The FDA has approved sodium zirconium cyclosilicate (Lokelma, AstraZeneca) for the treatment of hyperkalemia in adults.
Formerly called ZS-9, sodium zirconium cyclosilicate selectively exchanges potassium for hydrogen and sodium throughout the gastrointestinal tract. Its approval is supported by data from 3 double-blind, placebo-controlled trials and 2 open-label long-term trials.
In a trial, the onset of action in patients with hyperkalemia taking the drug was at 1 hour and the median time to achieving normal potassium levels was 2.2 hours. In addition, 92% of patients achieved normal potassium levels within 48 hours from baseline.
Data also show that sodium zirconium cyclosilicate was effective in lowering potassium levels in patients with chronic kidney disease, heart failure, diabetes, and those taking renin-aldosterone-angiotensin-system inhibitors.
The most common adverse event, occurring in 6% of patients, was mild to moderate edema with the recommended dose of 10 grams once daily.