Table 2.

Pharmacodynamics and pharmacokinetics of sodium zirconium cyclosilicate and patiromer

	SZC	Patiromer
Form	Powder for oral suspension: 5 g/sachet 10 g/sachet	Powder for oral suspension: 8.4 g/packet 16.8 g/packet 25.2 g/packet
Dosage	Initial: 10 g PO TID for up to 48 h Maintenance: 5 g to 10 g PO once daily or 5 g every other day	Initial: 8.4 g PO qDay Maintenance: may increase or decrease dose as necessary; not to exceed 25.2 g qDay May be uptitrated upwards at 1 week or longer intervals, in increments of 8.4 g Doses exceeding 50.4 g/day have not been tested; excessive doses may result in hypokalaemia; restore serum potassium if hypokalaemia occurs
Adverse effects	Oedema (6%) Hypokalaemia (4%)	Constipation (7.2%) Hypomagnesaemia (5.3%) Diarrhea (4.8%) Hypokalaemia, <3.5 mEq/L (4.7%) Nausea (2.3%) Abdominal discomfort (2%) Flatulence (2%)
Mechanism of action	Potassium binder and remover Captures and removes potassium from the GI tract Increases faecal potassium excretion	Potassium binder Removal. Binds and removes potassium from the GI tract, particularly the colon Increases faecal potassium excretion
Contraindications/cautions	Avoid with severe constipation or bowel obstruction or impaction, including abnormal post-operative bowel motility disorders Drug interactions: transient increase in gastric pH	Avoid with severe constipation or bowel obstruction or impaction, including abnormal postoperative bowel motility disorders Monitor for hypomagnesemia Patiromer binds many orally administered medications
Limitations	Not to be used as an emergency treatment for life-threatening hyperkalaemia because of its delayed onset of action	Not to be used as an emergency treatment for life-threatening hyperkalaemia because of its delayed onset of action
Absorption	Not systemically absorbed	Not systemically absorbed
Elimination	Excretion: faeces	Excretion: faeces

GI, gastrointestinal; PO, per os (per mouth); qDay, one a day; TID, three times a day.

Data from FDA-approved labelling information.