Vijayaganesh Kasinathan
Written & Compiled by Pharmacist Vijayaganesh Kasinathan, B.Pharm, M.Pharm
Suchitra Chari
Medically Reviewed by Suchitra Chari, M.S. M.Sc.
Last Updated on Jun 20, 2018
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General Information on Sodium zirconium cyclosilicate

Generic Name : Sodium zirconium cyclosilicate

Pronunciation : SOW-dee-um zir-KOE-nee-um SYE-kloe-SIL-i-kate

Latest prescription information about Sodium zirconium cyclosilicate. Learn how to pronounce the drug's name, its indications, dosage, how to take, when to take, when not to take, side effects, special precautions, warnings and its storage instructions . Also listed are the Indian trade name(s) of the drug and its price list.
Therapeutic Classification : Gastrointestinal Agents

Trade Names/Brand Names of Sodium zirconium cyclosilicate


Overview of Sodium zirconium cyclosilicate

Sodium zirconium cyclosilicate was approved by FDA on May 18, 2018, to use as an oral suspension for treating adult patients with high blood potassium levels.

Why is Sodium zirconium cyclosilicate Prescribed? (Indications)

Sodium zirconium cyclosilicate is prescribed for treating adult patients suffering from hyperkalemia or high potassium levels in the blood.

Sodium zirconium cyclosilicate acts as a selective potassium binder in the gastrointestinal tract; it works by reducing the concentration of potassium in the gastrointestinal lumen by binding with potassium thereby resulting in low blood potassium levels.

Hyperkalemia is a medical condition in which the serum potassium concentration is higher than 5.5 mEq/L which occurs either due to excess total body stores or increased movement of potassium out of the cell.

Sodium zirconium cyclosilicate works very slowly and therefore should not be recommended as an emergency treatment for life-threatening hyperkalemia. 

When should Sodium zirconium cyclosilicate not to be taken? (Contraindications)

Sodium zirconium cyclosilicate should not be used in patients with-

• Allergy to sodium zirconium cyclosilicate
• Pregnancy
• Severe constipation or obstruction of bowels
• Children less than 18 years of age
• Serious heart disease
• Hypokalemia or low potassium levels in the blood
• Severe kidney dysfunction

What is the dosage of Sodium zirconium cyclosilicate?

• The recommended initial adult dose of sodium zirconium cyclosilicate is 10 g taken three times daily for up to 48 hours.

• The maintenance dose of sodium zirconium cyclosilicate is 10 g taken once a day.

• The dose of sodium zirconium cyclosilicate should be adjusted every week based on the patient’s potassium concentration in the blood.

• The recommended maintenance dose of sodium zirconium cyclosilicate can be taken either as 5 g every other day or 15 g once a day.

How should Sodium zirconium cyclosilicate be taken?

• Empty the entire contents of sodium zirconium cyclosilicate into a glass of water (minimum 50 ml). Stir the solution and consume it immediately.

• Rinse the glass again with sufficient quantity of water and drink the left-over contents to make sure that the entire dose is taken.

• Sodium zirconium cyclosilicate can be taken with or without food.

What are the warnings and precautions for Sodium zirconium cyclosilicate?

• Patients should be advised to adjust or minimize the intake of sodium or sodium-rich foods to avoid the risk of fluid accumulation or edema.

• Patients with a history of mild kidney disease or heart disease should stop taking sodium therapy to reduce the fluid overload. In such cases, the physician can recommend increased diuretic doses to excrete sodium via urine.

• Fiber-rich foods should be taken during treatment with sodium zirconium cyclosilicate if the condition of constipation worsens.

• Patients must be strictly monitored for their heart and kidney function during treatment with sodium zirconium cyclosilicate and any changes in weight, ECG, and blood pressure should not be ignored.

• Treatment with sodium zirconium cyclosilicate can be discontinued if the potassium level in the blood reduces to less than 3.5 mmol/L.

• The dose of sodium zirconium cyclosilicate can be adjusted based on the patient’s potassium level in the blood, intake of potassium supplements, and progressive kidney function if any.

What are the side effects of Sodium zirconium cyclosilicate?

The most common side effects of sodium zirconium cyclosilicate are-

• Decreased potassium level in the blood
• Edema or fluid accumulation in the body
• Swelling of the ankles or feet
• Heart rhythm abnormalities
• Weight gain
• Constipation

Taking sodium zirconium cyclosilicate for long-term may cause severe gastrointestinal disturbances such as nausea, vomiting, loose stools, and pain in the stomach.

What are the other precautions for Sodium zirconium cyclosilicate?

• Patients registering for any X-ray diagnostic procedure should not take sodium zirconium cyclosilicate as the drug may be opaque to X-rays.

• If a dose is missed, the patient must be advised to take the next usual dose at the next scheduled time. Do not double the dose to make up for the missed dose.

What are the Drug Interactions of Sodium zirconium cyclosilicate?

• Drugs that get affected by the increase in gastric pH caused by sodium zirconium cyclosilicate should be avoided concomittantly.

• It is generally recommended to take drugs either two hours before or two hours after a dose of sodium zirconium cyclosilicate to avoid the loss of effectiveness of those medications.

What are the storage conditions for Sodium zirconium cyclosilicate?

• Store the foil-lined packets containing sodium zirconium cyclosilicate at room temperature between 15°C and 25°C.

• Protect from direct sunlight and excess moisture.

Last Updated : 6/20/2018

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