Sodium zirconium cyclosilicate: Difference between revisions
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Revision as of 17:26, 20 March 2026
Administration[1]
- Type: Potassium binder, antidote
- Dosage Forms: 5 g (1 ea, 30 ea); 10 g (1 ea, 30 ea), empty contents into glass with 45 mL of water
- Routes of Administration: Oral
- Common Trade Names: Lokelma
Adult Dosing
Hyperkalemia
- 10 g TID PO for up to 48 hours, then 10 g once daily
Pediatric Dosing
Special Populations
Pregnancy Rating
- unlikely to affect fetus as not absorbed
Lactation risk
- unlikely to be in breast milk as not absorbed
Renal Dosing
None
Hepatic Dosing
None
Contraindications
- Allergy to class/drug
- Avoid in GI motility disorders
Adverse Reactions
Serious
Common
- Mild to moderate edema
- Hypokalemia
Pharmacology
- Metabolism: none
- Excretion: feces
Mechanism of Action
- Highly selective, oral potassium removing agent
- Non-absorbed zirconium silicate that captures potassium in exchange for hydrogen and sodium
- Increases fecal potassium excretion through binding K+ in GI tract
Comments
- Onset of action at 1.0 hour and median time to achieving normal potassium levels at 2.2 hours, with 92% achieving normal potassium within 48 hours.
- Not used as an emergency treatment for life threatening hyperkalemia due to delayed onset of action
- Available at Harbor-UCLA, but not yet widely available in the community
- If asked by nephrology to give Kayexalate, kindly suggest Lokelma instead
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
See Also
References
- ↑ Packham, D. K., Rasmussen, H. S., Lavin, P. T., El-Shahawy, M. A., Roger, S. D., Block, G., … Singh, B. (2015). Sodium zirconium cyclosilicate in hyperkalemia. The New England Journal of Medicine, 372(3), 222–231.