Sodium Zirconium Cyclosilicate
Sodium zirconium cyclosilicate is a potassium-binding medicine used to treat hyperkalemia (high potassium levels in the blood) in adults.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 3 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Sodium Zirconium Cyclosilicate: Patient Information Guide
A plain-language walkthrough of Sodium Zirconium Cyclosilicate — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Sodium zirconium cyclosilicate is approved for one main purpose in adults: treating hyperkalemia (high potassium levels in the blood).
- Lokelma (oral suspension) is indicated for the treatment of hyperkalemia in adults.
- Lokelma is not for emergency use — it should not be used to treat life-threatening hyperkalemia because it takes time to work.
⚙️How it works▾
Sodium zirconium cyclosilicate (Lokelma) is a specially structured compound that works as a potassium binder. It is not absorbed into your bloodstream at all — it stays in your digestive tract the whole time. There, it has a very strong attraction to potassium ions, capturing them from the gut contents and trading them for small amounts of hydrogen and sodium. The potassium that gets bound to Lokelma then exits the body in your stool, which gradually brings blood potassium levels down.
Because it works by physical binding rather than chemical metabolism, Lokelma isn't broken down by the body's enzymes and passes through unchanged.
💊How it's taken▾
Lokelma is taken by mouth as a suspension — the powder is mixed with water in a glass, stirred, and drunk right away. Any remaining powder should be rinsed out with more water and consumed to get the full dose. Treatment typically starts with doses taken multiple times a day for up to 48 hours; after that, most people move to a once-daily maintenance dose, which may be adjusted by their doctor based on potassium levels.
- Patients on chronic hemodialysis take Lokelma only on non-dialysis days, with dosing guided by pre-dialysis potassium readings.
- Space all other oral medications at least 2 hours before or after taking Lokelma.
- Always follow your prescriber's exact instructions — your dose may be increased or decreased based on your potassium results.
🤒Side effects — in detail▾
The most commonly reported side effect with Lokelma is swelling (edema):
- Mild to moderate swelling, most often in the legs or feet — more likely at higher doses
- In patients not on dialysis, edema was reported more frequently at the highest doses tested
If you notice significant or sudden swelling, or rapid weight gain, contact your doctor promptly — especially if you have heart failure or kidney disease, since fluid retention can be more serious in those situations.
⚠️Warnings & precautions▾
- Edema (fluid retention): Lokelma contains sodium. While absorption is not fully known, edema was seen in clinical trials — most often mild to moderate, but more common at higher doses. People with heart failure or kidney disease should be monitored closely.
- Bowel problems: Do not use Lokelma if you have severe constipation, a bowel blockage, or a condition that slows down gut movement. It may be ineffective and could worsen these conditions.
- Low potassium (hypokalemia) in hemodialysis patients: If you're on hemodialysis and become ill — especially with poor eating or diarrhea — your potassium could drop too low. Your doctor may need to adjust your Lokelma dose.
- Abdominal X-rays: Lokelma is radio-opaque (visible on X-ray) and can look like an imaging contrast agent on abdominal scans. Always tell imaging staff that you take this medicine.
🔀What it interacts with▾
Lokelma temporarily raises the pH (reduces acidity) of your stomach, which can change how much of certain other oral medicines your body absorbs. The main rule: take other oral medications at least 2 hours before or 2 hours after Lokelma.
- Furosemide and atorvastatin — absorption may increase when taken close to Lokelma (due to stomach pH change)
- Dabigatran — absorption may decrease when taken close to Lokelma
- Tacrolimus — blood levels may be reduced by Lokelma; important for transplant patients
- Losartan, glipizide, and levothyroxine — no meaningful interaction was found in studies, but general spacing guidance still applies unless your prescriber advises otherwise
- Drugs that don't depend on stomach acidity for absorption are less likely to be affected, but check with your pharmacist or prescriber
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Bowel or gut problems: Tell your doctor if you have severe constipation, a bowel obstruction, impaction, or post-surgical gut motility issues — Lokelma should be avoided in these cases.
- Heart failure or kidney disease: Tell your doctor if you have these conditions or need to limit sodium — you'll need monitoring for fluid retention.
- Hemodialysis: Dosing is different for patients on chronic hemodialysis and is taken only on non-dialysis days.
- Pregnancy: Lokelma is not absorbed into the bloodstream and is not expected to reach the developing baby.
- Breastfeeding: Lokelma is not absorbed systemically and is not expected to be present in breast milk.
- Children: Safety and effectiveness have not been established in pediatric patients.
- Older adults: Most clinical trial participants were 65 or older; no significant differences in safety or effectiveness were seen compared with younger adults.
📡Pharmacodynamics — effects in the body▾
Lokelma works in a dose-dependent way — the higher the dose, the more potassium it removes through the stool and the more it lowers blood potassium. In people with hyperkalemia, measurable drops in blood potassium can be seen within one hour of starting treatment, with levels continuing to fall over 48 hours of dosing. When Lokelma is stopped, blood potassium levels tend to rise again. Lokelma also causes a small, dose-related rise in blood bicarbonate levels, though the clinical significance of this effect is not fully understood.
🔬Pharmacokinetics — how your body processes it▾
Lokelma is not absorbed into the bloodstream — it stays entirely within the digestive tract and is recovered in the stool unchanged. Because it is an inorganic, insoluble compound, it is not broken down by the body's enzymes. Blood and urine zirconium levels in people taking Lokelma were no different from those in untreated people, confirming that no meaningful systemic absorption occurs.
📦How to store it▾
Store LOKELMA at 15°C-30°C (59°F-86°F).
📄 Written from Sodium Zirconium Cyclosilicate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Sodium Zirconium Cyclosilicate
17 supplements and herbal products have documented interactions with Sodium Zirconium Cyclosilicate in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 1
- Moderate · 7
- Minor · 9
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Sodium Zirconium Cyclosilicate — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly is Lokelma for, and how does it work? ▾
How do I take it correctly? Is there anything special I need to do? ▾
What side effects should I watch for? ▾
Can I take my other medications at the same time as Lokelma? ▾
Is it safe to take if I'm pregnant or breastfeeding? ▾
I'm on dialysis — is Lokelma used differently for me? ▾
Is Sodium Zirconium Cyclosilicate available over the counter? ▾
When was Sodium Zirconium Cyclosilicate first available? ▾
Who makes Sodium Zirconium Cyclosilicate? ▾
💬 Answers drafted from Sodium Zirconium Cyclosilicate’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Sodium Zirconium Cyclosilicate comes
Sodium Zirconium Cyclosilicate is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Oral suspension
How this form is used
- Lokelma is used to treat hyperkalemia (high blood potassium) in adults
- Lokelma is not intended for emergency treatment of life-threatening hyperkalemia due to its delayed onset of action
- Lokelma: empty the entire contents of the packet(s) into a drinking glass with approximately 3 tablespoons of water or more, stir well, and drink immediately
- Lokelma: if powder remains in the glass after drinking, add more water, stir, and drink again — repeat until no powder is left
- Lokelma: take other oral medications at least 2 hours before or 2 hours after each dose
- Lokelma: patients on chronic hemodialysis should take it only on non-dialysis days, as directed by their doctor
📊 Sodium Zirconium Cyclosilicate across the U.S. market
How Sodium Zirconium Cyclosilicate appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Powder (1) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Sodium Zirconium Cyclosilicate is used
A general measure of how commonly Sodium Zirconium Cyclosilicate is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Sodium Zirconium Cyclosilicate is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Sodium Zirconium Cyclosilicate prescribed? Of the 1,596 medications we measure, Sodium Zirconium Cyclosilicate ranks #563 by Medicaid prescriptions — more than 65% of them.
Utilization by Sodium Zirconium Cyclosilicate product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
sodium zirconium cyclosilicate 10000 MG Powder for Oral Suspension Most dispensed
Summed across the 2 of 8 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2047642
sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension
Summed across the 2 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2047633
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Sodium Zirconium Cyclosilicate, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 12 listed Sodium Zirconium Cyclosilicate NDCs with Medicaid activity.
🔍 Compare Sodium Zirconium Cyclosilicate products
A representative set of FDA-listed product records for Sodium Zirconium Cyclosilicate — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Oral suspension | ||||
| 5 g/5 g | Oral | A-S Medication Solutions | NDA | View NDC → |
| 10 g/10 g | Oral | A-S Medication Solutions × 2 listings | NDA | View NDC → |
| 5 g/5 g | Oral | AstraZeneca Pharmaceuticals LP × 3 listings | NDA | View NDC → |
| 10 g/10 g | Oral | AstraZeneca Pharmaceuticals LP × 3 listings | NDA | View NDC → |
| 243 kg/243 kg | — | AstraZeneca Pharmaceuticals LP | BULK INGREDIENT | View NDC → |
| 💊Bulk drug substance | ||||
| 1 kg/kg | — | Hetero Drugs Limited | BULK INGREDIENT | View NDC → |
Showing 11 of 11 products — FDA National Drug Code Directory. See every product, package size and price: browse all 11 Sodium Zirconium Cyclosilicate NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Sodium Zirconium Cyclosilicate — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Sodium Zirconium Cyclosilicate in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Sodium Zirconium Cyclosilicate went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 2047628 1 dose form · 2 strengths
-
Dose form (SCDF) Powder for Oral Suspension RxCUI 2047632In current FDA listings
Look up RxCUI 2047628 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Sodium Zirconium Cyclosilicate is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Sodium Zirconium Cyclosilicate belongs to the Drugs for treatment of hyperkalemia and hyperphosphatemia class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 3 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. AstraZeneca Pharmaceuticals LP is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.