LOKELMATM Sodium Zirconium Cyclosilicate

New, highly-selective LOKELMA (sodium zirconium cyclosilicate)
is indicated for the treatment of hyperkalaemia in adult patients1

*In an emergency situation, standard of care should be used in line with local or national guidelines
Clinical trials with LOKELMA have not included exposure longer than one year

References & Resources



  1. LOKELMA Summary of Product Characteristics. AstraZeneca, 2019. https://www.medicines.org.uk/emc/product/10059/smpc; Accessed May 01, 2019.
  2. Kosiborod M, et al. Effect of Sodium Zirconium Cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial. JAMA. 2014;312(21):2223-2233.
  3. Stavros F, et al. Characterization of structure and function of ZS-9, a K+ selective ion trap. PLoS One. 2014;9(12):e114686.
  4. Spinowitz BS, et al. Sodium Zirconium Cyclosilicate among Individuals with Hyperkalaemia: A 12-month phase 3 study. Clin J Am Soc Nephrol. 2019;14:798-809.
  5. Rastergar A, Soleimani M. Hypokalemia and hyperkalemia. Postgrad Med J. 2001;77:759-764.
  6. Luo J, et al. Association between serum potassium and outcomes in patients with reduced kidney function. Clin J Am Soc Nephrol. 2016;11(1):90-100.
  7. Thomsen RW, et al. Elevated potassium levels in patients with chronic kidney disease: occurrence, risk factors and clinical outcomes – a Danish population-based cohort study. Nephrol Dial Transplant. 2017;1-10.
  8. Thomsen RW, et al. Elevated potassium levels in patients with congestive heart failure: occurrence, risk factors, and clinical outcomes – A Danish population-based cohort study. J Am Heart Assoc. 2018;7:e008912.
  9. Thomsen RW, et al. Research: complications. Hyperkalaemia in people with diabetes: occurrence, risk factors and outcomes in a Danish population-based cohort study. Diabet Med. 2018;35:1051-1060.
  10. Dunn JD, et al. The burden of hyperkalemia in patients with cardiovascular and renal disease. Am J Manag Care. 2015;21(15 Suppl):s307-s315.
  11. Rosano G, et al. Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors: coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology. Eur Heart J. 2018;4:180-188. 
  12. Ponikowski P, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-2200.
  13. KDOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Available from National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NK KDOQI) web site. www.kidney.org/professionals/KDOQl/guidelines_bp/guide_11.htrn#table 131; Accessed May 01, 2019. 
  14. NICE Clinical Guideline 182. Chronic kidney disease in adults. https://www.nice.org.uk!guidance/cg 182. Accessed May 01, 2019. 
  15. Think Kidneys, the Renal Association, and the British Society for Heart Failure Positioning Statement Oct 2017. https://www.thinkkidneys.nhs.uk/aki/wp-content/uploads/sites/2/2017/10/Changes-in-Kidney-Function-FINAL.pdf; Accessed May 01, 2019
  16. Renal Association UK. Emergency Management of Hyperkalaemia in Adults Algorithm. 2014.
  17. Epstein M, et al. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. Am J Manag Care. 2015;21(11 Suppl):S212-S220.
  18. Collins AJ, et al. Association of serum potassium with all-cause mortality in patients with and without heart failure, chronic kidney disease, and/or diabetes. Am J Nephrol. 2017;46:213-221.
  19. Furuland H, et al. Serum potassium as a predictor of adverse clinical outcomes in patients with chronic kidney disease: new risk equations using the UK clinical practice research datalink. BMC Nephrol. 2018;19(1):211.
  20. Aldahl M, et al. Associations of serum potassium levels with mortality in chronic heart failure patients. Eur Heart J. 2017;38:2890-2896.
  21. Bennett H, et al. Quantifying the relationship between hyperkalaemia and outcomes in Patients with heart failure and chronic kidney disease. Value in Health. 2017;20(9):A682.
  22. Desai AS, et al. Incident Hyperkalaemia, Hypokalaemia, and Clinical Outcomes During Spironolactone Treatment of Heart Failure With Preserved Ejection Fraction: Analysis of the TOPCAT. J Card Fail. 2018;24(5):313-320.
  23. U.S. National Institutes of Health. Open-label safety & efficacy of ZS (Sodium Zirconium Cyclosilicate) 10g QD to extend Study ZS-004 in hyperkalemia. ClinicalTrials.gov website. https://clinicaltrials.gov/ct2/show/ NCT02107092; Accessed May 01, 2019.
  24. Fishbane, S, et al. Long-term Efficacy and Safety of Sodium Zirconium Cyclosilicate for Hyperkalemia: A 12-Month, Open-Label, Phase 3 Study. Poster presentation at: American Society of Nephrology Kidney Week. 2017.


GB-16424 – May 2019