Answer
Feb 09, 2026 - 02:27 PM
Yes. Lokelma (sodium zirconium cyclosilicate) can be used in adults receiving chronic hemodialysis to help manage hyperkalemia (high potassium). The FDA specifically approved labeling for use in patients on chronic hemodialysis.
For patients on chronic hemodialysis, Lokelma is generally given only on non-dialysis days. The recommended starting dose is 5 g once daily on non-dialysis days; a 10 g starting dose may be considered when serum potassium is greater than 6.5 mEq/L. The dose is then adjusted according to the pre-dialysis potassium level, with a recommended maintenance range of 5–15 g once daily on non-dialysis days.
Potassium should be monitored because hypokalemia can occur, particularly during illnesses associated with decreased food intake or diarrhea. Lokelma also contains sodium, so fluid status and edema may need monitoring.
Lokelma is not intended as emergency treatment for life-threatening hyperkalemia because its onset is not rapid enough for that purpose.
