Drug updated on 6/10/2024

Dosage FormSuspension (oral; 8.4 g, 16.8 g, 25.2 g)
Drug ClassPotassium binders
Ongoing and
Completed Studies


  • Indicated for the treatment of hyperkalemia in adults and pediatric patients ages 12 years and older.

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  • Patiromer (Veltassa) is indicated for the treatment of hyperkalemia in adults and pediatric patients ages 12 years and older. It has demonstrated efficacy in reducing the risk of hyperkalemia, especially among individuals with heart failure and chronic kidney disease.
  • Twelve studies were reviewed to compile information about patiromer's effectiveness against hyperkalemia.
  • Compared to other potassium binders such as sodium zirconium cyclosilicate (SZC), sodium polystyrene sulfonate (SPS), and calcium polystyrene sulfonate (CPS), patiromer often presented a more favorable safety profile. Nevertheless, there is a necessity for vigilant monitoring due to an increased risk of hypokalemia in some populations.
  • Besides managing hyperkalemia, patiromer has also shown potential benefits in controlling high phosphorus levels or 'hyperphosphatemia' in individuals with chronic kidney disease, suggesting it could serve a dual therapeutic role advantageous for managing CKD complications.
  • For individuals with heart failure, patiromer effectively ameliorated instances of high potassium levels, which supported the optimization of renin–angiotensin–aldosterone system inhibitors therapy—a crucial aspect of managing heart failure conditions—thus enhancing overall patient outcomes.
  • Patiromer proved effective across various stages of Chronic Kidney Disease, particularly in those receiving RAAS inhibitor therapy, according to subgroup analysis results within these studies.
  • When compared with other treatments like SZC or traditional potassium binders SPS/CPS, both patiromer and SZC are notable not only for reducing serum potassium levels but also for potentially being safer for long-term management. However, the choice between them might depend on factors including the risks associated with low potassium levels and gastrointestinal tolerability.
  • Patiromer provides a viable alternative with a possibly better safety profile, but its use should be individualized with consideration given to the potential for hypokalemia and gastrointestinal side effects.

Product Monograph / Prescribing Information

Document TitleYearSource
Veltassa (patiromer) Prescribing Information.2023CSL Vifor, Flughofstrasse, Glattbrugg, Switzerland

Systematic Reviews / Meta-Analyses

Document TitleYearSource
The efficacy and safety of new potassium binders on renin-angiotensin-aldosterone system inhibitor optimization in heart failure patients: a systematic review and meta-analysis.2024ESC Heart Failure
Efficacy and safety of patiromer for chronic hyperkalemia: a systematic review and meta-analysis of randomized controlled trials.2023American Journal of Therapeutics
Novel potassium binders to optimize RAASi therapy in heart failure: a systematic review and meta-analysis.2023European Journal of Internal Medicine
The efficacy and safety of patiromer for heart failure patients: a systematic review and meta-analysis.2023Cardiovascular Drugs and Therapy
Patiromer treatment in patients with CKD, hyperkalemia, and hyperphosphatemia: a post hoc analysis of 3 clinical trials.2023American Journal of Kidney Diseases
Safety and efficacy of new potassium binders on hyperkalemia management in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials.2023Clinical Research in Cardiology
Safety and efficacy of patiromer in hyperkalemic patients with CKD: a pooled analysis of three randomized trials.2022Kidney360
Efficacy and safety of potassium binders in the treatment of patients with chronic kidney disease and hyperkalemia.2022European Journal of Pharmacology
Optimization of RAASi therapy with new potassium binders for patients with heart failure and hyperkalemia: rapid review and meta-analysis.2021Journal of Clinical Medicine
Binding potassium to improve treatment with renin-angiotensin-aldosterone system inhibitors: results from multiple one-stage pairwise and network meta-analyses of clinical trials.2021Frontiers in Medicine
Patiromer and sodium zirconium cyclosilicate in treatment of hyperkalemia: a systematic review and meta-analysis.2021Current Therapeutic Research, Clinical and Experimental
Potassium binders for chronic hyperkalaemia in people with chronic kidney disease.2020The Cochrane Database of Systematic Reviews
Effect of patiromer on serum potassium in hyperkalemic patients with heart failure: pooled analysis of 3 randomized trials.2020Progress in Cardiovascular Diseases
Efficacy and safety of the pharmacotherapy used in the management of hyperkalemia: a systematic review.2019Pharmacy Practice

Clinical Practice Guidelines

Document TitleYearSource
Clinical Practice Guidelines: treatment of acute hyperkalaemia in adults.2020The Renal Association