Citric acid bladder mixture vs Calcium Polystyrene Sulfonate

Interacting Drugs
Citric acid bladder mixture
vs
Calcium Polystyrene Sulfonate
Security Level
Moderate, Consider therapy modification
Mechanism
Calcium Polystyrene Sulfonate: Antacids may enhance the adverse/toxic effect of Calcium Polystyrene Sulfonate. The combined use of these two agents may result in metabolic alkalosis and/or loss of efficacy of the cation exchange resin.
Management
To minimize this interaction, consider: a)separating doses by 2 or more hours; b)rectal administration of the exchange resin; or c)alternatives to antacids. Monitor for metabolic alkalosis and attenuation of CPS effects. Avoid magnesium hydroxide.

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