Patiromer may decrease the serum concentration of Ciprofloxacin (Systemic). Management: Administer oral ciprofloxacin at least 3 hours before or 3 hours after patiromer. Consider therapy modification

Levothyroxine: Patiromer may decrease the serum concentration of Levothyroxine. Management: Administer oral levothyroxine at least 3 hours before or 3 hours after patiromer. Consider therapy modification

MetFORMIN: Patiromer may decrease the serum concentration of MetFORMIN. Management: Administer metformin at least 3 hours before or 3 hours after patiromer. Consider therapy modification

Adverse Reactions

1% to 10%:

Endocrine & metabolic: Hypomagnesemia (5% to 9%), hypokalemia (5%)

Gastrointestinal: Constipation (7%; transient), diarrhea (5%), abdominal distress (2%), flatulence (2%), nausea (2%)

<1%, postmarketing, and/or case reports: Hypersensitivity reaction (including lip edema)


Concerns related to adverse effects:

  • GI effects: Avoid use in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders; patiromer may be ineffective and may worsen GI conditions.
  • Hypomagnesemia: Patiromer binds to magnesium in the colon, which can lead to hypomagnesemia. Monitor serum magnesium and consider magnesium supplementation if hypomagnesemia develops.

Special populations:

  • Elderly: May experience more gastrointestinal adverse reactions.

Monitoring Parameters

Serum potassium and magnesium.


Pregnancy Considerations

Patiromer is not absorbed systemically following oral administration. Use during pregnancy is not expected to result in significant exposure to the fetus.

Patient Education

What is this drug used for?

  • It is used to treat high potassium levels.

Frequently reported side effects of this drug

  • Constipation
  • Diarrhea
  • Nausea
  • Abdominal pain
  • Passing gas

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

  • Low magnesium like mood changes, muscle pain or weakness, muscle cramps or spasms, seizures, tremors, lack of appetite, severe nausea or vomiting, an abnormal heartbeat
  • Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Source: Wolters Kluwer Health. Last updated January 7, 2020.