Pedi: Safety and effectiveness not established in children.
Adv. Reactions/Side Effects⬆⬇
CV: edema
F and E: hypokalemia
GI: constipation
Interactions⬆⬇
Drug-drug:
May ↑ gastric pH and ↓ absorption of any medications that have pH-dependent absorption; administer all other oral medications ≥2 hr before or after sodium zirconium cyclosilicate.
Route/Dosage⬆⬇
PO (Adults ): 10 g three times daily for up to 48 hr, then 10 g once daily (if treatment continued beyond 48 hr); may titrate chronic therapy in increments of 5 g at 1-wk intervals (recommended maintenance dose range = 5–15 g once daily).
Renal Impairment
PO (Adults ): Chronic hemodialysis: 5 g once daily on nondialysis days (consider initial dose of 10 g once daily on nondialysis days in patients with serum potassium level >6.5 mEq/L); adjust dose based on predialysis serum potassium level (recommended maintenance dose range = 5–15 g once daily on nondialysis days).
Assess bowel patterns prior to administration. Avoid use in patients with severe constipation and bowel obstruction or impaction, including abnormal postoperative bowel motility disorders.
Monitor for signs of edema, particularly in patients with sodium restriction or prone to fluid overload (HF, renal disease). Each dose contains 400–800 mg of sodium. Advise patients to adjust dietary sodium, if appropriate. Increase dose of diuretics as needed.
Medication has radio-opaque properties and may give the appearance typical of an imaging agent during abdominal x-ray procedures
Lab Test Considerations:
Monitor serum potassium frequently during therapy.
Implementation⬆⬇
Sodium zirconium cyclosilicate is not used as emergency treatment for life-threatening hyperkalemia due to delayed action.
PO: Empty entire contents of packet(s) into drinking glass with at least 3 tablespoons of water. Stir well and drink immediately. If powder remains in glass, add water, stir, and drink immediately. Repeat until no powder remains to ensure entire dose is taken.
Administer other oral medications at least 2 hr before or 2 hr after sodium zirconium cyclosilicate.
Patient/Family Teaching⬆⬇
Instruct patient to take medication as directed.
Advise patient to modify dietary sodium intake, if needed.
Inform patient of need to take other oral medications 2 hr before or 2 hr after sodium zirconium cyclosilicate
Advise patient to notify health care professional if edema or constipation occur.