National Institute for Health and Care Excellence (NICE) has recommended patiromer (Veltassa) as a treatment option for hyperkalaemia.
Patiromer is recommended for the treatment of hyperkalaemia in adults:
- In emergency management of acute life-threatening hyperkalaemia along with standard care.
- For those with persistent hyperkalaemia and stages 3b-5 chronic kidney disease or heart failure, if:
- serum potassium level is at least 6.0 mmol/L;
- renin-angiotensin-aldosterone system (RAAS) inhibitor is not being taken or is taken at a lower dose because of hyperkalaemia; and
- not on dialysis.
Recommended starting dose for patiromer is 8.4 g once a day orally (maximum, 25.2 g). The dose can be titrated after at least one week based on serum potassium levels. If serum potassium falls below the desired range, the dose should be decreased or the therapy should be stopped.
Evidence from clinical trials have shown patiromer to lower serum potassium; however, there is no evidence that it improves quality of life or extends life. Patiromer may allow patients to remain on RAAS inhibitors for a longer time or at a higher dose.
The recommendations should not affect patients whose treatment with the drug was started before the publication of the guidance.