Lokelma (sodium zirconium cyclosilicate) is a prescription drug used to treat high blood potassium levels. Lokelma can cause side effects that range from mild to serious. Examples include fluid swelling in areas of the body and low blood potassium levels.

Specifically, Lokelma is used in adults to treat high potassium levels in your blood. Because this is a slow-acting medication, it isn’t used for emergencies.

The active ingredient in Lokelma is sodium zirconium cyclosilicate. (An active ingredient makes a drug work.) The drug comes as a powder that you mix with water and drink.

Keep reading to learn about the common, mild, and serious side effects Lokelma can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may have mild to serious side effects during their Lokelma treatment. There may be other mild side effects of the drug not listed here, and not everyone will get these side effects.

Examples of Lokelma’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below

Mild side effects have been reported with Lokelma. These include:

Most of the time, edema is mild and can be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Lokelma unless your doctor recommends it.

Lokelma may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Lokelma, but this side effect wasn’t reported in studies.

Rare but serious side effects have been reported with Lokelma, including low blood potassium levels.*

Severe allergic reaction* is also possible after taking Lokelma, but this side effect wasn’t reported in studies.

If you experience serious side effects while taking Lokelma, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Lokelma, visit MedWatch.

Get answers to some frequently asked questions about Lokelma’s side effects.

How do side effects of Lokelma compare with those of Kayexalate?

Kayexalate works in the same way as Lokelma to lower potassium levels in the bloodstream. But there have been more side effects reported with Kayexalate, including:

  • lack of appetite
  • nausea and vomiting
  • diarrhea
  • constipation
  • hard stool stuck in the colon
  • thickened food stuck in the stomach

And in rare cases, colon damage and bleeding can happen with Kayexalate.

The only side effects seen in Lokelma studies were edema (fluid buildup in your body) and low blood potassium levels. And studies done after Lokelma came on the market showed edema was the main side effect.

Can Lokelma cause constipation?

No, constipation was not a side effect reported in studies of Lokelma. But it’s best to let your doctor know if you have severe constipation before beginning Lokelma treatment. If you have severe constipation, Lokelma may worsen your symptoms, and it may not work as well to lower your potassium levels.

Can Lokelma cause diarrhea?

No, Lokelma does not cause diarrhea. Although diarrhea is common with other potassium-lowering drugs, such as Kayexelate, this side effect was not seen in Lokelma studies.

Learn more about some of the side effects Lokelma may cause.

Edema (fluid buildup in your body)

Swelling of hands, fingers, lower legs, ankles, feet, or toes from fluid retention was a common side effect reported in Lokelma studies. Fluid retention was caused by the sodium content in the drug.

Swelling may cause symptoms such as:

  • tightness in the swollen area
  • misshapen-looking wrists, fingers, ankles, or toes
  • fluid seeping from the skin
  • redness or skin discoloration
  • pain when touched

Factors that can increase the risk of fluid buildup and swelling when taking this drug include:

* This daily dosage contains a total of 1,200 milligrams (mg) of sodium.

What might help

If you have edema during Lokelma treatment, consider the following tips to help relieve your symptoms:

If swelling happens, it’s best to talk with your doctor. They’ll likely recommend lab tests and an office visit so they can prescribe a medication to help remove extra fluid from your body.

Low blood potassium

Lokelma may cause blood potassium to get too low, which is called hypokalemia. When blood potassium drops too low, it may cause a heart attack and lead to death. You might feel symptoms when your potassium gets really low. Symptoms to watch for include:

If you’re getting hemodialysis (a special treatment to filter your blood), you have a higher risk of very low potassium levels with Lokelma.

What might help

If you notice symptoms of low blood potassium, call your doctor right away. If your symptoms are severe, they’ll likely recommend a hospital visit for an immediate dose of potassium and a Lokelma dosage adjustment.

Allergic reaction

Like most drugs, Lokelma can cause an allergic reaction in some people. But this side effect wasn’t reported in studies. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Lokelma, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Lokelma, they may have you switch to a different treatment.

Keeping track of side effects

During your Lokelma treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Lokelma affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before taking Lokelma.


Lokelma can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Lokelma is a good treatment option for you.

Talk with your doctor about your health history before starting Lokelma. Be sure to tell them if any of the following factors apply to you:

Alcohol and Lokelma

There are no known interactions between alcohol and Lokelma. If you have questions about consuming alcohol while taking this drug, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Lokelma

Before starting Lokelma treatment, it’s important to talk with your doctor if you’re pregnant, breastfeeding, or planning to be either.


Lokelma is generally considered safe to take during pregnancy because it’s not absorbed into the bloodstream. But if you’re pregnant or planning a pregnancy, you should still talk with your doctor before starting treatment with this medication.


Lokelma is generally considered safe to take while breastfeeding because it doesn’t pass into breast milk. But if you’re breastfeeding or planning to do so, you should still talk with your doctor before starting Lokelma treatment.

Like most drugs, Lokelma can cause a number of side effects that range from mild to serious. However, most are temporary and go away after a few days to weeks. If you have questions about side effects that Lokelma can cause, talk with your doctor.

Examples of questions to help get you started include:

  • Will Lokelma cause me to gain weight?
  • Will the sodium from Lokelma give me high blood pressure?
  • Is kidney damage a side effect of Lokelma?

To learn more about Lokelma, see these articles:

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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.