From the Guidelines
Lokelma, also known as sodium zirconium cyclosilicate, is used to treat hyperkalemia, a condition characterized by high potassium levels in the blood, as established in a 2021 study published in the Mayo Clinic Proceedings 1. This medication works by binding to potassium in the intestines and removing it from the body through stool. Key points to consider when using Lokelma include:
- The usual dose is up to three 10-g doses within 10 hours, added to insulin plus glucose, which can provide reductions in mean serum K+ levels of 0.72 mEq/L within 2 hours, as seen in a study of emergency department patients with serum K+ concentrations of 5.8 mEq/L or higher 1.
- For patients with chronic hyperkalemia, a 3-times-daily or once-daily 5- or 10-g dose of Lokelma can effectively reduce and maintain normokalemia over 14 to 28 days 1.
- Significant reductions in serum K+ levels can be observed within 1 hour of a single 10-g dose of Lokelma, making it a valuable treatment option for patients with severe hyperkalemia (6.0 mEq/L) 1.
- The efficacy and safety of Lokelma have been documented over 12 months, with once-daily doses on nondialysis days effectively maintaining normal predialysis serum K+ levels in patients with end-stage renal disease (ESRD) and persistent hyperkalemia 1.
- Common adverse effects of Lokelma include hypokalemia and a dose-dependent increase in edema, but it has not been associated with any serious adverse events in randomized trials 1.
From the FDA Drug Label
LOKELMA is a powder for oral suspension. The active ingredient in LOKELMA is sodium zirconium cyclosilicate, a potassium binder LOKELMA (sodium zirconium cyclosilicate) is a non-absorbed zirconium silicate that preferentially captures potassium in exchange for hydrogen and sodium. LOKELMA increases fecal potassium excretion through binding of potassium in the lumen of the gastrointestinal tract. In patients with hyperkalemia treated with LOKELMA 10 g three times a day for up to 48 hours, reductions in serum potassium were observed one hour after initiation of therapy;
Lokelma is used for the treatment of hyperkalemia. It works by binding to potassium in the gastrointestinal tract and increasing its excretion in the feces, thereby reducing serum potassium levels 2.
From the Research
Lokelma Uses
- Lokelma, also known as sodium zirconium cyclosilicate (SZC), is used for the treatment of hyperkalemia in adults 3, 4, 5, 6, 7.
- Hyperkalemia is a condition where the serum potassium level is higher than 5.0 mEq/L, and it can be associated with serious cardiac dysrhythmias, sudden death, and increased mortality risk 4.
- SZC is a non-absorbed, non-polymer zirconium silicate compound that preferentially exchanges hydrogen and sodium for potassium and ammonium ions in the gastrointestinal tract, thereby increasing faecal potassium excretion and lowering serum potassium levels 3.
Patient Groups
- Lokelma is effective in treating hyperkalemia in various patient groups, including those with chronic kidney disease, diabetes, and heart failure 3, 4, 6.
- It is also effective in patients who are taking renin-angiotensin-aldosterone system (RAAS) inhibitors, which are commonly used to treat heart failure and chronic kidney disease 3, 4, 6.
Dosage and Administration
- Lokelma is available as a powder for oral suspension and is typically administered at a dose of 10g three times daily for the initial 48 hours, followed by a maintenance dose of 5-10g once daily 3, 7.
- The dosage and administration of Lokelma may vary depending on the individual patient's needs and response to treatment 7.
Efficacy and Safety
- Clinical trials have shown that Lokelma is effective in lowering serum potassium levels and maintaining normokalemia in patients with hyperkalemia 3, 4, 7.
- Lokelma has been shown to be generally well-tolerated, with a safety profile similar to that of placebo 3, 7.
- The most common adverse events associated with Lokelma include gastrointestinal events and a dose-dependent risk of edema 6, 7.