The present invention relates to a preventive and/or therapeutic agent for hyperkalemia, and a potassium excretion promoter containing EP4 agonist. Since EP4 agonist promotes potassium excretion, it is useful as a preventive and/or therapeutic agent for hyperkalemia. In addition, if selective EP4 agonist uses, it is a preventive and/or therapeutic agent for hyperkalemia without side effects. Further, if EP4 agonist is used, it is useful as improving agent for various symptoms (e.g. paresthesia, error of perception, weakness, myoparalysis, nausea, vomit, abdominal pain, diarrhea, arrhythmia, atrioventricular block, ventricular fibrillation, atrial fibrillation, cardiac arrest, asphyxia and/or dyspnoea etc.).