When This Medicine Should Not Be Used:
You or your child should not use this medicine if you have had an allergic reaction to sodium polystyrene sulfonate, or if you have blocked bowels or low potassium in your blood. This medicine should not be given to newborn infants who have reduced or slow bowel movements.

How to Use This Medicine:
Enema, Liquid

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• A nurse or other trained health professional will give you the Kayexalate® brand of this medicine as a rectal enema in a hospital.
• Carefully follow your doctor's instructions about any special diet.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using aluminum or magnesium-containing antacids or laxatives, such as aluminum carbonate, aluminum hydroxide, magnesium hydroxide, milk of magnesia, Basalgel®, Gaviscon®, Maalox®, or Rolaids®. Tell your doctor if you are also using digoxin (Digitek®, Lanoxin®), digitoxin, lithium (Eskalith®, Lithobid®), sorbitol, or thyroxine (Levoxyl®, Synthroid®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you or your child have heart rhythm problems (such as arrhythmia, QT prolongation), congestive heart failure, high blood pressure, severe swelling or bloating, kidney disease, low calcium in the blood, low magnesium in the blood, or stomach or bowel problems (such as bleeding, constipation, perforation). Tell your doctor if you are on a special low-salt (low-sodium) diet.
• Do not use this medicine together with a liquid called sorbitol. Sorbitol is a medicine used for constipation. If the 2 medicines are used together, they may cause a serious stomach or bowel problem called intestinal necrosis. This is more likely to occur if you have a history of bowel disease, bowel surgery, low blood volume, or kidney problems. Tell your doctor right away if you or your child have severe constipation; severe stomach pain; bloody, black, or tarry stools; or vomit blood or a material that looks like coffee grounds.
• Hypokalemia (low potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you or your child have more than one of the following symptoms: confusion, dry mouth, increased thirst, irregular heartbeat, irritability, muscle cramps, nausea or vomiting, or shortness of breath.
• This medicine may cause alkalosis, which is a change in the chemical balance of your blood. This is more likely to occur if you use antacids or laxatives that contain aluminum or magnesium together with this medicine. Tell your doctor right away if you or your child have changes in mental alertness or speech; diarrhea; a fast or slow heartbeat; a lack or loss of strength; mood or mental changes; muscle cramps; overactive reflexes; slurred speech; trouble with speaking; or vomiting.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. Blood tests may be needed to check for unwanted effects.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bloody, black, or tarry stools.
• Chest pain, cough, or shortness of breath.
• Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
• Fast or uneven heartbeat.
• Muscle cramps in your hands, arms, feet, legs, or face.
• Muscle spasms or twitching.
• Seizures.
• Severe constipation or stomach pain.
• Swelling in your hands, ankles, or feet.
• Trouble thinking clearly, or feeling confused or grouchy.
• Unusual weakness.
• Vomiting of blood or material that looks like coffee grounds.

If you notice these less serious side effects, talk with your doctor:

• Mild constipation, diarrhea, loss of appetite, or upset stomach.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088