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How does the drug Lokelma work?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on May 30, 2023.

Official answer


Key Points

  • Lokelma (sodium zirconium cyclosilicate) is an oral medicine that works by binding to potassium (K+) in the small and large intestines to help remove potassium from the blood.
  • Lokelma binds to potassium and exchanges it for hydrogen and sodium. It is an insoluble, non-absorbed sodium zirconium silicate agent classified as a cation exchange resin. These drugs are often called "potassium binders".
  • Lokelma should not be used as an emergency treatment for life-threatening high potassium levels because it has a delayed onset of action.

Lokelma is used to treat high potassium levels (hyperkalemia) in adults. High potassium in the blood is associated with common conditions including chronic kidney disease, high blood pressure, heart failure, diabetes, and side effects of some medications.

The kidneys normally remove potassium from the blood to help maintain an even balance in your body. But if the kidneys lose this full ability, through disease or side effects from medicines, the levels of potassium in your blood can get dangerously high. If you receive hemodialysis, potassium levels can also rise to unwanted levels between dialysis treatments.

High potassium in your blood can lead to weakness, nausea, a dangerous change in your heartbeat, and paralysis. If you experience any of these symptoms, call 911 or get immediate medical assistance.

How fast does Lokelma work?

Potassium levels in the blood start to decline in one hour of the start of Lokelma therapy. In studies, normal potassium levels in the blood were reached in 2.2 hours (median time). Most patients (92%) had normal potassium levels within 48 hours.

In clinical studies, patients received 10 grams of Lokelma three times per day for up to 48 hours. Reductions in serum potassium levels were observed within one hour, and potassium levels continued to decline over the 48 hour period. In patients who did not continue therapy, potassium levels increased.

Lokelma was effective in lowering potassium levels in patients with chronic kidney disease, heart failure, diabetes and those taking renin-angiotensin-aldosterone system (RAAS) inhibitors, for example lisinopril (an ACE inhibitor) or losartan (an ARB).

Related: Lokelma side effects (in more detail)

How do I take Lokelma?

Always take Lokelma exactly as your doctor prescribes it.

Lokelma is available as a powder for oral suspension. It comes in foil packets of either 5 grams (g) or 10 g for reconstitution. It has no taste or smell. You will mix the powder with a small amount of water before you drink it. It does not expand in water, so it is not expected to swell within the digestive tract.

Lokelma can decrease the absorption of other oral medicines and reduce their effectiveness. If you are taking other oral medications, you may need to take them either 2 hours before or 2 hours after you take Lokelma. Ask your doctor or pharmacist.

Related: Lokelma dosing (in more detail)

This is not all the information you need to know about Lokelma for safe and effective use. Review the full Lokelma information here, and discuss this information and any questions you have with your doctor or other health care provider.

  • Lokelma [product information]. AstraZeneca. Wilmington, DE. Updated Oct. 2020. Accessed Feb. 1, 2021 at
  • Patient site. AstraZeneca. Wilmington, DE. Updated April. 2020. Accessed Feb. 1, 2021 at

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