Sodium zirconium cyclosilicate

Administration

• 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

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

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

Hyperkalemia