May cause genitourinary upset (e.g. abdominal pain, diarrhea, discomfort, nausea, vomiting) and lead to genitourinary ulceration, bleeding, perforation and/or obstruction. Severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (e.g. heart block, ventricular arrhythmias, asystole). Use with caution in renal impairment (contraindicated with severe impairment), in severe tissue breakdown (e.g. chemotherapy or hemodialysis), and in patients receiving concomitant medications or therapies which increase potassium (e.g. ACEI, potassium-sparing diuretics, potassium-containing salt substitutes).