Lokelma (sodium zirconium cyclosilicate) is a prescription drug that’s used to treat hyperkalemia (high potassium levels) in adults. The drug comes as a powder you’ll mix with water to drink.

This section describes the usual dosages of Lokelma. Keep reading to learn more.

What is Lokelma’s form?

Lokelma comes as a powder in individual foil packets. You’ll mix the powder with water to make a suspension (a type of liquid mixture) that you drink.

What strengths does Lokelma come in?

Lokelma comes in two strengths: 5 grams (g) per packet and 10 g per packet.

What are the usual dosages of Lokelma?

Your dosage of Lokelma depends on your potassium levels. The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for hyperkalemia

The typical starting dosage of Lokelma to treat hyperkalemia is 10 g taken three times per day for the first 48 hours (2 days).

If you need to continue taking Lokelma beyond 48 hours, your doctor will likely lower your dosage to 10 g taken once per day. Your doctor will check your blood potassium levels to adjust your dosage if needed and determine how long you should take Lokelma.

If needed, your doctor will adjust your dosage once weekly until you reach the desired potassium level. They’ll typically adjust your dose by 5 g per week if needed. The recommended maintenance dosage ranges from 5 g taken every other day to 15 g taken once per day.

Is Lokelma used long term?

It’s possible. How long you’ll take Lokelma depends on your potassium levels. Your doctor will monitor your potassium levels and determine how long you’ll take the drug.

If you have questions about how long your Lokelma treatment may last, talk with your doctor.

Dosage adjustments

If you have chronic kidney disease and are on hemodialysis, your doctor will likely adjust your dosage. You’ll only take Lokelma on days you don’t have dialysis.

Your doctor will likely start your Lokelma treatment by prescribing a starting dose of 5 grams (g) per day to be taken on days you don’t have dialysis. In some cases, if your potassium level is very high, your doctor may prescribe a starting dose of 10 g of Lokelma once per day on days you don’t have dialysis. Your doctor will monitor your potassium levels and adjust your dosage if needed.

For most people, the maintenance dosage ranges from 5–15 g, taken once per day on non-dialysis days. You’ll take this dosage as long as needed to lower your potassium levels. Your doctor will have you stop taking Lokelma once your potassium reaches the desired level or if you have a low potassium level.

If you have questions about your dosage, talk with your doctor.

The dosage of Lokelma you’re prescribed may depend on several factors. These include:

  • the severity of the condition you’re taking the drug to treat
  • other medications you may be taking
  • other conditions you may have (see the “Dosage adjustments” section above)

Lokelma comes as a powder in individual foil packets. You’ll mix the powder with at least 3 tablespoons of water (you can add more if needed). Then, stir and drink the entire contents.

You should not mix Lokelma with water until you’re ready to take your dose. You can take Lokelma with or without food.

You’ll likely need to space out doses of any other medications from your Lokelma dose by at least 2 hours. This is because Lokelma may affect how your body absorbs some drugs. Before starting Lokelma treatment, talk with your doctor about any other medications or supplements you take.

For information on the expiration, storage, and disposal of Lokelma, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you miss a dose of Lokelma, take it as soon as you remember. If you’re not sure whether you should take a missed dose, talk with your doctor or pharmacist. Do not double your dose of Lokelma to catch up on a missed dose.

If you need help remembering to take your dose of Lokelma on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not take more Lokelma than your doctor prescribes, as this can lead to harmful effects.

What to do in case you take too much Lokelma

Call your doctor right away if you think you’ve taken too much Lokelma. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Lokelma’s dosage.

Is Lokelma’s dosage similar to those of Kayexalate or Veltassa?

Lokelma, patiromer (Veltassa) and sodium polystyrene sulfonate (Kayexalate*) are all used to lower potassium levels, and they belong to the same group of drugs.

The forms and how often you take each drug are similar. All three medications come as a powder you mix with water and drink. In some cases, Kayexalate may also be given as an enema (solution given through a tube rectally).

These drugs have different active ingredients (what makes a drug work) and different dosages. Your doctor will prescribe the drug and the dosage that’s right for you.

To learn more about how these drugs compare, talk with your doctor.

* It’s important to note that the brand-name drug Kayexalate is no longer available in the United States. It’s only available as the generic drug sodium polystyrene sulfonate.

How long does it take for Lokelma to start working?

Lokelma works by attaching to potassium in your digestive tract and removing it from your body through your stool. This lowers your potassium levels. Based on studies of Lokelma, the drug should start to work within about an hour after you take your first dose.

Because of how the drug works, you likely won’t feel it working in your body. But your doctor will monitor your potassium levels during treatment to check how well Lokelma is working for you. How long you take Lokelma depends on how your body responds to treatment and the severity of your condition.

If you have other questions about what to expect from your Lokelma treatment, talk with your doctor.

The sections above describe the usual dosages provided by the manufacturer. If your doctor recommends Lokelma for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Lokelma without your doctor’s recommendation. Only take Lokelma exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Examples of questions you may want to ask your doctor include:

  • Will you need to prescribe a different dosage of Lokelma if I’m taking other medications with it?
  • Will you need to prescribe a higher dosage of Lokelma if my current dosage isn’t working for me?
  • Will you need to adjust my dosage if I have serious constipation?

To learn more about Lokelma, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.