From the Guidelines
The maximum dose of Lokelma (sodium zirconium cyclosilicate) is 15 g per day.
Dosing Information
- The dosing for Lokelma is as follows:
- 10 g three times a day (TID) orally for initial correction of hyperkalemia (for 48 hours)
- Then 5 g every other day (QOD) to 15 g once daily (QD) for maintenance 1.
Mechanism of Action
- Lokelma works by binding to potassium ions in exchange for hydrogen and sodium ions in the gastrointestinal tract, with a highly selective mechanism of action 1.
Adverse Events
- The most common adverse events associated with Lokelma include gastrointestinal disorders such as constipation, diarrhea, nausea, and vomiting, as well as mild to moderate edema 1.
From the FDA Drug Label
The initial dosage of LOKELMA was 5 g once daily and was adjusted to a minimum of 5 g every other day up to maximum of 15 g once daily, based on serum potassium level. All three doses (5,10 and 15 g) of once daily LOKELMA maintained mean potassium at lower levels than placebo During the dose adjustment period (initial 4 weeks), the dose was adjusted weekly in 5 g increments up to 15 g once daily
The maximum dose of Lokelma (sodium zirconium cyclosilicate) is 15 g once daily 2.
From the Research
Maximum Dose of Lokelma (Sodium Zirconium Cyclosilicate)
- The maximum dose of Lokelma (sodium zirconium cyclosilicate) is not explicitly stated in the provided studies, but the highest dose mentioned is 15 g per day 3.
- In the HARMONIZE study, patients received 10 g of zirconium cyclosilicate three times daily in the initial 48-hour open-label phase, and then were randomized to receive 5 g, 10 g, or 15 g once daily for 28 days 3.
- In the open-label extension of the HARMONIZE study, the median daily dose of SZC was 10 g, with a range of 2.5-15 g 4.
- Another study mentions that patients received SZC 5 or 10 g once daily, with no mention of a higher dose 5.
- A study published in The New England Journal of Medicine mentions doses of 1.25 g, 2.5 g, 5 g, and 10 g of ZS-9 (sodium zirconium cyclosilicate) three times daily for 48 hours, and then once daily on days 3 to 14 6.
Dosing Regimens
- The dosing regimens for Lokelma (sodium zirconium cyclosilicate) vary across the studies, with some using a three-times-daily regimen and others using a once-daily regimen 3, 6.
- The studies suggest that the dose of Lokelma (sodium zirconium cyclosilicate) can be adjusted based on the patient's response to treatment, with some patients requiring higher or lower doses to achieve normokalemia 3, 4.