Patiromer Mechanism of Action (MOA)

Patiromer sold under the brand name Veltassa, is a medication used to treat hyperkalemia (high levels of potassium in the blood). Patiromer is in a class of medications called potassium removing agents. It works by removing excess potassium from the body. Patiromer is not used for emergency treatment of life-threatening hyperkalemia because it takes some time to work.

How Patiromer works

Patiromer is a novel, spherical, non-absorbed polymer that works by binding free potassium ions in the gastrointestinal tract and releasing calcium ions for exchange, thus lowering the amount of potassium available for absorption into the bloodstream and increasing the amount that is excreted via the feces, it is designed to remove potassium, primarily in the colon, thereby decreasing serum potassium in patients with hyperkalemia.

How long does Patiromer take to work?

Patiromer takes time to work, its potassium lowering effects is noticeable 7 hours after administration. Levels continue to decrease for at least 48 hours if treatment is continued, and remain stable for 24 hours after administration of the last dose. After this, potassium levels start to rise again over a period of at least four days. This explains why it is not used for emergency treatment of life-threatening hyperkalemia.

Patiromer has been found to decrease serum potassium in patients with hyperkalemia having chronic kidney disease who were on renin-angiotensin-aldosterone system inhibitors.

How should this medicine be used?

Patiromer comes as a powder to mix with water and take by mouth. It is usually taken along with food once a day. Take patiromer at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take patiromer exactly as directed. Do not take more or less of it, or take it more often than prescribed by your doctor.

You will need to mix the medication powder with water right before you take it. Do not take the powder before it is mixed with water. Do not mix the powder with any other liquid or food, except for water. To prepare each dose of your medication, pour 1/3 cup (about 3 ounces [90 mL]) of water into a cup. Add the contents of the packet(s) of patiromer into the cup along with half of the water and stir well. (You may need to use more than one packet of patiromer to make up your full dose.) Add the remaining half of the water to the cup and stir well. The powder will not completely dissolve and the mixture will look cloudy. You may need to add more water to the cup if the mixture is too thick. Drink the mixture right away. If any powder is left in the cup after drinking it, add more water, stir, and drink right away. Repeat as needed until there is no more powder left in the cup. Mix the medication with water only when you are ready to take it; do not prepare the mixture in advance. Be sure to ask your pharmacist or doctor if you have any questions about how to mix or take this medication.

Do not try to warm the medication by heating it in a microwave, or adding it to heated foods or liquids. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

What are the side effects of Patiromer?

Common side effects of patiromer include:

  • Constipation
  • Low blood magnesium (hypomagnesemia)
  • Diarrhea
  • Low blood potassium (hypokalemia, less than 3.5 mEq/L)
  • Nausea
  • Abdominal discomfort
  • Gas (flatulence).

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What special dietary instructions should I follow?

Your doctor may tell you to limit the amount of potassium in your diet. Follow these instructions carefully. Talk to your doctor about the amount of potassium-rich foods such as artichokes, avocados, bananas, cantaloupe, grapefruit juice, milk, orange juice, potatoes, prunes, raisins, squash, tomato paste, and tomato juice you may have in your diet.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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