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Sodium Zirconium Cyclosilicate (Lokelma)
⚡ Sodium zirconium cyclosilicate (SZC) is a highly selective cation exchanger in the gastrointestinal tract. It is licensed for the management of acute hyperkalaemia. Always check the BNF here for up-to-date prescribing advice.
ℹ️ About
- 📖 Prescribing advice must be checked in the BNF or local guidelines
- 💊 Brand name: Lokelma
- 🧪 Developed as a safer alternative to sodium polystyrene sulfonate (Resonium)
⚙️ Mode of Action
- 💡 Non-absorbed, inorganic cation-exchange compound
- 🔄 Selectively binds potassium in the gastrointestinal tract → increases faecal excretion
- ⚖️ Minimal absorption → systemic side effects are rare
📋 Indication / Dose
- Used for the treatment of hyperkalaemia (both acute and maintenance)
💊 Dose Range (Always confirm with BNF / datasheet)
| Name | Starting Dose | Frequency | Route |
|---|---|---|---|
| Lokelma (initial) | 10 g | 3 times daily, for up to 72 hours | PO |
| Lokelma (maintenance) | 5–10 g | Once daily or alternate days | PO |
🔄 Interactions
- ⚠️ Can reduce absorption of other oral medicines (binds non-selectively) → separate by at least 2 hours before or after
- Particular caution with immunosuppressants (e.g. tacrolimus, ciclosporin)
⚠️ Cautions
- 🌊 Risk of sodium and fluid overload → monitor in patients with heart failure or CKD
- 💧 Caution in patients at risk of oedema
- 🧪 Monitor potassium closely to avoid hypokalaemia
🚫 Contraindications
- ❌ Severe constipation, bowel obstruction or impaction
- ❌ Known hypersensitivity to the drug or excipients
⚡ Side Effects
- 🌊 Fluid retention, peripheral oedema
- ⚖️ Hypokalaemia if overdosed
- 🚽 Gastrointestinal: constipation, mild diarrhoea
📚 References
- NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
- BNF – Sodium Zirconium Cyclosilicate
📝 Revisions
- Content expanded with interactions, cautions, contraindications (Aug 2025)
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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