Sodium Zirconium Cyclosilicate

Sodium zirconium cyclosilicate is used for high blood potassium (hyperkalemia).

Sodium zirconium cyclosilicate is available under the following different brand names: Lokelma.

Dosages of Sodium Zirconium Cyclosilicate:

Dosage Forms and Strengths

Powder for Oral Suspension

• 5g/packet
• 10g/packet

Dosage Considerations – Should be Given as Follows:

Hyperkalemia

• Indicated for hyperkalemia
• Initial: 10 g orally three times daily for up to 48 hours

Maintenance

• 10 g orally once daily
• May titrate based on serum potassium level and desired target range at intervals of 1 week or longer and in increments of 5 g
• Dosing may range from 5 g every other day to 15 g once daily); not to exceed 15 g/day

Dosing Considerations

• Not to be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action
• Monitor serum potassium and adjust dose based on the serum potassium level and desired target range
• The dose should be decreased or discontinued if serum potassium is below the desired target range
• Safety and efficacy not established in pediatric patients

Common side effects of sodium zirconium cyclosilicate include:

• Fluid retention (edema)
• Low blood potassium (hypokalemia)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Sodium zirconium cyclosilicate has no listed severe interactions with other drugs.
• Sodium zirconium cyclosilicate has no listed serious interactions with other drugs.
• Sodium zirconium cyclosilicate has no listed moderate interactions with other drugs.
• Sodium zirconium cyclosilicate has no listed mild interactions with other drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains sodium zirconium cyclosilicate. Do not take Lokelma if you are allergic to sodium zirconium cyclosilicate or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• None

Effects of Drug Abuse

• No information is available

Short-Term Effects

• See "What Are Side Effects Associated with Using Sodium Zirconium Cyclosilicate?”

Long-Term Effects

• See "What Are Side Effects Associated with Using Sodium Zirconium Cyclosilicate?”

Cautions

• Avoid severe constipation or bowel obstruction or impaction, including abnormal post-operative bowel motility disorders; safety and efficacy not studied in these patients and may be ineffective and may worsen gastrointestinal (GI) conditions
• Each 5-g dose of sodium zirconium cyclosilicate contains approximately 400 mg of sodium; in clinical trials, mild-to-moderate edema was more commonly seen in patients treated with 15 g once daily; monitor for signs of edema, particularly in patients who should restrict their sodium intake or are prone to fluid overload (e.g., heart failure, renal disease); increase the diuretic dose as needed

Edema

• Each 5 g dose contains approximately 400 mg of sodium; in clinical trials, edema was generally mild to moderate in severity and was more commonly seen in patients treated with 15 g once daily
• Monitor for signs of edema, particularly in patients who should restrict their sodium intake or are prone to fluid overload (e.g., heart failure or renal disease)
• Advise patients to adjust dietary sodium, if appropriate; increase the dose of diuretics as needed

Drug interactions overview

• Transient changes of gastric pH
• Sodium zirconium cyclosilicate transiently increases gastric pH, which can change the absorption of co-administered drugs that exhibit pH-dependent solubility, potentially leading to altered efficacy or safety of these drugs when co-administered

In general, other oral medications whose solubility is pH-dependent should be administered at least 2 hours before or after sodium zirconium cyclosilicate

Pregnancy and Lactation

• Sodium zirconium cyclosilicate is not absorbed systemically following oral administration and maternal use is not expected to result in fetal exposure to the drug.