Lokelma: A Comprehensive Guide To The Medication For Hyperkalemia

Introduction

What is Lokelma?

Lokelma is a medicine that contains an active ingredient called sodium zirconium cyclosilicate, which belongs to a group of medicines called potassium binders, a class of medicines that binds extra potassium in bowels and helps to remove the excess potassium from the body through stool. ¹ Introduction | Researched based study from Electronic Medicines Compendium Lokelma is a prescription drug that is indicated to treat hyperkalemia in adults. It functions by reducing the excessive levels of potassium in the body and assisting in maintaining it at a healthy level. Potassium binds to the drug as it travels through the stomach and intestines, and the two are then excreted from the body together in the feces thus lowering the potassium level in the body. ¹ Introduction | Researched based study from Lokelma , ² Introduction| Researched based study from Lokelma

Mechanism

How does Lokelma Work?

• By binding to potassium in the gastrointestinal (digestive) tract lumen, Lokelma increases fecal potassium excretion.
• By reducing the amount of free potassium in the gastrointestinal lumen, binding of potassium lowers the serum potassium level, treating hyperkalemia in those who are affected by it. ³ Mechanism of Action| Researched based study from United States Food and Drug Administration

Hyperkalemia

What is Hyperkalemia?

• A disease called hyperkalemia is brought on by excessive potassium levels in the blood.
• Abdominal pain, nausea, vomiting, and/or diarrhea are few symptoms associated with this condition.
• Serious symptoms include weakening of your muscles, and/or cardiac effects.
• A low-potassium diet, drugs that lower potassium levels, and dialysis are effective forms of treatment used to treat the condition.  ⁴ Hyperkalemia| Researched based study from Cleveland Clinic

Dosage

Strength & Dosage Forms

• A packet of Lokelma contains a powder that ranges in color from white to grey.
• For each sachet of Lokelma oral suspension, there are 5g and 10g of powder to be mixed in.
• Typically, a carton of 3 or 30 sachets is used to deliver the sachets. ¹ Dosage Forms | Researched based study from Electronic Medicines Compendium

Administration

How is Lokelma Taken?

Always take this medication precisely as your doctor has prescribed. Consult your doctor if you have any questions.

• Take Lokelma every day at the same time, with or without food.
• Pour the powder into a glass with around 45 ml of still (non-carbonated) water after opening the packet.
• Stir thoroughly before immediately drinking the flavorless drink. To ensure that you’ve consumed all of the medicine, thoroughly rinse the glass with extra water.  ¹ Administration | Researched based study from Electronic Medicines Compendium

Side Effects

Lokelma Side Effects

Consult your doctor if any of these symptoms bother you or are persistent-

Common side effects:

• Edema
• Constipation
• Diarrhea
• Vomiting
• Palpitation (pounding heartbeat)
• High blood pressure. ⁵ Side Effects| Researched based study from National Institutes of Health

Serious side effect: (resulting in patients stopping their Lokelma medication)

• Severe hypokalemia (low potassium level in blood) associated with signs such as tiredness, muscle weakness, and/or cramps in affected individuals. ¹ Side Effects | Researched based study from Electronic Medicines Compendium

Precautions

Warnings & Precautions

• Lokelma should be avoided if a patient is allergic or hypersensitivity to sodium zirconium cyclosilicate or any other medication ingredients. ¹ Precautions| Researched based study from Electronic Medicines Compendium
• Before taking Lokelma, let your doctor know if any of the following apply to you:
• QT prolongation (Heart signaling disorder)
• Sudden/severe abdominal pain.

Use in particular populations:

Pregnant women:

Since the safety and effectiveness of using the medication during pregnancy are unknown, Lokelma is not recommended during pregnancy.

Breastfeeding women:

Given that breastfeeding women receive very little systemic exposure to Lokelma, it is advised to use this medication with caution.

Use in children:

Children (under the age of 18) should not take Lokelma because research on the drug’s safety and effectiveness in this age range is lacking.

Use in geriatric (elderly) patients:

In order to prevent adverse effects in this age group, patients who are elderly (65 years of age or older) should use Lokelma medication cautiously and in consultation with their healthcare physician. ¹ Precautions| Researched based study from Electronic Medicines Compendium , ³ Precautions | Researched based study from United States Food and Drug Administration

Interactions

Drug Interactions with Lokelma

Several medications should not be taken together with Lokelma owing to possible drug interactions. Before beginning treatment with Lokelma, be sure to tell your doctor about all of the medications you are presently taking, especially any of those listed below, to prevent side effects.

• Posaconazole, itraconazole, and ketoconazole (used to treat fungal infections)
• Nelfinavir, atazanavir, ritonavir, indinavir, saquinavir, rilpivirine, ledipasvir, and raltegravir (used to treat HIV infection)
• Anticancer medicines such as tyrosine kinase inhibitors (Ex. nilotinib, dasatinib, and erlotinib). ¹ Interactions| Researched based study from Electronic Medicines Compendium

FAQs

Frequently Asked Questions About Lokelma

Q. What does Lokelma do during dialysis?

• Due to hyperkalemia that develops on non-dialysis days, patients receiving hemodialysis therapy have been demonstrated to be related with an increased risk of hospitalization and ER visits. 
• Lowering blood potassium levels between treatments can be facilitated by taking LOKELMA during days off from dialysis.
• It is advised to avoid taking Lokelma while on dialysis since adverse effects such as abrupt illness, decreased appetite, and/or diarrhea may occur which should be informed immediately to the doctor for dose adjustment. ⁶ FAQs| Researched based study from Lokelma

Q. How much does Lokelma reduce potassium levels?

• A statistically significant 14% potassium reduction was seen one hour after the first dose of Lokelma 10 g, which was given three times per day. ⁷ FAQs| Researched based study from Electronic Medicines Compendium
• This resulted from a decrease in serum potassium of 0.7 mmol/L at 48 hours.
• A stronger response to Lokelma was seen in patients with higher baseline potassium levels, who were also observed with lower blood potassium levels. ⁷ FAQs| Researched based study from Electronic Medicines Compendium

Takeaway

Lokelma: Prescription Drug for Hyperkalemia

• Lokelma is used to treat hyperkalemia in adults, but not in emergency situations.
• Lokelma might be advised three times daily for the first two days of treatment. The appropriate starting dose will be recommended for you by your doctor.
• If you miss a dosage of Lokelma, take it as soon as you remember. If it will be soon before your next dose, omit the missed dose and take your usual dosage instead.
• Lokelma starts to work 1 hour after the first dose, and then continues to lower potassium levels for the next 48 hours. ¹ Takeaway Tips| Researched based study from Electronic Medicines Compendium