Sodium zirconium cyclosilicate

(Lokelma®)

Sodium zirconium cyclosilicate

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Drug updated on 5/17/2024

Dosage FormSuspension (oral; 5 g, 10 g)
Drug ClassPotassium binders
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of hyperkalemia in adults.

Summary
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  • Sodium zirconium cyclosilicate (Lokelma) is indicated for the treatment of hyperkalemia in adults, effectively reducing serum potassium levels with a significant proportion of individuals achieving normal potassium levels across several studies.
  • Nine systematic reviews and meta-analyses were reviewed to gather information about Lokelma's effectiveness and safety profile.
  • Comparisons suggest that Lokelma is as effective as other novel potassium binders like patiromer in managing hyperkalemia, especially among patients with heart failure or chronic kidney disease who are using renin-angiotensin-aldosterone system inhibitors or mineralocorticoid receptor antagonists.
  • The safety profile of Lokelma was generally acceptable according to the reviewed studies, but an increase in the incidence of hypokalemia was noted as a side effect requiring careful monitoring.
  • Compared to traditional potassium exchange resins like sodium polystyrene sulfonate, fewer gastrointestinal side effects have been associated with Lokelma, making it a preferential option for long-term management of hyperkalemia in patients with chronic kidney disease. However, one study mentioned an increased risk of edema compared to placebo, which should be considered particularly for patients with heart failure or chronic kidney disease due to their fluid management needs.
  • The effectiveness and safety profiles make this drug beneficial not only for the general population but also for specific patient subgroups such as those suffering from heart failure and chronic kidney disease, along with high-risk populations including those with diabetes or using renin-angiotensin-aldosterone system inhibitors.

Product Monograph / Prescribing Information

Document TitleYearSource
Lokelma (sodium zirconium cyclosilicate) Prescribing Information.2024AstraZeneca Pharmaceuticals LP, Wilmington, DE

Systematic Reviews / Meta-Analyses

Document TitleYearSource
The efficacy and safety of new potassium binders on renin-angiotensin-aldosterone system inhibitor optimization in heart failure patients: a systematic review and meta-analysis.2024ESC Heart Failure
Safety and efficacy of new potassium binders on hyperkalemia management in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials.2023Clinical Research in Cardiology
Novel potassium binders to optimize RAASi therapy in heart failure: A systematic review and meta-analysis. 2023European Journal of Internal Medicine
Therapeutic update on oral potassium exchange resin use in chronic kidney disease patients: a systematic review of randomized controlled clinical trials.2023Journal of Pharmacy & Pharmaceutical Sciences
Efficacy and safety of potassium binders in the treatment of patients with chronic kidney disease and hyperkalemia. 2022European Journal of Pharmacology
Effects and safety of a novel oral potassium-lowering drug-sodium zirconium cyclosilicate for the treatment of hyperkalemia: a systematic review and meta-analysis.2021Cardiovascular Drugs and Therapy
Binding potassium to improve treatment with renin-angiotensin-aldosterone system inhibitors: Results from multiple one-stage pairwise and network meta-analyses of clinical trials.2021Frontiers in Medicine
Potassium binders for chronic hyperkalaemia in people with chronic kidney disease.2020The Cochrane Database of Systematic Reviews
Efficacy and safety of the pharmacotherapy used in the management of hyperkalemia: a systematic review.2019Pharmacy Practice

Clinical Practice Guidelines