Sodium zirconium cyclosilicate: Difference between revisions
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==Administration<ref>Packham, D. K., Rasmussen, H. S., Lavin, P. T., El-Shahawy, M. A., Roger, S. D., Block, G., … Singh, B. (2015). Sodium zirconium cyclosilicate in hyperkalemia. The New England Journal of Medicine, 372(3), 222–231.</ref>== | ==Administration<ref>Packham, D. K., Rasmussen, H. S., Lavin, P. T., El-Shahawy, M. A., Roger, S. D., Block, G., … Singh, B. (2015). Sodium zirconium cyclosilicate in hyperkalemia. The New England Journal of Medicine, 372(3), 222–231.</ref>== | ||
*Type: Potassium binder, antidote | *Type: Potassium binder, [[antidote]] | ||
*Dosage Forms: 5 g (1 ea, 30 ea); 10 g (1 ea, 30 ea), empty contents into glass with 45 mL of water | *Dosage Forms: 5 g (1 ea, 30 ea); 10 g (1 ea, 30 ea), empty contents into glass with 45 mL of water | ||
*Routes of Administration: Oral | *Routes of Administration: Oral | ||
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==Adult Dosing== | ==Adult Dosing== | ||
===Hyperkalemia=== | ===[[Hyperkalemia]]=== | ||
10 g TID PO for up to 48 hours, then 10 g once daily | *10 g TID PO for up to 48 hours, then 10 g once daily | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
*Highly selective, oral potassium removing agent | *Highly selective, oral potassium removing agent | ||
*Non-absorbed zirconium silicate that captures potassium in exchange | *Non-absorbed zirconium silicate that captures potassium in exchange for hydrogen and sodium | ||
*Increases fecal potassium excretion through binding K+ in GI tract | *Increases fecal potassium excretion through binding K+ in GI tract | ||
| Line 48: | Line 48: | ||
*Onset of action at 1.0 hour and median time to achieving normal potassium levels at 2.2 hours, with 92% achieving normal potassium within 48 hours. | *Onset of action at 1.0 hour and median time to achieving normal potassium levels at 2.2 hours, with 92% achieving normal potassium within 48 hours. | ||
*Not used as an emergency treatment for life threatening hyperkalemia due to delayed onset of action | *Not used as an emergency treatment for life threatening hyperkalemia due to delayed onset of action | ||
*Available at Harbor-UCLA, but not yet widely available in the community | |||
*If asked by nephrology to give Kayexalate, kindly suggest Lokelma instead | |||
==See Also== | ==See Also== | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:FEN]] | |||
Latest revision as of 20:13, 29 March 2023
Administration[1]
- Type: Potassium binder, antidote
- Dosage Forms: 5 g (1 ea, 30 ea); 10 g (1 ea, 30 ea), empty contents into glass with 45 mL of water
- Routes of Administration: Oral
- Common Trade Names: Lokelma
Adult Dosing
Hyperkalemia
- 10 g TID PO for up to 48 hours, then 10 g once daily
Pediatric Dosing
Special Populations
Pregnancy Rating
- unlikely to affect fetus as not absorbed
Lactation risk
- unlikely to be in breast milk as not absorbed
Renal Dosing
None
Hepatic Dosing
None
Contraindications
- Allergy to class/drug
- Avoid in GI motility disorders
Adverse Reactions
Serious
Common
- Mild to moderate edema
- Hypokalemia
Pharmacology
- Metabolism: none
- Excretion: feces
Mechanism of Action
- Highly selective, oral potassium removing agent
- Non-absorbed zirconium silicate that captures potassium in exchange for hydrogen and sodium
- Increases fecal potassium excretion through binding K+ in GI tract
Comments
- Onset of action at 1.0 hour and median time to achieving normal potassium levels at 2.2 hours, with 92% achieving normal potassium within 48 hours.
- Not used as an emergency treatment for life threatening hyperkalemia due to delayed onset of action
- Available at Harbor-UCLA, but not yet widely available in the community
- If asked by nephrology to give Kayexalate, kindly suggest Lokelma instead
See Also
References
- ↑ Packham, D. K., Rasmussen, H. S., Lavin, P. T., El-Shahawy, M. A., Roger, S. D., Block, G., … Singh, B. (2015). Sodium zirconium cyclosilicate in hyperkalemia. The New England Journal of Medicine, 372(3), 222–231.
