Consumer medicine information

What is in this leaflet

This leaflet answers some common questions about Span-K. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking Span-K against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine.

You may need to read it again.

What Span-K is used for

Span-K tablets are used to provide extra potassium for people who have lost potassium from their bodies because of illness or treatment with certain medicines. Span-K is also used for people who do not have enough potassium in their regular diet or cannot replace the potassium they have lost from their diet alone.

Potassium is essential for life and health. Vegetables, potatoes and fruit are good sources of dietary potassium.

Too much potassium can be harmful. That is why it is important to take Span-K only as prescribed by your doctor.

The dose of Span-K may need to be adjusted if your diet is rich in natural sources of potassium. However, never change your dose without first checking with your doctor.

Ask your doctor if you have any questions about why Span-K has been prescribed for you.

Your doctor may have prescribed it for another purpose.

Before you take Span-K

When you must not take it

Do not take Span-K and talk to your doctor or pharmacist if:

1. You have an allergy to it or to any of the ingredients listed at the end of this leaflet.

Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips or tongue; skin rash, itching or hives.

2. You have any of the following medical conditions:

• Severe burns or other serious injury
• Kidney failure
• Significant dehydration
• Blockage in food passage, stomach or gut
• Untreated Addison's Disease - a disease where the adrenal glands don't work properly

Talk to your doctor or pharmacist if you are not sure whether any of these medical conditions apply to you.

Do not take this medicine after the expiry date (EXP) printed on the pack or if the packaging is torn or shows signs of tampering.

If you take this medicine after the expiry date has passed, it may not work as well.

If you are not sure whether you should start taking this medicine, talk to your doctor or pharmacist.

Before you start to take it

Tell your doctor if you are allergic to any other medicines, foods, preservatives or dyes.

Tell your doctor is you have or have had any other medical conditions, in particular:

• Any problems with your kidneys or adrenal glands
• Cirrhosis of the liver
• Heart disease
• Peptic ulcer or other problems with your stomach or gut, or with swallowing or digestion

Also tell your doctor if you are on any type of special diet and in particular, if you use salt substitutes on your food.

Salt substitutes containing potassium should be avoided when taking Span-K.

Tell your doctor if you are pregnant or plan to become pregnant.

The possibility of side effects can be increased during pregnancy.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Span-K passes into breast milk.

Your doctor will discuss the risks and benefits of you taking Span-K when breastfeeding.

If you have not told your doctor about any of the above, tell him or her before you start taking Span-K.

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Span-K may interfere with each other. These include:

• Some types of fluid tablets, also known as "diuretics", e.g. spironolactone, triamterene or amiloride
• Certain types of heart medicines, known as ACE-inhibitors
• Cyclosporin, a medicine that acts on the immune system, e.g. after a transplant or for the treatment of severe skin disease or arthritis
• Other medicines that contain potassium, including some types of penicillin
• Any medicine that acts on the stomach or gut to slow down the passage of food

These medicines may be affected by Span-K or may affect how well it works. You may need to take different amounts of your medicines, or you may need to take different medicines. Your doctor or pharmacist will advise you.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Span-K.

Talk to your doctor or pharmacist if you have any questions.

How to take Span-K

Follow all directions given to you by your doctor or pharmacist carefully.

They may differ from the information contained in this leaflet.

If you do not understand the instructions on the label, ask your doctor or pharmacist for help.

How much to take

Your doctor will tell you how much Span-K to take. Do not take more than your doctor tells you to.

The amount of Span-K you need will depend on your condition. The usual dose is 1 or 2 tablets taken 2-3 times a day, i.e. from 2 to 6 tablets each day. However, you may need only 1 or 2 tablets each day if you are also taking a diuretic (fluid tablet).

When to take it

Take Span-K at meal times.

Taking it with food will reduce the chance of you having a side effect.

How to take it

Swallow the tablets whole with a full glass of water. Do not crush or chew the tablets.

How long to take it

Continue taking Span-K until your doctor tells you to stop.

Your doctor may need to check the potassium levels in your blood to help decide when you should stop taking Span-K.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Do not take a double dose to make up for the dose that you missed.

This may increase the chance of you getting an unwanted side effect.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Span-K. Do this even if there are no signs of discomfort or poisoning.

You may need urgent medical attention.

If you take too much Span-K you may feel very weak and your heart beat may be slow and irregular.

While you are taking Span-K

Things you must do

Stop taking Span-K and contact your doctor if you have severe vomiting or gut pain, a lot of wind or blackened stools.

Although rare, potassium supplements such as Span-K have been known to cause stomach or gut ulcers.

Tell your doctor if you become pregnant while taking Span-K.

Your doctor can discuss with you the risks and benefits of taking it during pregnancy.

Tell any other doctors, dentists, and pharmacists who treat you that you are taking this medicine.

Remind your doctor and pharmacist that you are taking Span-K if you are about to be started on any new medicine.

Keep all of your doctor's appointments so that your progress can be checked.

Your doctor may do tests such as blood counts from time to time to make sure the medicine is working and to prevent unwanted side effects.

Things you must not do

Do not take Span-K to treat any other complaints unless your doctor tells you to. Do not stop taking your medicine or increase the dose even if you think the medicine is not working.

Do not start taking salt substitutes without first discussing this with your doctor or pharmacist.

It may be necessary to avoid salt substitutes containing potassium when taking Span-K. Your doctor or pharmacist can advise you.

Do not give your medicine to anyone else, even if they have the same symptoms or condition as you.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Span-K.

This medicine helps most people needing a potassium supplement but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Do not be alarmed by the following lists of side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

• Feeling sick (nausea) or being sick (vomiting)
• Diarrhoea or discomfort in your stomach or gut

The above list includes the more common side effects of your medicine. The chance of you getting these side effects can be reduced by taking Span-K at meal times.

Tell your doctor as soon as possible if you experience:

• Muscle weakness
• Slow, irregular heart beat

These side effects may mean that you are getting too much potassium and you may need medical attention. These side effects are rare.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

• severe vomiting or gut pain
• a lot of wind or blackened stools

The above list includes very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are also rare.

Tell your doctor or pharmacist if you notice anything else that is making you feel unwell.

Other side effects not listed above may also occur in some people.

After using Span-K

Storage

Keep your tablets in the bottle until it is time to take them.

If you take the tablets out of the bottle they may not keep well.

Keep your tablets in a cool dry place where the temperature stays below 30 °C. Do not expose them to direct sunlight.

Do not store Span-K or any other medicine in the bathroom or near a sink. Do not leave it on a window sill or in the car.

Heat and dampness can destroy some medicines.

Keep Span-K tablets where children cannot reach them.

A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.

Product description

What it looks like

Span-K tablets are round, white and sugar-coated. There are 200 tablets in each bottle.

Ingredients

Each Span-K tablet contains 600 mg of potassium chloride. It also contains:

• stearic acid
• macrogol 6000
• ethylcellulose
• cocoa powder
• sucrose
• gelatin
• calcium carbonate
• magnesium stearate
• purified talc
• sodium benzoate
• potassium sorbate
• titanium dioxide
• povidone
• hydrogenated castor oil
• PVP/VA copolymer

Supplier

Span-K is supplied in Australia by:
Aspen Pharmacare Australia Pty Ltd
34-36 Chandos St
St Leonards NSW 2065

Australian Registration Number

AUST R 27978

This leaflet was prepared in August 2008

® Span-K is a registered trademark

Name of the medicine

Potassium chloride 600 mg (≡ potassium 8 mmol, chloride 8 mmol).

Actions

Sustained release potassium chloride supplement. The tablets consist of potassium chloride crystals partially coated with an inert, insoluble wax, then pressed into a wax matrix. The whole is then sugar coated (not enteric). The tablet does not disintegrate. The potassium chloride gradually leaches through the wax. The sustained release of the therapeutically correct formula, with no enteric association, provides conditions of maximum gastric tolerance and effective absorption for the treatment of all types of potassium deficiency, whether hypochloraemic or hypokalaemic alkalosis. Span-K does not alter normal kidney function; can be used in all age groups; replaces the essential chloride anion and potassium, and so prevents hypochloraemic alkalosis.

Indications

Treatment of all types of potassium deficiencies, particularly hypochloraemic or hypokalaemic alkalosis, associated with prolonged or intensive diuretic therapy, e.g. in hypertension, cardiac failure or massive oedema (potassium replacement is particularly important to patients receiving digitalis, as the clinical response to this drug is seriously affected by hypokalaemia), in renal disease associated with increased potassium excretion, e.g. nephrotic syndrome; vomiting and diarrhoea, ulcerative colitis, steatorrhoea, diabetes insipidus and uncontrolled diabetes mellitus; ileostomy or colostomy patients, cirrhosis; Cushing's syndrome and dietary insufficiency; during prolonged or intensive treatment with corticosteroids, ACTH or carbenoxolone; hyperaldosteronism in megaloblastic anaemia, during the early stages of treatment. Here Span-K is indicated if a diet rich in potassium cannot be guaranteed.

Contraindications

Severe tissue destruction, including burns; advanced renal failure, untreated Addison's disease, acute dehydration, hyperkalaemia; in the presence of obstruction in the digestive tract (e.g. resulting from compression of the oesophagus due to dilatation of the left atrium or from stenosis of the gut); history of allergic reaction to Span-K or any of the ingredients in the tablets.

Warnings

If the patient develops severe vomiting, severe abdominal pains, flatulence or gastrointestinal haemorrhage, the preparation must be withdrawn at once. To prevent the risk of hyperkalaemia, potassium supplements should not be administered with potassium sparing diuretic agents such as spironolactone, triamterene or amiloride. In cases of metabolic acidosis, hypokalaemia should not be treated with potassium chloride, but with a potassium salt containing an alkalinising anion (e.g. potassium bicarbonate). Span-K should not be used in patients with hyperchloraemia.

Precautions

Excessive use of Span-K may lead to accumulation of potassium especially in patients with renal insufficiency. Caution is required in cases of chronic renal disease, adrenocortical insufficiency or hepatic cirrhosis because of the risk of hyperkalaemia. Considerable care is required in patients with cardiac disease. Regular monitoring of clinical status, serum electrolytes and electrocardiogram (ECG) is advisable in patients receiving potassium therapy, particularly with large doses given for protracted periods and in those with cardiac or renal impairment.
Care is required if Span-K is given to patients in whom passage through the gastrointestinal tract may be delayed or when given to patients with a history of peptic ulcer.

Use in pregnancy.

Use in lactation.

Interactions

Span-K should be used with caution, if at all, in patients receiving drugs that increase serum potassium concentrations. These include potassium sparing diuretics (see Warnings), angiotensin converting enzyme (ACE) inhibitors, cyclosporin and drugs that contain potassium such as the potassium salts of penicillin. The concomitant use of potassium containing salt substitutes for flavouring food should be avoided. Antimuscarinics delay gastric emptying and may increase the risk of gastrointestinal adverse effects in patients taking Span-K.

Adverse Effects

Oral potassium preparations can provoke gastrointestinal disturbances (e.g. nausea, vomiting, abdominal pain, diarrhoea). Span-K may also cause these side effects, particularly when not taken with food or if passage through the gastrointestinal tract is delayed. Should this occur, reduction in dosage or withdrawal of the drug may be necessary. Though rare, gastrointestinal ulceration has occurred after the use of sustained release oral potassium supplements. Span-K should be discontinued immediately if the patient reports severe vomiting, severe abdominal pain, flatulence or gastrointestinal haemorrhage (see Warnings).
Hyperkalaemia adverse effects are rare with oral dosage forms of potassium, such as Span-K, in patients with normal renal function. When present, severe muscle weakness and a slow irregular heart beat are the most common symptoms.

Dosage and Administration

An average dose is 1 or 2 tablets two or three times daily, each tablet swallowed whole with a little water, preferably during meals. Where Span-K is given routinely with an average daily maintenance dose of an oral diuretic, 1 or 2 tablets daily may be sufficient.

Presentation

Slow release tablets, 600 mg (white): 100's, 200's (200's not currently marketed in Australia).

Poison Schedule

S4.