sodium zirconium cyclosilicate (Lokelma, ZS-9)

Indications

• hyperkalemia (FDA-approved May 2018)

* 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

More general terms

• metabolic agent (metabolic modifier)
• gastrointestinal agent