Sodium zirconium cyclosilicate for treating hyperkalaemia

Sodium zirconium cyclosilicate (Lokelma, AstraZeneca) has a marketing authorisation 'for the treatment of hyperkalaemia in adult patients'.

Correction phase:

The recommended starting dose of sodium zirconium cyclosilicate is 10 g, administered 3 times a day orally as a suspension in water. When normal serum potassium levels are reached, the maintenance regimen should be followed. If normal serum potassium levels are not reached after 72 hours of treatment, sodium zirconium cyclosilicate should be stopped.

Maintenance phase:

For people with normal serum potassium levels after the correction phase, the minimal effective dose of sodium zirconium cyclosilicate to prevent recurrence of hyperkalaemia should be established. A starting dose of 5 g once daily is recommended, with possible titration up to a maximum of 10 g once daily or down to 5 g once every other day as needed to maintain a normal serum potassium level.

The list price of sodium zirconium cyclosilicate is £10.40 per 10-g sachet or £5.20 per 5-g sachet (company information, November 2021).

Costs may vary in different settings because of negotiated procurement discounts.