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sodium zirconium cyclosilicate (Lokelma, ZS-9)
Indications:
- hyperkalemia (FDA-approved May 2018) [2]
* useful for patients with broad range of hyperkalemia
Dosage:
- oral agent
- start: 10 g TID for up to 48 hours
- maintenance: 10 g QD
- adjust dose weekly as needed (5 g increments)
- hemodialysis: 5 g once daily on non-dialysis days
Adverse effects:
- diarrhea
- edema
Drug interactions:
- other oral medications should be administered at least 2 hours before or 2 hours after Lokelma
Mechanism of action:
- selective cation exchange Na+ for K+
- binds K+ in the gastrointestinal tract
- rapidly lowers serum K+
Radiology:
- radio-opaque properties thus may give the appearance of a contrasg agent during abdominal X-ray procedures
General
metabolic agent (metabolic modifier)
gastrointestinal agent
References
- Packham DK et al
Sodium Zirconium Cyclosilicate in Hyperkalemia.
N Engl J Med. Nov 21, 2014
PMID: 25415807
http://www.nejm.org/doi/full/10.1056/NEJMoa1411487
- Ingelfinger JR
A New Era for the Treatment of Hyperkalemia?
N Engl J Med. Nov 21, 2014
PMID: 25415806
http://www.nejm.org/doi/full/10.1056/NEJMe1414112
- Brown T.
FDA Approves Lokelma for Hyperkalemia.
Medscape - May 18, 2018.
https://www.medscape.com/viewarticle/896933
- Highlights of Prescribing Information
Lokelma (sodium zirconium cyclosilicate) for oral suspension
https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/6de8f71b-d3af-4f76-9600-907c98616be6/6de8f71b-d3af-4f76-9600-907c98616be6_viewable_rendition__v.pdf