Lokelma (Sodium Zirconium Cyclosilicate)
Although statistically a success, ZS-9 adds very little to the acute management of clinically relevant hyperkalemia - Ryan Radecki
HWN Suggests
A Brave New Kayexalate Free World
There may soon come a time when we witness the death of the much maligned cation-exchange resin, Kayexalate Unfortunately not for the reasons we hoped. We will not see the use of sodium polystyrene sulfonate fade from use in the modern Emergency Department because of our tireless efforts to remind our Internal Medicine colleagues of its lack of efficacy. Rather its clinically irrelevant place in the management of acute hyperkalemia will now be replaced by a brand new shiny cation-exchange resin that our Nephrologist consultants can use to delay the 3 am dialysis treatment our patient with a potassium of 9 mmol/L desperately requires.
Articles of Interest
Choose Lokelma in the Emergency Department
LOKELMA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action. LOKELMA may be initiated in the emergency department to eliminate potassium.
Drug Trials Snapshots: LOKELMA
The FDA approved LOKELMA based primarily on evidence from two clinical trials (Trial 1 #NCT01737697 and Trial 2 #NCT02088073) of patients with hyperkalemia. The trials were conducted in the USA, Australia and South Africa.
Lokelma (sodium zirconium cyclosilicate)
Lokelma is not approved to treat acute hyperkalemia. Acute hyperkalemia refers to a sudden and life threatening episode of hyperkalemia.
New Kid on The HyperK Block… Lokelma
First off, Lokelma is the brand name, and way more preferred over its generic name, Zirconium cyclosilicate, since it says right in the name what it does—it lowers your potassium. If you really want to show your age, you may see it sometimes referred to as ZS-9 when it was first being studied in the early 2010s. Per Kidney International Journal (who knew this existed): “Zirconium is a biologically inert trace element found widely in nature.” And according to other sources, you likely eat ~4 mg of zirconium daily in your normal diet.
Resources
Lokelma
LOKELMA is a prescription medicine for adults with hyperkalemia (high potassium). It lowers your high potassium level and helps keep it in a normal range with continued use.
