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LOKELMA® (sodium zirconium cyclosilicate) is indicated for the treatment of hyperkalaemia in adult patients.
Watch now to learn more about how LOKELMA is administered.
Adapted from Spinowitz et al. 2019.
This guidance is not prescriptive or intended to replace clinical judgement. In an emergency situation, standard of care should be used in line with local or national hyperkalaemia management guidelines.
Adapted from Spinowitz et al. 2019.
* Study ZS-005 was a 12-month, multicentre, open-label, single-arm, phase 3 trial evaluating the long-term safety and efficacy of LOKELMA in patients with hyperkalaemia. In the correction phase, adult patients (n=751) with serum potassium levels of ⪰ 5 mmol/L received LOKELMA 10g three times daily for 24-72 hours until normokalaemic (3.5-5.0 mmol/L). Patients (n=746) who achieved normokalaemia entered the subsequent 12-month maintenance phase and received 5g of LOKELMA once daily titrated to maintain normokalaemia without dietary or medication restrictions. Prespecified primary end points were restoration of normal serum potassium values (3.5-5.0 mmol/L) during the correction phase and maintenance of serum potassium ⪰5.1 mmol/L during maintenance phase. Adverse events were assessed throughout.3
Serum potassium levels should be monitored regularly during hyperkalaemia treatment, and monitoring frequency can depend on several factors, including:1,2
In the event of severe hypokalaemia, LOKELMA administration should be discontinued and the patient should be re-evaluated.1,2
LOKELMA dosing should exclusively occur on non-dialysis days.1,2
The recommended LOKELMA starting dose is 5g once daily. To establish normokalaemia (4.0–5.0 mmol/L), this dose may be titrated up or down weekly based on the pre-dialysis serum potassium value after the long interdialytic interval.1,2
Dose adjustments should be done at intervals of 1 week in increments of 5g up to 15g once daily on non-dialysis days.1,2
It is recommended to monitor serum potassium weekly while the LOKELMA dosage is adjusted. Once normokalaemia is established, potassium should be monitored regularly (e.g. monthly, or more frequently based on clinical judgement including changes in dietary potassium or medication affecting serum potassium).1,2
If a dose of LOKELMA is missed, advise patients to resume their regular dosing schedule with the next dose.
An overdose of LOKELMA (sodium zirconium cyclosilicate) may result in hypokalaemia. Serum potassium levels should be monitored and potassium supplemented as needed.1,2
There are no data from the use of LOKELMA in pregnant women. Therefore, as a precautionary measure, it is advisable to avoid the use of LOKELMA during pregnancy.1,2
In a postnatal study in rats, maternal exposure to LOKELMA had no effect on postnatal development. Due to its physicochemical properties, LOKELMA is not systemically absorbed and is not expected to be excreted in breast milk. No effects on the breastfed newborn/infant are anticipated since the systemic exposure of the breast-feeding woman to LOKELMA is negligible. LOKELMA can be used during breast-feeding.1,2
There are no specific dosage or administration guidelines recommended for the elderly population.1,2
The safety and efficacy of LOKELMA in children and adolescents under 18 years of age have not been established.1,2
If you have any questions about LOKELMA or would like to speak to an
AstraZeneca representative, please contact us
AD, alternate days; CKD, chronic kidney disease; OD, once daily.
GB-75600 | DOP: April 2026
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to AstraZeneca by visiting https://contactazmedical.astrazeneca.com/ or by calling 0800 783 0033.
GB-74216| DOP : February 2026
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