sodium zirconium cyclosilicate

Contraindicated in:

Severe constipation, bowel obstruction/impaction, postoperative motility disorders (ineffective and may worsen condition).

Use Cautiously in:

HF or renal impairment (sodium content may cause edema);
Hemodialysis (↑ risk of hypokalemia);
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.

Availability ⬆ ⬇

Oral suspension: 5 g/pkt (contains 400 mg sodium); 10 g/pkt (contains 800 mg sodium)

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).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Exchanges hydrogen and sodium ions for potassium ions in the intestine.

Therapeutic effects:

Reduction of serum potassium concentrations.

Classifications ⬆ ⬇

Therapeutic Classification: hypokalemic, electrolyte modifiers

Pharmacologic Classification: cationic exchange resins

Pharmacokinetics ⬆ ⬇

Absorption: Not systemically absorbed.

Distribution: Not distributed.

Metabolism/Excretion: Does not undergo metabolism; eliminated in the feces.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(↓ in serum potassium concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	1 hr	unknown	48 hr

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.

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Indications ⬇

Contraind./Precautions ⬆ ⬇