Sodium zirconium cyclosilicate (Lokelma) is available on the NHS as a possible treatment for hyperkalaemia in adults, if used:

  • for acute life-threatening hyperkalaemia in emergency care alongside standard care or
  • for persistent hyperkalaemia in outpatient care for people with chronic kidney disease stage 3b to 5 or heart failure, if they:
    • have a confirmed serum potassium level of at least 6.0 mmol/litre
    • are not taking an optimised dosage of renin-angiotensin-aldosterone system (RAAS) inhibitor because of hyperkalaemia and
    • are not on dialysis.

In outpatient care, sodium zirconium cyclosilicate should be stopped if RAAS inhibitors are not longer suitable.

If you are not eligible for sodium zirconium cyclosilicate but are already taking it, you should be able to continue until you and your doctor decide when best to stop.

Is this treatment right for me?

Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. Your family can be involved too, if you wish. Read more about making decisions about your care.

Questions to think about

  • How well does it work compared with other treatments?
  • What are the risks or side effects? How likely are they?
  • How will the treatment affect my day-to-day life?
  • What happens if the treatment does not work?
  • What happens if I do not want to have treatment? Are there other treatments available?

Information and support

The NHS website may be a good place to find out more.

These organisations can give you advice and support:

You can also get support from your local Healthwatch.

NICE is not responsible for the quality or accuracy of any information or advice provided by these organisations.

ISBN: 978-1-4731-3525-3


This page was last updated: 04 September 2019