Hyperkalemia Treatment with Lokelma

Efficacy and Safety

The American Heart Association recommends Lokelma for the treatment of hyperkalemia, with a rapid onset of action, reducing serum potassium levels within 1 hour of initiation of therapy with 10g three times a day 1
Lokelma causes a dose-dependent increase in serum bicarbonate concentrations, which may provide an additional benefit for patients with metabolic acidosis, with an increase of 1.1 mmol/L with 5g daily, 2.3 mmol/L with 10g daily, and 2.6 mmol/L with 15g daily 1
The incidence of edema increases with the dose of Lokelma, with 2% incidence at 5g daily, 6% at 10g daily, and 14% at 15g daily 1

The Mayo Clinic recommends a dosage of 10g three times a day for the initial treatment of hyperkalemia, with a reduction in serum potassium levels of approximately 1.1 mEq/L during the 48-hour treatment period 1

Lokelma binds potassium in exchange for both hydrogen ions (H+) and sodium ions (Na+) throughout the gastrointestinal tract, which theoretically could release sodium for absorption 2
Each 5-gram dose contains 400 mg of sodium, compared to 1500 mg per 15-gram dose of sodium polystyrene sulfonate 2
Standard dosing involves 10 g three times daily initially (1200 mg sodium per dose), then 5-15 g once daily for maintenance (400-1200 mg sodium daily) 2

The most common adverse effects are gastrointestinal disorders (constipation, diarrhea, nausea) and hypokalemia, not sodium-related complications 2

Monitor for peripheral edema, particularly when using maintenance doses ≥10 g daily 2