Patiromer

VELTASSA

What it isNon-absorbed potassium binder exchanging calcium for potassium; hyperkalemia.

Why this oneIt allows RAAS inhibitors to be continued in heart failure and CKD, which is usually the point of using it.

What limits itOnset takes about seven hours, so it is not for emergencies. It binds other drugs — separate by three hours; hypomagnesemia.

FDA label

FDA dosing	Population	Start	Target	Max
Hyperkalemia	Adults	8.4 g QD	titrate by 8.4 g at ≥1-wk intervals	25.2 g QD
Hyperkalemia	Children 12–17 yr	4 g QD	titrate by 4 g at ≥1-wk intervals	25.2 g QD

Titration Adjust at 1-week or longer intervals

Renal No adjustment needed

Hepatic Undefined

Separate from other oral medications by at least 3 hours

Take at least 3 hours before or after other oral medications (unless no clinically important interaction)
Do not heat (e.g., microwave) or add to heated foods/liquids
Do not take in dry form
Mix with water or soft food and drink/consume immediately

Worsening of GI motility — avoid in severe constipation, bowel obstruction, or impaction
Hypomagnesemia — monitor serum magnesium and consider supplementation

Pregnancy Not absorbed systemically; maternal use not expected to result in fetal risk.

Lactation Not absorbed systemically; not expected to result in risk to the infant.

NO BOXED WARNINGS

Principal riskSlow onset; binds other drugs, separate by three hours

Cost, est. cash$5–$500/month

Generic entry2033 est.

Therapeutic safety burden0 / 4

Overdose danger0 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.