Lokelma (Sodium Zirconium Cyclosilicate Hydrate)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Lokelma Used For?
Lokelma is a medication specifically designed to treat adults who have too much potassium in their blood, a condition called hyperkalaemia.
Primary Uses
Lokelma is used to treat hyperkalaemia (high potassium levels) in adults. This condition can be dangerous if left untreated.
How It Works
Lokelma works by passing through your stomach and intestines, where it attaches to excess potassium. The medicine and potassium are then eliminated together through your bowel movements, helping to lower and maintain normal potassium levels in your body.
Good to know: The medicine takes one to two days to start working effectively
How to Take Lokelma
Lokelma comes as a powder that you mix with water to create a cloudy liquid. It’s important to follow your doctor’s instructions exactly for the best results.
Dosage Instructions
Starting dose (to lower high potassium): 10g three times daily for no more than 3 days. Maintenance dose (to keep potassium normal): 5g once daily, though your doctor may adjust this to 10g once daily or 5g every other day. For patients on dialysis: Take only on non-dialysis days, starting with 5g once daily (up to 15g once daily if needed). Mix the powder with approximately 45mL of still water, stir well, and drink immediately. The powder doesn’t dissolve completely, so stir again if it settles and drink all of it.
What If You Miss a Dose?
If it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take a double dose to make up for the missed one.
Important: Never take more than 10g once daily for regular treatment, or 15g once daily if you’re on dialysis
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Muscle weakness and tiredness (may indicate low potassium)
- Muscle cramps
- Swelling in feet and ankles
- Fluid buildup in tissues
- Constipation
Seek immediate medical attention if you experience:
- Worsening of pre-existing heart failure
- Signs of heart failure: worsening shortness of breath, leg/ankle swelling, sudden weight gain
Important Warnings
There are several important safety considerations before starting Lokelma. Your doctor will monitor your potassium levels closely during treatment.
Who Should Not Take Lokelma
Do not take Lokelma if you: are under 18 years old, are pregnant or planning to become pregnant, have low blood potassium levels, or are allergic to sodium zirconium cyclosilicate.
Medical Conditions to Discuss
Tell your doctor if you: need to have an X-ray (Lokelma may affect results), take medicines that change potassium levels (like diuretics, ACE inhibitors, or blood pressure medications), have heart signaling disorders (QT prolongation), or have heart failure (this medicine may worsen your condition in some cases).
Pregnancy and Breastfeeding
Do not take Lokelma if you are pregnant, think you may be pregnant, or plan to become pregnant. For breastfeeding mothers, the medicine is not expected to pass into breast milk, but discuss with your doctor before use.
Heart Failure Warning: If you have heart failure, watch for worsening symptoms like increased shortness of breath, leg/ankle swelling, or sudden weight gain – contact your doctor immediately if these occur
Drug Interactions
Lokelma can affect how certain medications are absorbed in your digestive system, so timing is important when taking other medicines.
Timing is crucial: Most interacting medications should be taken 2 hours before or after Lokelma, except lithium which needs 3 hours separation
- Tacrolimus (immune system suppressants) – take 2 hours before or after Lokelma
- Antifungal medicines (ketoconazole, itraconazole, posaconazole) – take 2 hours before or after Lokelma
- HIV medications (atazanavir, nelfinavir, indinavir, ritonavir, saquinavir, raltegravir, ledipasvir, rilpivirine) – take 2 hours before or after Lokelma
- Cancer medications (erlotinib, dasatinib, nilotinib) – take 2 hours before or after Lokelma
- Lithium-based medicines – take 3 hours before or after Lokelma
Alcohol & Driving
Lokelma is unlikely to affect your ability to drive or operate machinery, but you should be cautious until you know how the medication affects you personally.
Alcohol
No specific alcohol interactions are mentioned in the prescribing information, but discuss alcohol use with your doctor.
Driving and Operating Machinery
Lokelma is unlikely to affect your ability to drive or use machines, but be careful until you know how it affects you personally.
Storage
Store Lokelma sachets at room temperature – no special storage conditions are required. Do not use after the expiry date shown on the carton and sachet. Keep out of reach of children and do not use damaged or tampered packages.
Overdose Information
If you think you have taken too much Lokelma, seek immediate medical attention even if you feel fine. Call the Poisons Information Centre at 13 11 26, contact your doctor, or go to your nearest hospital emergency department right away.
Frequently Asked Questions
Lokelma typically takes one to two days to start working effectively to lower your potassium levels.
Yes, you can take Lokelma with or without a meal – it doesn’t matter for the medication’s effectiveness.
If it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Never take a double dose to make up for a missed one.
No, do not stop taking Lokelma or change your dosage without checking with your doctor first. Your potassium levels need to be monitored.
This is normal – Lokelma is designed as an insoluble powder that creates a cloudy liquid. If it settles in the glass, just stir it again and drink it all.
Tell your doctor if you need an X-ray, as Lokelma may affect the interpretation of the results.
Some medications need to be taken 2-3 hours before or after Lokelma to work properly. Always tell your doctor about all medicines you’re taking so they can advise on proper timing.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.