following a resubmission:

sodium zirconium cyclosilicate (Lokelma®) is accepted for restricted use within NHSScotland.

Indication under review: treatment of hyperkalaemia in adult patients.

SMC restriction: patients with hyperkalaemia (defined as a serum potassium of >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure, who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level (normokalaemia)

Sodium zirconium cyclosilicate, compared with placebo, reduced serum potassium in two and four-week studies in adults with hyperkalaemia. In an uncontrolled one-year study sodium zirconium cyclosilicate produced normal serum potassium in a proportion of adults with hyperkalaemia.

This advice applies only in the context of an approved NHSScotland Patient Access Scheme (PAS) delivering the cost-effectiveness results upon which the decision was based, or a PAS/list price that is equivalent or lower.

Medicine details

Medicine name:
sodium zirconium cyclosilicate (Lokelma)

For the treatment of hyperkalaemia (HK) in adult patients.

Pharmaceutical company
AstraZeneca UK Ltd
BNF chapter
Nutrition and blood
Submission type
Date advice published
07 September 2020