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.
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.
Sodium zirconium cyclosilicate should not be used in patients with-
Allergy to sodium zirconium cyclosilicate
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
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 patients 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.
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.
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 patients potassium level in the blood, intake of potassium supplements, and progressive kidney function if any.
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
Taking sodium zirconium cyclosilicate for long-term may cause severe gastrointestinal disturbances such as nausea, vomiting, loose stools, and pain in the stomach.
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.
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.
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.
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