People with certain conditions may be more likely to develop high potassium levels (hyperkalemia). Although these high levels may only last for a short time, some people will have high levels that do not return to normal. To lower their potassium levels, these people may need to take medicine, adjust their current medicines, follow a low-potassium diet, or a combination of these.
Lokelma is an oral liquid medicine that can help to treat high potassium levels. This medicine may be an option for some people who need to lower their potassium levels and then keep their levels in the normal range over time.
How Does Lokelma Work for High Potassium Levels?
Potassium is an important mineral that helps the heart, muscles, and nerves to work properly. If you have too much or too little potassium, however, the body may not be able to function correctly.
High potassium levels in the blood (hyperkalemia) can cause serious health issues. If your potassium levels stay high for a long time, this can cause damage to your heart. Very high potassium levels can cause a heart attack. Some people who have high potassium levels may not have any symptoms. Other people may have symptoms that include chest pain, abnormal heart rhythm, muscle weakness or numbness, or feeling the heart fluttering in the chest (heart palpitations).
There are many reasons that a person may have high potassium levels. Here are some of the more common causes:
- Kidney problems. When the kidneys aren’t working correctly, they may not flush enough potassium out with your urine.
- Certain medicines. Some medicines can stop your kidneys from flushing out enough potassium with your urine. These medicines can cause high potassium levels, especially if you take more than one.
- Eating too much potassium. If your diet is very high in potassium, or if you are taking potassium supplements, your kidneys may not be able to keep up. This can cause your potassium levels to increase. Salt substitutes also contain large amounts of potassium and may cause some people to have high potassium levels.
The key to treating high potassium levels is to reduce the amount of potassium in the body. This can be done in a few different ways, including:
- Reducing the amount of potassium in the diet
- Stopping medicines that are causing high potassium levels
- Adding certain medicines that can help the body to flush out more potassium in the urine (diuretics)
- Taking medicines that stop the body from absorbing potassium from foods
Lokelma is one of the medicines that can stop the body from absorbing potassium from food. The active ingredient in Lokelma is a medicine called sodium zirconium cyclosilicate. This medicine binds to potassium in the intestines, which stops the body from absorbing it. Instead, it stays in the gut and passes into the feces. Higher doses of this medicine bind to more potassium, which can help bring high potassium levels back to normal. Lower doses can help to keep potassium levels in the normal range.
How Do I Use It?
If you have high potassium levels, your health care provider may tell you to take Lokelma up to three times each day for 2 days to bring your potassium levels down to normal. Once your potassium levels are normal, you may only need to take Lokelma once every day or once every other day. Your health care provider will monitor your potassium levels to decide which dose you should take and how often.
If you are on dialysis, your health care provider may give you different instructions for taking Lokelma. For example, they may tell you to only take it on non-dialysis days. Once you have started taking the medicine, they will monitor your potassium levels and let you know which dose to take and how often.
Lokelma is a flavor-free powder that must be mixed with water and then taken by mouth. To take a dose, you will pour the powder out of a foil packet and into a cup, then mix it with at least 3 tablespoons (45 mL) of water. You can use more water if you prefer. The powder will not mix completely into the water, so expect the liquid to look cloudy. Stir the dose well and then immediately drink the water after stirring. If there is still powder in the cup after taking a dose, you should add more water, stir it well, and drink the rest of the dose. Make sure there is no powder left in the cup.
How Was It Studied for Treating High Potassium Levels?
Two studies were done to see if Lokelma was safe and effective for adults with high potassium levels. Everyone in these studies had high levels of potassium in their blood before the study started. Both studies included people who were at least 18 years old, with an average age of about 62-65. A little more than half (58%) of the people in these studies were male. Most of the people (83%) were White, about 12% were Black, and less than 1% were Asian.
Lokelma was compared with a placebo. The people in the study did not know whether they were receiving the medicine or the placebo. For the first 2 days of the study, everyone took three doses each day. After that, they took one dose each day.
These studies measured effectiveness in two ways:
- One study measured how much each person’s potassium levels decreased during the first 1-2 days of the study.
- Both studies measured potassium levels after 1-2 weeks in the study. One study also counted the number of people who still had normal potassium levels after 1 month in the study.
What Were the Benefits?
Bringing potassium levels back to normal. In the first 2 days of the study, people were taking Lokelma or placebo three times each day. The people who took Lokelma had their potassium levels drop further than the people who took placebo during the first 2 days. Everyone that took 10 grams of Lokelma three times daily had their potassium levels return to normal during this time.
Keeping potassium levels normal. After the first 2 days, people took Lokelma or placebo once each day. On average, the people taking Lokelma had lower potassium levels than the people taking placebo over the next 1-2 weeks. Also, more people taking Lokelma had normal potassium levels after 1 month.
How Quickly Will Lokelma Work for High Potassium Levels?
Lokelma should lower your potassium levels within 1-2 days. Your health care provider will check your levels to make sure it is working for you. Once your potassium levels have dropped back into the normal range, you may be told to continue taking Lokelma to keep your potassium levels normal. Your health care provider will continue to monitor your potassium levels and may tell you to change your dose over time.
Do not increase or decrease your dose without talking to your health care provider first. Taking too much Lokelma may cause your potassium levels to drop too low; taking too little may cause your potassium levels to get too high.
What If I Stop Taking Lokelma?
If you stop taking Lokelma, your potassium levels may become too high again. In clinical studies, people who stopped taking the medicine had high potassium levels again within a week after stopping. If you are considering stopping your Lokelma, speak with your health care provider first. They can discuss your other treatment options with you.
How Can I Prevent or Manage Side Effects?
Lokelma contains large amounts of sodium (each 5-gram dose contains 400 milligrams of sodium). Depending on the daily dose prescribed by your health care provider, you may take up to 1,200 milligrams of sodium daily. If you have high potassium levels and are taking Lokelma more than once per day, you may get up to 2,400 milligrams of sodium from the medicine each day.
People who are on a low-sodium diet or who are sensitive to salt may need to change their diet while they are taking Lokelma. Large amounts of sodium can cause fluid retention and swelling (edema). For people with certain conditions, such as heart failure or kidney problems, this can cause serious health issues. Let your health care provider know if you have any of these conditions or if you have a history of fluid retention. They can work with you to modify your diet or your other medicines to help prevent fluid retention.
These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Lokelma, you can also report side effects to the FDA at 800-FDA-1088.
Are There Any Interactions With Other Medicines?
Tell your pharmacist or health care provider about all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them to determine the best treatment plan for you.
Lokelma can change the absorption of other medicines. To prevent this from happening, you should avoid taking Lokelma within 2 hours before taking other medicines and within 2 hours after taking other medicines. If you are unable to schedule your doses this way, speak with your pharmacist or other health care provider about your options. They will review all of your medicines and work with you to come up with a schedule for taking them.
What Are Other Unique Considerations to Be Aware Of?
Lokelma may show up on X-rays of the abdomen, making it difficult for your health care provider to read the results of the test. Let your health care provider know ahead of time that you are taking Lokelma if you are scheduled to have an X-ray. You should also mention this to the person who is taking your X-ray.
Is There a Coupon Card Available?
There is a savings coupon available from the manufacturer that may allow you to pay as little as $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. You can find out more at www.lokelma.com/support-program.html.