Veltassa (patiromer)

Veltassa is indicated for the treatment of hyperkalemia, or high levels of potassium. High levels of potassium usually are caused by kidney or adrenal gland malfunctions and may cause symptoms such as 

• Nausea
• Fatigue
• Weakness
• Slow heartbeat

Veltassa works in the colon by binding with potassium from your food and preventing your body from absorbing it.

• Veltassa should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action
• Veltassa is contraindicated in patients with a history of a hypersensitivity reaction to Veltassa or any of its components
• Because Veltassa is not absorbed into the bloodstream, doctors consider it low-risk for pregnant women and nursing mothers.

Worsening of Gastrointestinal Motility

Avoid use of Veltassa in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders, because Veltassa may be ineffective and may worsen gastrointestinal conditions.

Patients with a history of bowel obstruction or major gastrointestinal surgery, severe gastrointestinal disorders, or swallowing disorders were not included in the clinical studies.

Hypomagnesemia

Veltassa binds to magnesium in the colon, which can lead to hypomagnesemia. In clinical studies, hypomagnesemia was reported as an adverse reaction in 5.3% of patients treated with Veltassa. Monitor serum magnesium.

Consider magnesium supplementation in patients who develop low serum magnesium levels on Veltassa.

During the clinical studies, the most commonly reported adverse reactions leading to discontinuation of Veltassa were gastrointestinal adverse reactions (2.7%), including

• vomiting (0.8%),
• diarrhea (0.6%),
• constipation (0.5%) and
• flatulence (0.5%).

Mild to moderate hypersensitivity reactions were reported in 0.3% of patients treated with Veltassa in clinical trials. Reactions have included edema of the lips.

Administer Veltassa at least 3 hours before or 3 hours after other oral medications

Do not heat Veltassa (e.g., microwave) or add to heated foods or liquids. Do not take Veltassa in its dry form.

• Measure 1/3 cup of water.
• Pour half of the water into a glass, then add Veltassa and stir.
• Add the remaining half of the water and stir thoroughly.
• The powder will not dissolve and the mixture will look cloudy.
• Add more water to the mixture as needed for desired consistency.
• Drink the 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.

The recommended starting dose of Veltassa is 8.4 grams patiromer once daily. Monitor serum potassium and adjust the dose of Veltassa based on the serum potassium level and the desired target range.

The dose may be increased or decreased, as necessary, to reach the desired serum potassium concentration, up to a maximum dose of 25.2 grams once daily. The dose can be up-titrated based on serum potassium level at 1-week or longer intervals, in increments of 8.4 grams.

In clinical studies, Veltassa decreased systemic exposure of some coadministered oral medications. Binding of Veltassa to other oral medications could cause decreased gastrointestinal absorption and loss of efficacy when taken close to the time Veltassa is administered.

Administer other oral medications at least 3 hours before or 3 hours after Veltassa.

• Veltassa is not absorbed systemically following oral administration and maternal use is not expected to result in fetal risk.
• Veltassa is not absorbed systemically by the mother, so breastfeeding is not expected to result in risk to the infant.