ISSUE 1561
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The FDA has approved sodium zirconium cyclosilicate (Lokelma – AstraZeneca), an oral potassium binder that exchanges hydrogen and sodium for potassium in the gastrointestinal (GI) lumen, for treatment of non-life-threatening hyperkalemia in adults. Sodium zirconium cyclosilicate (SZC) is the third drug to be approved for this indication; sodium polystyrene sulfonate and patiromer (Veltassa)1 were approved earlier.
HYPERKALEMIA — Risk factors for hyperkalemia include renal disease, diabetes, and heart failure. The risk is increased with use of drugs that inhibit the renin-angiotensin-aldosterone system (RAAS) such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), direct renin inhibitors, and aldosterone antagonists. Dosage reduction or discontinuation of RAAS inhibitors because of hyperkalemia is sometimes required. Some
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- A Henneman et al. Emerging therapies for the management of chronic hyperkalemia in the ambulatory care setting. Am J Health Syst Pharm 2016; 73:33.
- M Chaitman et al. Potassium-binding agents for the clinical management of hyperkalemia. P T 2016; 41:43.
- B Long et al. Controversies in management of hyperkalemia. J Emerg Med 2018; 55:192.
- DK Packham et al. Sodium zirconium cyclosilicate in hyperkalemia. N Engl J Med 2015; 372:222.
- M Kosiborod et al. Effect of sodium zirconium cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial. JAMA 2014; 312:2223.
- SD Anker et al. Maintenance of serum potassium with sodium zirconium cyclosilicate (ZS-9) in heart failure patients: results from a phase 3 randomized, double-blind, placebo-controlled trial. Eur J Heart Fail 2015; 17:1050.
- C Palleria et al. Pharmacokinetic drug-drug interaction and their implication in clinical management. J Res Med Sci 2013; 18:601.
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