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Kalexate and Os-Cal 500+D

Determining the interaction of Kalexate and Os-Cal 500+D and the possibility of their joint administration.

Check result:
Kalexate <> Os-Cal 500+D
Relevance: 21.06.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using sodium polystyrene sulfonate together with calcium carbonate. Combining these medications may increase the risk of developing metabolic alkalosis, which is a pH imbalance in the body caused by accumulation of an alkaline substance such as bicarbonate. It may be more likely to occur if you have kidney impairment. Symptoms of metabolic alkalosis may include nausea, vomiting, lightheadedness, tremor, muscle twitching, numbness or tingling, prolonged muscle spasms, slowed breathing, irregular heartbeat, confusion, and stupor. Severe cases may lead to seizure and coma. Do not take any over-the-counter antacids or laxatives without consulting with a healthcare professional first. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Systemic alkalosis has been reported when cation-exchange resins were administered orally in combination with nonabsorbable cation-donating preparations such as antacids or laxatives. The mechanism involves binding of the cation to the resin, which prevents the cation from neutralizing bicarbonate ions in the intestine and also interferes with the resin's potassium exchange capability. This interaction may be more likely and more severe in patients with renal dysfunction. Other serious adverse effects have also been reported. One patient with chronic hypocalcemia of renal failure developed alkalosis and grand mal seizure when given sodium polystyrene sulfonate with magnesium hydroxide as a laxative. Intestinal obstruction due to concretions of aluminum hydroxide has occurred in combination with sodium polystyrene sulfonate and morphine.

MANAGEMENT: Nonabsorbable calcium, magnesium, or aluminum preparations such as antacids or laxatives should not be used in patients receiving oral cation-exchange resins. Alternatively, the interaction may be avoided by administering the resin as an enema.

References
  • Ziessman HA "Alkalosis and seizure due to a cation-exchange resin and magnesium hydroxide." South Med J 69 (1976): 497-9
  • Madias NE, Levey AS "Metabolic alkalosis due to absorption of "nonabsorbable" antacids." Am J Med 74 (1983): 155-8
  • Baluarte HJ, Prebis J, Goldberg M, Gruskin AB "Metabolic alkalosis in an anephric child caused by the combined use of Kayexalate and Basaljel." J Pediatr 92 (1978): 237-9
  • "Product Information. Resonium Calcium (calcium polystyrene sulfonate)." Sanofi-Synthelabo Canada Inc, Markham, ON.
  • "Product Information. Kayexalate (sodium polystyrene sulfonate)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  • Foresti V "Intestinal obstruction due to kayexalate in a patient concurrently treated with aluminum hydroxide and morphine sulfate." Clin Nephrol 41 (1994): 252
Kalexate

Generic Name: sodium polystyrene sulfonate

Brand name: Kalexate, Kayexalate, Kionex

Synonyms: Kalexate Powder

Os-Cal 500+D

Generic Name: calcium / vitamin d

Brand name: Calcitrate, Caltrate 600+D, Os-Cal 500+D, Calcitrate with D, Caltrate 600+D Soft Chews, Citracal + D, Os-Cal Extra D3, Oystercal-D, UpCal D, Os-Cal 250 with D, Oysco D, Dical-D, Calcet, Oyster Shell Calcium with Vitamin D, O-Cal-D, Oyster-D, Oyst-Cal-D, Caltro with Vitamin D, Oysco 500 with D, Oysco D with Calcium, Os-Cal with D, Caltrate 600 with D, Calcarb with D, Posture-D H/P, Dical Captabs, Dicalphos plus D, Os-Cal 500 with D, Caltrate 600 with D Plus Soy, Caltrate Colon Health, Calvite P & D, Sedecal D, Chewable Calcium with Vitamin D, Osteocit D Plus, Os-Cal 500 + D, Citracal Petites, Citracal Creamy Bites, Citracal 250 mg + D, Calcio Del Mar, Citrus Calcium with Vitamin D, Calcium 600+D, Risacal-D, Liquid Calcium with Vitamin D, Citracal Maximum + D, Citracal Calcium + D Slow Release 1200, Citracal Calcium Gummies, Caltrate Gummy Bites, Super Calcium 600 + D3 400, Os-Cal Calcium+D3, Caltrate 600 + D, Citracal Regular, Calcet Petites, Calcium 500+D, D3 with Calcium, Os-Cal 500+Extra D Chewable

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction