Lokelma is a brand-name prescription medication that’s used to treat hyperkalemia (high potassium levels) in adults.

The active drug in Lokelma is sodium zirconium cyclosilicate, which belongs to a class of medications called potassium binders. (A medication class is a group of drugs that work in a similar way.)

Lokelma comes as a powder, with each dose contained in an individual packet. This powder is mixed with water to form a liquid solution, which you should drink right away.

FDA approval

The Food and Drug Administration (FDA) first approved Lokelma to treat hyperkalemia in adults in 2018.

Effectiveness

For information on the effectiveness of Lokelma, see the “Lokelma uses” section below.

When not to use

Lokelma doesn’t start working right away, so it shouldn’t be used if your hyperkalemia is life threatening.

Life threatening high potassium levels can cause a fast or irregular heart rate, shortness of breath, vomiting, chest pain or paralysis. For this kind of hyperkalemia, you need drugs that act faster than Lokelma. Therefore, you should call 911 or your local emergency number or go to the emergency room right away if you experience these symptoms.

Lokelma is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Lokelma can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Lokelma. These lists do not include all possible side effects.

For more information on the possible side effects of Lokelma, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Lokelma, you can do so through MedWatch.

Mild side effects

Mild side effects of Lokelma, explained below in “Side effect details,” can include*:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Lokelma. To learn about other mild side effects, talk with your doctor or pharmacist, or view Lokelma’s prescribing information.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects, explained below in “Side effect details,” include:

Side effect details

You may wonder how often certain side effects occur with this drugor whether certain side effects pertain to it. Here’s some detail on certain side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Lokelma. It isn’t known how often this side effect occurred with Lokelma in clinical studies.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Lokelma. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Edema

Lokelma can cause edema (fluid buildup in your body). In clinical trials, this was the most commonly reported side effect of the drug. Specifically, in people not on dialysis:

  • 4.4% of people who took 5 g of Lokelma every day for 28 days reported edema
  • 5.9% of people who took 10 g of Lokelma every day for 28 days reported edema
  • 16.1% of people who took 15 g of Lokelma every day for 28 days reported edema
  • 2.4% of people who took a placebo (treatment with no active drug) every day for 28 days reported edema

Lokelma may cause edema because it contains sodium (salt). For every 5 g dose of Lokelma you take, you also take in about 400 mg of sodium. Taking in extra salt can cause your body to retain (hold on to) extra water, which may cause fluid buildup.

Most people in clinical trials who developed edema while taking Lokelma reported that their edema was mild or moderate. People who took 15 g of Lokelma daily were more likely to develop edema compared with people who took a lower dose.

It’s important to note that people in these studies took Lokelma every day for 28 days, but not everyone needs to take the drug long term. Some people may only need to take it for up to 48 hours to lower their potassium levels.

If you develop edema while taking Lokelma, talk with your doctor. They may suggest that you reduce the amount of sodium in your diet. They may also suggest using a diuretic (water pill). Or, they may suggest another medication for treating your hyperkalemia.

Hypokalemia

Lokelma may cause hypokalemia (low potassium levels). The drug is used to treat hyperkalemia (high potassium levels), and in some cases it can cause potassium levels to get too low.

In clinical trials, 4.1% of people who weren’t on dialysis and took Lokelma developed hypokalemia. It’s not known how often this occurred (or if it occurred) in people who took a placebo. In most patients, potassium levels went back to normal once the doctor lowered their dose or discontinued it.

Hypokalemia usually doesn’t cause symptoms unless it becomes severe. Symptoms of severe hypokalemia to watch for include:

While taking Lokelma, your doctor will monitor levels of potassium in your body to make sure they stay within normal range. If you develop symptoms of hypokalemia, call your doctor as soon as possible.

Diarrhea (not a side effect)

Diarrhea was not a reported side effect of Lokelma in clinical trials. However, other drugs used to treat hyperkalemia in adults can cause diarrhea.

Diarrhea can also be linked to hypokalemia (low potassium levels). That’s because having too much diarrhea can cause you to lose potassium from your body, resulting in hypokalemia. If you have diarrhea while taking Lokelma, talk with your doctor. They’ll work with you to determine the cause and the best treatment options for you.

People on dialysis who take Lokelma are at increased risk for hypokalemia. This is because they’re more likely to have certain conditions or take medications that raise their risk for diarrhea. They’re also more likely to have a diet that’s low in potassium. Because of these risks, you will most likely have to skip your Lokelma dose on days that you have dialysis. This is to help prevent hypokalemia.

Constipation (not a side effect)

Constipation was not a reported side effect of Lokelma in clinical trials. However, other drugs used to treat hyperkalemia in adults can cause constipation.

Constipation can also cause hyperkalemia. Therefore, if you were already experiencing constipation, it’s possible that you may still have constipation when you first start taking Lokelma. However, this doesn’t make it a side effect of the drug.

If you’re concerned about constipation before or during your Lokelma treatment, talk with your doctor or pharmacist.

The Lokelma dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Lokelma to treat
  • the strength of Lokelma you take
  • other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Lokelma comes as a powder, with each dose in an individual packet. This powder is mixed with water to form a liquid solution, which you should drink right away. Lokelma is available in two strength: 5 g and 10 g.

Dosage for hyperkalemia

Your dosage will depend on whether you’re on dialysis.

For all people taking Lokelma, your dose may be adjusted up or down or discontinued depending on your potassium levels. Doses can be adjusted by 5 g every week or longer.

For people who are not on dialysis

The Lokelma dosage for treating hyperkalemia (high potassium levels) is typically 10 g three times a day for up to 2 days (48 hours).

After that, if your doctor decides you should continue treatment with Lokelma, they’ll likely change your dosage to 10 g once a day.

For people who are on dialysis

For people on dialysis, Lokelma is only given on non-dialysis days.

The recommended starting non-dialysis day dose of Lokelma for treating hyperkalemia is 5 g once a day. You can start with 10 g once a day if your potassium levels are greater than 6.5 mEq/L.

After one week, if your doctor decides you should continue treatment with Lokelma, they’ll check your potassium levels before dialysis. Based on your lab results, your non-dialysis day dose will be adjusted to between 5 g to 15 g once a day.

What if I miss a dose?

If you miss a dose, take your dose as soon as you remember. However, if it’s close to when you should take your next dose, just skip the missed dose and take your next dose as scheduled. You shouldn’t take two doses at once to make up for a missed dose. This can raise your risk for side effects.

To help make sure you don’t miss a dose, try setting a reminder in your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

It depends. Some people have their hyperkalemia clear up within 48 hours. If this is the case for you, your doctor may decide you don’t need to continue taking Lokelma.

In some cases, your hyperkalemia may not go away after taking Lokelma for 48 hours. Lokelma is safe for use as a long-term treatment. If you and your doctor determine that Lokelma is safe and effective for you, you may take it long term.

Other drugs are available that can treat hyperkalemia (high potassium levels). Some may be a better fit for you than others. If you’re interested in finding an alternative to Lokelma, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for hyperkalemia

Examples of other drugs that may be used to treat hyperkalemia include:

  • patiromer (Veltassa)
  • sodium polystyrene sulfonate (Kionex, Kalexate, SPS, Kayexalate [discontinued])

You may wonder how Lokelma compares with other medications that are prescribed for similar uses. Here we look at how Lokelma and sodium polystyrene sulfonate (Kayexalate) are alike and different.

It’s important to note that brand-name Kayexalate has been discontinued and is no longer available. The active drug in Kayexalate, sodium polystyrene sulfonate, is still available as a generic medication.

Ingredients

Lokelma contains the active drug sodium zirconium cyclosilicate. Sodium polystyrene sulfonate is a generic drug that also comes as the brand names Kalexate, SPS, and Kionex.

Both sodium zirconium cyclosilicate and sodium polystyrene sulfonate belong to a drug class known as potassium binders. (A drug class is a group of medications that work in a similar way.)

Uses

Both Lokelma and sodium polystyrene sulfonate are FDA-approved to treat hyperkalemia (high potassium levels) in adults. This is the only condition either drug is approved to treat.

Drug forms and administration

Lokelma comes as a powder, with each dose contained in an individual packet. This powder is mixed with water to form a liquid solution, which you should drink right away.

Sodium polystyrene sulfonate and its brand-name products all come as a powder. This powder is mixed with water to create a liquid solution that you can drink. In some cases, the solution can be given rectally as an enema (solution give through a rubber tube placed in the anus).

Side effects and risks

Lokelma and sodium polystyrene sulfonate have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Lokelma and sodium polystyrene sulfonate (when taken individually).

  • Can occur with Lokelma:
    • edema (fluid buildup in your body)
  • Can occur with sodium polystyrene sulfonate:
    • constipation
    • diarrhea
    • loss of appetite
    • nausea and vomiting
    • bezoars (a tightly packed mass blocking your digestive tract)
  • Can occur with both Lokelma and sodium polystyrene sulfonate:
    • no unique mild side effects

Serious side effects

These lists contain examples of serious side effects that can occur with Lokelma, with SPS, or with both drugs (when taken individually).

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, they’ve been indirectly compared in a meta-analysis. The researchers determined that Lokelma appears to be more effective than sodium polystyrene sulfonate for treating hyperkalemia.

Costs

According to estimates on GoodRx.com, Lokelma costs significantly more than sodium polystyrene sulfonate. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Lokelma is a brand-name drug. There is currently no generic form of Lokelma. Brand-name medications usually cost more than generics.

Sodium polystyrene sulfonate is a generic drug. It also comes as the brand-name drugs Kalexate, SPS, Kionex, and Kayexalate. (Kayexalate has been discontinued and is no longer available.)

Lokelma and Veltassa are prescribed for similar uses. Here we look at how these drugs are alike and different.

Ingredients

Lokelma contains the active drug sodium zirconium cyclosilicate. Veltassa contains the active drug patiromer.

Both sodium zirconium cyclosilicate and patiromer belong to a drug class known as potassium binders. (A drug class is a group of medications that work in a similar way.)

Uses

Both Lokelma and Veltassa are FDA-approved to treat hyperkalemia (high potassium levels) in adults. This is the only condition either drug is approved to treat.

Drug forms and administration

Lokelma comes as a powder, with each dose in an individual packet. This powder is mixed with water to form a liquid solution, which you should drink right away.

Veltassa also comes as a powder in individual packets. This powder is mixed with water to form a liquid solution that you should drink right away.

Side effects and risks

Lokelma and Veltassa have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Lokelma and Veltassa (when taken individually).

  • Can occur with Lokelma:
    • edema (fluid buildup in your body)
  • Can occur with Veltassa:
    • constipation
    • diarrhea
    • nausea
    • upset stomach
  • Can occur with both Lokelma and Veltassa:
    • no unique mild side effects

Serious side effects

These lists contain examples of serious side effects that can occur with Lokelma, with Veltassa, or with both drugs (when taken individually).

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, studies have found both Lokelma and Veltassa to be effective for treating hyperkalemia.

Costs

According to estimates on GoodRx.com, Lokelma may cost slightly less than Veltassa. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Lokelma and Veltassa are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

The Food and Drug Administration (FDA) approves prescription drugs such as Lokelma to treat certain conditions. Lokelma may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Lokelma for hyperkalemia

Lokelma is FDA-approved to treat hyperkalemia (high potassium levels). This condition is typically caused by problems such as kidney disease, unmanaged diabetes, or heart failure, or by certain medications.

Potassium is a mineral electrolyte. It helps regulate the amount of fluid in your body, helps your nerves send signals, and is necessary for your muscles and heart to contract (tighten). Your body must have potassium to work properly.

Hyperkalemia doesn’t usually cause symptoms. When it does, mild to moderate symptoms can include weakness or fatigue (lack of energy), muscle weakness, nausea, numbness, and tingling. Even though these symptoms could be caused by other conditions, you should call your doctor right away if you experience them.

Lokelma should not be used to treat serious hyperkalemia (see below).

When not to use Lokelma

Lokelma is not approved to treat acute hyperkalemia. Acute hyperkalemia refers to a sudden and life threatening episode of hyperkalemia.

Life threatening symptoms and warning signs include chest pain, heart palpitations or an irregular heartbeat, trouble breathing, vomiting, or paralysis. Call 911 or your local emergency number or go to the nearest emergency room if you have these symptoms. You’ll need drugs that act faster than Lokelma to treat life threatening hyperkalemia.

To learn more, see the “Common questions about Lokelma” section.

Effectiveness for hyperkalemia

Two clinical studies have shown Lokelma to be effective for treating hyperkalemia in adults.

Study 1

This clinical study was a two-part trial. The first part looked at how well Lokelma lowered potassium levels over 2 days (48 hours).

In this part of the study, 753 people with hyperkalemia took either Lokelma or a placebo (a treatment with no active drug). They took their treatment three times a day, with meals, for 2 days. This study included people with chronic kidney disease, diabetes, and heart failure.

People in the Lokelma group randomly received one of four different doses of Lokelma, given three times daily: 1.25 g, 2.5 g, 5 g, or 10 g.

After 48 hours, the researchers found that:

  • people who took a placebo had their potassium levels drop by an average of 0.2 mEq/L
  • people who took Lokelma had their potassium drop by an average of 0.3 to 0.7 mEq/L, depending on their dosage

Researchers also found that people with higher starting potassium levels experienced a greater drop when they took Lokelma.

In the second part of the study, the researchers only looked at the people whose potassium had dropped to normal levels. At this point, people took either Lokelma or a placebo for 12 days to see if their potassium stayed at normal levels.

People in the Lokelma group randomly received one of four doses of Lokelma, given once a day at breakfast: 1.25 g, 2.5 g, 5 g, or 10 g. After 12 days, researchers found that only the 5 g and 10 g doses of Lokelma helped keep potassium levels steady at normal levels.

Study 2

In a second study, which took place over 28 days, researchers again looked at how well Lokelma lowered potassium levels over the first 2 days of the trial. They then looked at how well the drug kept potassium levels steady over the next 26 days. People in the study had potassium levels that ranged from 5.1 to 7.4 mEq/L at the start of the study. The average potassium level of the people in the study was 5.6 mEq/L.

For the first 2 days, people received 10 g of Lokelma three times a day. Researchers found that 92% of people had their potassium levels drop to normal. For this study, having a potassium level of 3.5 mEq/L to 5 mEq/L was considered “normal.”

The people in the study whose potassium levels went back to normal then received either Lokelma or a placebo taken once a day before breakfast. People in the Lokelma group randomly received 1 of 3 different doses of Lokelma given once daily: 5 g, 10 g, or 15 g.

At the end of the study, researchers compared potassium levels from day 8 to day 29 in people who took Lokelma and people who took a placebo. They found that:

  • people who took a placebo once a day had an average potassium level of 5.1 mEq/L
  • people who took Lokelma once a day had an average potassium level of 4.4 to 4.8 mEq/L, depending on their dosage

The researchers also noted that 46% of people who took a placebo kept their potassium levels within a normal range during the study. Depending on the dose they got, 80% to 94% of people who took Lokelma kept their potassium levels within a normal range.

Lokelma and children

Lokelma is not approved for use in children. This drug hasn’t been studied for treating hyperkalemia in children.

You should take Lokelma according to your doctor or healthcare provider’s instructions.

How to take

Lokelma comes as a white powder, with each dose in an individual packet. To take your dose, empty the powder from one packet into a glass with at least 3 tablespoons of water. (You can add more water if you like). Stir the powder into the water until it dissolves, then drink it right away.

If there is powder left in your glass, add more water, stir again, and drink right away. Keep repeating this until there’s no powder remaining.

Note: Lokelma should not be taken with beverages other than water.

When to take

For treating high levels of potassium, Lokelma is typically taken three times per day, for up to 2 days (48 hours).

If your doctor determines that you should continue taking Lokelma for more than 2 consecutive days, your dose will most likely be 10 g taken once a day.

To help make sure you don’t miss a dose, try setting a reminder in your phone. A kitchen timer could be useful, too.

Taking Lokelma with food

Lokelma may be taken with or without food.

There isn’t a known interaction between Lokelma and alcohol. However, drinking alcohol can affect your potassium levels. For example, beer contains a small amount of potassium. Also, studies have found that people who consistently drink large amounts of alcohol are more likely to have hypokalemia (low potassium levels).

Excessive alcohol use can also lead to hyperkalemia (high potassium levels). This is because heavy alcohol use can cause your muscles to break down, which releases potassium into your blood.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink while taking Lokelma.

Lokelma can interact with other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Lokelma and other medications

Below is a list of medications that can interact with Lokelma. This list does not contain all drugs that may interact with Lokelma.

Before taking Lokelma, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Lokelma and medications that require certain levels of stomach acid

Your stomach creates stomach acid to break down food. For some drugs to be properly broken down and absorbed by your body, there needs to be a certain amount of acid in your stomach.

When you take a dose of Lokelma, your stomach may have less acid for a short period of time. For medications that depend on stomach acid to be absorbed, this can make the drugs less effective.

For other medications, having low acid levels in the stomach can actually increase the amount of medication that your body absorbs. This is because some drugs are absorbed better when there’s less acid in your stomach.

For many other drugs, it’s not known how changes in stomach acid affects how well your body can absorb them. So to be safe, the manufacturer of Lokelma recommends taking other medications at least 2 hours before or 2 hours after your Lokelma dose.

Examples of medications that may have their levels in your body increased if taken with Lokelma include:

  • atorvastatin (Lipitor)
  • furosemide (Lasix)
  • warfarin (Coumadin)

Examples of medications that may have their levels in your body decreased if taken with Lokelma include:

This interaction can be avoided by taking your dose of Lokelma at least 2 hours before or at least 2 hours after these medications.

Lokelma and other medications you take by mouth

If you take any other medication by mouth, you should take these medications at least 2 hours before or 2 hours after your Lokelma dose. This is because, in clinical studies, the researchers didn’t look at how Lokelma affects (or doesn’t affect) your body’s ability to absorb other medications you take by mouth.

Although it’s known that the medications listed above interact with Lokelma, there may be more interactions that haven’t been studied. So to be safe, the manufacturer of Lokelma recommends taking other medications at least 2 hours before or 2 hours after your Lokelma dose.

If you have additional questions about drug interactions while taking Lokelma, talk with your doctor or pharmacist.

Lokelma and herbs and supplements

If you take any herbs or supplements, you should take these at least 2 hours before or at least 2 hours after your Lokelma dose. This is because it’s not known how Lokelma may affect your body’s ability to absorb herbs and supplements. You should also still check with your doctor or pharmacist before using any of these products while taking Lokelma.

Lokelma and foods

There aren’t any foods that have been specifically reported to interact with Lokelma. If you have any questions about eating certain foods with Lokelma, talk with your doctor.

As with all medications, the cost of Lokelma can vary. To find current prices for Lokelma in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Lokelma, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Lokelma, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Lokelma, or if you need help understanding your insurance coverage, help is available.

AstraZeneca, the manufacturer of Lokelma, offers the My Lokelma Support Program. This program includes a savings card, which may help lower the cost of the drug for you. For more information and to find out if you’re eligible for support, call 866-494-8080 or visit the program website.

Generic version

Lokelma is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Lokelma is FDA-approved to treat hyperkalemia (high potassium levels) in adults.

What is potassium?

Potassium is a mineral electrolyte. It helps regulate the amount of fluid in your body, helps your nerves send signals, and is necessary for your muscles and heart to contract (tighten). Your body must have potassium to work properly.

The normal range for potassium levels is between 3.6 and 5.2 millimoles per liter (mmol/L). Anything above 6 mmol/L is considered a life-threatening level of potassium. In clinical studies, people with hyperkalemia who were treated with Lokelma had potassium levels that ranged from 5 to 7.4 mEq/L at the start of the studies. (The measurement of 1 mEq/L of potassium is equal to 1 mmol/L of potassium).

It’s important to note that Lokelma is not approved to treat acute hyperkalemia. Acute hyperkalemia refers to a sudden and life threatening episode of hyperkalemia. To learn more, see the “Common questions about Lokelma” section.

Hyperkalemia causes and symptoms

Hyperkalemia or hypokalemia (low potassium levels) can be caused by a variety of health conditions, as well as certain medications. Common causes of hyperkalemia include:

Symptoms of hyperkalemia can include chest pain, heart palpitations, or an irregular heartbeat, trouble sleeping, or weakness or fatigue (lack of energy).

If not treated, high potassium levels can lead to heart failure, paralysis, or cardiac arrest. (Cardiac arrest occurs when your heart abruptly stops working. This can be fatal.)

What Lokelma does

The active drug in Lokelma, sodium zirconium cyclosilicate, doesn’t get absorbed by your body. After you take your dose, it binds (attaches) to potassium in your digestive tract. When your body gets rid of Lokelma, it takes the attached potassium with it. This lowers the amount of potassium in your blood.

How long does it take to work?

Lokelma begins working within about 1 hour of taking your first dose. Clinical studies showed that Lokelma can lower potassium to normal levels in some people within 48 hours when it’s taken three times a day.

Lokelma is believed to be safe for use while pregnant.

The active drug in Lokelma, sodium zirconium cyclosilicate, doesn’t get absorbed by your body. It binds (attaches) to potassium, and then your body gets rid of it. Therefore, this drug should be safe to use during pregnancy.

If you have questions about using Lokelma while pregnant, talk with your doctor.

Lokelma is believed to be safe to take during pregnancy. However, Lokelma may affect how well your body absorbs birth control pills. If you take a birth control pill, you should take it at least 2 hours before or 2 hours after your Lokelma dose.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Lokelma.

For more information about taking Lokelma during pregnancy, see the “Lokelma and pregnancy” section above.

Lokelma is believed to be safe for use while breastfeeding.

The active drug in Lokelma, sodium zirconium cyclosilicate, doesn’t get absorbed by your body. It binds (attaches) to potassium, and then your body gets rid of it. Therefore, a breastfed child isn’t expected to be exposed to the drug, and it should be safe to use while breastfeeding,

If you have questions about using Lokelma while breastfeeding, talk with your doctor.

Here are answers to some frequently asked questions about Lokelma.

Will Lokelma cure my hyperkalemia?

Lokelma may cure your hyperkalemia (high potassium levels). Whether or not Lokelma cures your hyperkalemia may depend on what’s causing your condition.

For example, some people may only need to use Lokelma for up to 48 hours for their hyperkalemia to be cured.

On the other hand, people with chronic kidney disease may not have their potassium levels back to a normal range with only a short-term treatment. They may need to take Lokelma long term to prevent their hyperkalemia from coming back.

This is because the kidneys are responsible for removing excess potassium from the body. Without Lokelma, people with chronic kidney disease may be unable to get rid of potassium on their own.

If you have questions about how long you’ll need to use Lokelma, or about cures for hyperkalemia, talk with your doctor.

Can Lokelma be used to treat acute hyperkalemia?

No, Lokelma isn’t approved to treat acute hyperkalemia (a sudden onset of hyperkalemia symptoms). Usually, acute episodes of hyperkalemia are also life threatening. Lokelma doesn’t work right away, so it won’t treat acute or life threatening hyperkalemia quickly enough.

It’s important to note that Lokelma wasn’t studied in people with acute hyperkalemia. However, there’s currently a clinical trial in progress to see how well Lokelma works in treating acute hyperkalemia. Initial results were first released in January 2020, but the final analysis hasn’t been published yet.

If you have questions about treating acute hyperkalemia, talk with your doctor.

What should I tell my doctor before starting Lokelma?

Before taking Lokelma, talk with your doctor about all your medical conditions.

It’s especially important that you tell them about any trouble you experience in having bowel movements. This includes constipation, or a history of bowel blockage or dry, hard stool that you can’t pass. You should also let your doctor know if you’ve experienced problems with your bowel movements after surgery.

Lokelma hasn’t been studied in people with these bowel-related conditions. Lokelma may not work as well in people with these conditions. There’s even a possibility that it could make digestive conditions worse.

If you have a history of digestive conditions or problems, tell your doctor before you take Lokelma.

Will I have to make any changes to my diet while taking Lokelma?

It’s possible that you’ll need to adjust the amount of sodium (salt) in your diet while taking Lokelma.

In clinical trials, edema (fluid buildup in the body) was one of the most common side effects among people who took Lokelma. Lokelma may cause edema because it contains sodium. For every 5 g dose of Lokelma you take, you also take in about 400 mg of sodium. Taking in extra salt can cause your body to retain (hold on to) extra water, which may cause fluid buildup.

If you develop edema while taking Lokelma, talk with your doctor. They may suggest that you reduce the amount of sodium in your diet. For more information on edema as a side effect of Lokelma, see the “Lokelma side effects” section above.

Why can’t I take Lokelma at the same time as my other medications?

For some drugs to be properly broken down and absorbed by your body, there needs to be a certain amount of acid in your stomach. When you take a dose of Lokelma, your stomach may have less acid for a short period of time. For medications that depend on stomach acid to be absorbed, this can make the drugs less effective.

For other medications, having low acid levels in the stomach can actually increase the amount of medication that your body absorbs. This is because some drugs are absorbed better when there’s less acid in your stomach.

For still other drugs, it’s not known how changes in stomach acid affects how well your body can absorb them.

So to be safe, the manufacturer of Lokelma recommends taking other medications at least 2 hours before or 2 hours after your Lokelma dose.

If you have questions about taking Lokelma with other medications, talk with your doctor or pharmacist.

Before taking Lokelma, talk with your doctor about your health history. Lokelma may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Hemodialysis. If you rely on hemodialysis, you may have a higher risk for hypokalemia while taking Lokelma. Therefore, you may need a lower dose of the drug. Tell your doctor if you’re on hemodialysis before using Lokelma.
  • Constipation or other motility disorders. You shouldn’t use Lokelma if you have severe constipation. You should also avoid Lokelma if you have other motility disorders (problems with movement in your digestive system). These include a blockage or mass in your bowel or dry, hard stool that’s difficult to pass. Lokelma hasn’t been studied in people with these conditions, and the drug could potentially make them worse. Tell your doctor if you have a motility disorder before using Lokelma.
  • Sodium restrictions. If you have a sodium restriction (for example, because of heart failure or kidney disease), you may need to change the amount of sodium in your diet while taking Lokelma. Otherwise, you may develop edema. Every 5,000 mg (5 g) of Lokelma contains about 400 mg of sodium. If you’re on a sodium-restricted diet, talk with your doctor before using Lokelma.
  • Allergic reaction. If you’ve had an allergic reaction to Lokelma or any of its ingredients, you shouldn’t take Lokelma. Ask your doctor which other medications may be a better option for you.
  • Pregnancy. Lokelma is believed to be safe for use during pregnancy. For more information, see the “Lokelma and pregnancy” section above.
  • Breastfeeding. Lokelma is believed to be safe for using while breastfeeding. For more information, see the “Lokelma and breastfeeding” section above.

Note: For more information about the potential negative effects of Lokelma, see the “Lokelma side effects” section above.

Do not use more Lokelma than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Lokelma

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Lokelma from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Store Lokelma packets at a temperature of 59°F to 86°F (15°C to 30°C). Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Lokelma and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Lokelma is approved by the FDA for treating hyperkalemia in adults. Due to its slow onset of action, Lokelma should not be used in emergencies to treat life-threatening hyperkalemia.

Administration

Lokelma is supplied in individual packets as a white powder for reconstitution into an oral suspension. To reconstitute, empty the entire packet into a glass (or similar drinking vessel) containing at least 3 tablespoons of water. Stir well and administer immediately.

If powder remains, add water, stir, and repeat administration. This should be repeated until no powder remains in the glass or container.

The manufacturer of Lokelma recommends taking other medications at least 2 hours before or 2 hours after a Lokelma dose. This is because Lokelma may cause the stomach to temporarily have less acid, which could affect absorption of certain other medications.

Mechanism of action

The active ingredient in Lokelma, sodium zirconium cyclosilicate, has a high affinity for potassium ions. It binds potassium in exchange for sodium and hydrogen. Since zirconium silicate isn’t absorbed, all potassium bound to the molecule is eliminated in the feces, reducing serum potassium levels.

Pharmacokinetics and metabolism

The active ingredient in Lokelma, sodium zirconium cyclosilicate, isn’t absorbed or affected by enzymatic metabolism. To date, there is no evidence of systemic absorption of Lokelma.

Contraindications

There are no known contraindications to Lokelma.

Storage

Store Lokelma packets at a temperature of 59°F to 86°F (15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.