Patiromer (Veltassa)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Hyperkalemia, which means too much potassium in the blood, in adults and in children ages 12 and older.

What it is for, in depth

Veltassa (patiromer) is prescribed to treat hyperkalemia — potassium in the blood that is higher than it should be — in adults and in patients ages 12 and older. High potassium is a long-term management problem for many people, and this drug is part of ongoing control, not emergency care: the label is clear that it should not be used as an emergency treatment for life-threatening hyperkalemia because its onset of action is delayed. The dose is adjusted no more often than once a week to reach the target blood potassium range, which also fits ongoing rather than emergency use. It is supplied as a powder for oral suspension in single-use packets of 1, 8.4, 16.8, and 25.2 grams of patiromer; the active ingredient is patiromer sorbitex calcium, a non-absorbed potassium-binding polymer, with xanthan gum as the inactive ingredient.

How it works

Patiromer is a powder that is not absorbed into the body. It works in the gut: it is a cation-exchange polymer that binds potassium in the digestive tract and carries it out in the stool. By removing potassium this way, it lowers the amount of free potassium in the gut and lowers potassium levels in the blood.

How it is taken

It is a powder that you mix with water and drink, taken by mouth once a day. For adults, the starting dose is 8.4 grams once a day; the dose can be raised or lowered by 8.4 grams at least one week apart, up to a maximum of 25.2 grams once a day. For ages 12 to 17, the starting dose is 4 grams once a day, adjusted by 4 grams at one-week intervals, up to the same 25.2 gram maximum. It comes in single-use packets of 1 gram, 8.4 grams, 16.8 grams, and 25.2 grams.

Common side effects

The label gives special attention to low magnesium in the blood (hypomagnesemia), which your care team may check with blood tests. The label also warns that the drug can worsen gut movement problems (gastrointestinal motility). Tell your doctor about ongoing stomach or bowel problems.

Serious warnings

Do not use this drug as an emergency treatment for life-threatening high potassium, because it starts working slowly. People who have had an allergic reaction to Veltassa or any of its ingredients should not take it. It can worsen existing gut motility problems and can lower blood magnesium, which can be serious if not found and treated.

Who should be careful

People with slow gut movement or other gastrointestinal motility problems should be careful, because the label warns this drug can make those problems worse. People at risk for low magnesium should have their levels watched. The label notes the drug is not absorbed into the body after being swallowed, so use in pregnancy is not expected to expose the fetus.

Major interactions

This drug can stick to other medicines taken by mouth in the gut and keep them from being absorbed well, which can make them work less well. Take all other oral medicines at least 3 hours before or at least 3 hours after patiromer.

Cost and saving notes

If your Medicare Part D plan charges a lot for this drug, you can ask the plan for a tier exception to move it to a lower cost tier, with a letter from your doctor explaining why you need it. If you have low income, Extra Help (the Part D Low Income Subsidy) can lower your premiums and drug costs. You can apply for Extra Help through Social Security at any time.

Why it is in its tier

Patiromer (Veltassa) sits on Tier 3 in 61.69% of the plans that list it (388 of 629 listing plans). Tier 3 is the preferred brand tier — mid-level copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $3,358 per beneficiary for 2024 — a mid-cost drug, which matches where plans place it. Only 11.45% of Part D plans list it at all, so many readers will find their plan does not list it and covers a similar drug instead. The tier shown is the most common one; individual plans vary.

Sources

• VELTASSA (PATIROMER) POWDER, FOR SUSPENSION [VIFOR PHARMA, INC.] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Patiromer

What official patient guides say

Patiromer comes as a powder to mix with water and take by mouth, taken along with food once a day at around the same time every day, exactly as directed — do not take more or less of it or take it more often than your doctor prescribed. Mix it right before you take it and do not take the powder before it is mixed: pour 1/3 cup (about 3 ounces or 90 mL) of water into a cup, add the contents of the packet or packets for your full dose along with half of the water and stir well, then add the remaining half of the water and stir well again; the powder will not completely dissolve and the mixture will look cloudy, and you may add more water if it is too thick. Drink the mixture right away, and if any powder is left in the cup, add more water, stir, and drink right away, repeating until no powder is left; do not prepare the mixture in advance. Other beverages or soft foods such as yogurt, pudding, or applesauce may be used instead of water following the same directions, but do not heat the medication in a microwave or add it to heated foods or liquids. If you forget a dose, take it as soon as you remember it, unless it is almost time for the next dose, in which case skip the missed dose and continue your regular schedule; do not take a double dose to make up for a missed one. Keep it in the container it came in, closed and out of the sight and reach of children, stored either in the refrigerator or at room temperature away from excess heat and moisture (not in the bathroom), and if the powder is stored at room temperature, dispose of it after 90 days out of the refrigerator.

Source: MedlinePlus — Patiromer

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 33.97031 per unit (VELTASSA 16.8 GM POWDER PACKET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-08

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 629 list Patiromer (Veltassa) — 11.4% of plans. Most of those plans put it on Tier 3: 388 plans, 61.7% of the plans that list it. Other plans place it on Tier 4 (190 plans), Tier 1 (43 plans) or Tier 2 (8 plans). For example: CareSource MyCare Ohio (HMO D-SNP) puts it on Tier 1; Essence Advantage Select (HMO) puts it on Tier 3; Univera SeniorChoice Secure (HMO-POS) puts it on Tier 4. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.