sodium zirconium cyclosilicate
Lokelma · ATC code V03AE10
Also known as: Sodyum zirkonyum siklosilikat
- Key facts
- Active substance
- sodium zirconium cyclosilicate
- Drug class
- Antihyperkalemic agents
- ATC code
- V03AE10
- Authorisation
- centrally authorised across the EU (EMA)
- Dosage forms
- Lokelma 5 g powder for oral suspension / Lokelma 10 g powder for oral suspension
- Marketing authorisation holder
- AstraZeneca AB
- Information as of
- 2026-10-28
Key facts
Sodium zirconium cyclosilicate is a non-absorbed potassium binder that traps potassium in the gut. It is used to treat hyperkalaemia in adults.
What it is used for
- Treatment of hyperkalaemia in adults.
Dosing
- Lokelma (powder for oral suspension), correction phase: 10 g three times a day as a suspension in water; normokalaemia is typically reached within 24 to 48 hours. If still hyperkalaemic after 48 hours, the same regimen can continue for an additional 24 hours; if not normokalaemic after 72 hours, consider other treatments.
- Maintenance phase: start with 5 g once daily, titrating up to 10 g once daily or down to 5 g once every other day; no more than 10 g once daily.
- Patients on dialysis: dose only on non-dialysis days, starting dose 5 g once daily; adjust weekly in 5 g increments up to 15 g once daily based on pre-dialysis potassium.
- No adjustment in renal impairment without chronic haemodialysis, in hepatic impairment or in the elderly.
- Empty the sachet into a glass with approximately 45 ml of water, stir and drink while still cloudy; with or without food.
Contraindications
- Hypersensitivity to the active substance.
Important warnings
- Monitor serum potassium, including after changes to RAAS inhibitors or diuretics and after dose titration.
- Hypokalaemia may occur; discontinue in severe hypokalaemia.
- High sodium content (approximately 400 mg sodium per 5 g dose): monitor patients with pre-existing heart failure for worsening (dyspnoea, oedema, rapid weight gain); consider in low-salt diets.
- QT lengthening can occur physiologically as potassium falls during correction.
- May be opaque to X-rays; watch for signs of intestinal perforation.
Side effects
- Most common: hypokalaemia (4.1%) and oedema related events (5.7%).
- Others: constipation, nausea, diarrhoea, abdominal pain, vomiting, rash, pruritus, mostly mild to moderate.
- Worsening of pre-existing heart failure in 13.6% on Lokelma versus 5.7% on placebo.
Interactions
- Can transiently raise gastric pH: take medicines with pH-dependent bioavailability (e.g. ketoconazole, itraconazole, posaconazole, atazanavir, erlotinib, dasatinib, nilotinib) at least 2 hours before or after.
- Take tacrolimus at least 2 hours before or after Lokelma.
Pregnancy and breastfeeding
- As a precaution, it is preferable to avoid use during pregnancy.
Summary of the official product information, written with AI on 2026-10-29. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.
Common questions – ask Medelix
For patients
Package leaflet, verbatim
This product has no separate US patient information.
Authorisation and brand names by country
Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.
EU – centrally authorised (all member states)
- LokelmaAstraZeneca AB · EMEA/H/C/004029
Source: European Medicines Agency (EMA), product information
Turkey
- SimkelmaASTRAZENECA İLAÇ SAN. VE TİC. LTD. ŞTİ. · 4 register entries
Source: TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, as of 2026-10-16
Brand names in 3 more European countries
- Iceland
- Lokelma
- Liechtenstein
- Lokelma
- Norway
- Lokelma
EMA – Article 57 product data (EU/EEA), 2026-10-29
Medelix receives no money from pharmaceutical companies. Brand names are listed alphabetically and without ranking.
Other substances in the same group
Another question about this substance?
Medelix answers clinical questions from guidelines, studies and product information – every claim with its source.
Sources
- European Medicines Agency. Lokelma – EPAR, Product Information. 2026-10-28. https://www.ema.europa.eu/en/documents/product-information/lokelma-epar-product-information_en.pdf
- TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, 2026-10-16. https://www.titck.gov.tr/dinamikmodul/85
- Wikidata (CC0): ATC V03AE.
Editorial: Medelix editorial team · last updated 2026-10-28 · How these pages are made · Report an error
Source: European Medicines Agency (EMA), product information. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.