Key takeaways
- Lokelma (sodium zirconium cyclosilicate) is a prescription drug used to treat high blood potassium levels.
- Examples of side effects of Lokelma include fluid swelling in areas of the body and low blood potassium levels.
- If side effects from Lokelma become difficult to tolerate, talk with your doctor about coping tips or other treatment options.
Specifically, Lokelma is used in adults to treat high potassium levels in your blood. Because this is a slow-acting medication, it isn’t used for emergencies.
The active ingredient in Lokelma is sodium zirconium cyclosilicate. (An active ingredient makes a drug work.) The drug comes as a powder that you mix with water and drink.
Keep reading to learn about the common, mild, and serious side effects Lokelma can cause.
Some people may have mild to serious side effects during their Lokelma treatment. There may be other mild side effects of the drug not listed here, and not everyone will get these side effects.
Examples of Lokelma’s commonly reported side effects include:
- edema (fluid buildup in your body)
- low blood potassium levels
For more information about some of these side effects, see “Tips for managing side effects.”
Mild side effects have been reported with Lokelma, including edema (fluid buildup in your body). For more information about this side effect, see “Tips for managing side effects.”
Most of the time, edema is mild and can be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Lokelma unless your doctor recommends it.
Lokelma may cause mild side effects other than those listed above. See the drug’s prescribing information for details.
Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.
Rare but serious side effects have been reported with Lokelma, including low blood potassium levels. For more information about this side effect, see “Tips for managing side effects.”
If you experience serious side effects while taking Lokelma, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Lokelma and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
Allergic reactionFor some people, Lokelma can cause an allergic reaction. But this side effect wasn’t reported in the drug’s studies.
In general, symptoms of an allergic reaction can be mild or serious.
What might helpIf you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Lokelma treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Lokelma, they may have you switch to a different treatment.
Get answers to some frequently asked questions about Lokelma’s side effects.
How do side effects of Lokelma compare with those of Kayexalate?
Kayexalate works in the same way as Lokelma to lower potassium levels in the bloodstream. But there have been more side effects reported with Kayexalate, including:
- lack of appetite
- nausea and vomiting
- diarrhea
- constipation
- hard stool stuck in the colon
- thickened food stuck in the stomach
And in rare cases, colon damage and bleeding can happen with Kayexalate.
The only side effects seen in Lokelma studies were edema (fluid buildup in your body) and low blood potassium levels. And studies done after Lokelma came on the market
Note: Kayexalate has been discontinued. But, it is available as a generic, sodium polystyrene sulfonate. If you have questions about the generic form of Kayexalate talk with your doctor or pharmacist.
Can Lokelma cause constipation?
No, constipation was not a side effect reported in studies of Lokelma. But it’s best to let your doctor know if you have severe constipation before beginning Lokelma treatment. If you have severe constipation, Lokelma may worsen your symptoms, and it may not work as well to lower your potassium levels.
Can Lokelma cause diarrhea?
No, Lokelma does not cause diarrhea. Although diarrhea is common with other potassium-lowering drugs, such as Kayexelate, this side effect was not seen in Lokelma studies.
There may be things you can do to help make certain Lokelma side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.
Edema (fluid buildup in your body)
Swelling of hands, fingers, lower legs, ankles, feet, or toes from fluid retention was a common side effect reported in Lokelma studies. Fluid retention was caused by the sodium content in the drug.
Swelling may cause symptoms such as:
- tightness in the swollen area
- misshapen-looking wrists, fingers, ankles, or toes
- fluid seeping from the skin
- redness or skin discoloration
- pain when touched
Factors that can increase the risk of fluid buildup and swelling when taking this drug include:
- kidney disease
- heart failure
- taking Lokelma’s maximum maintenance dosage of 15 grams (g) daily
Note: The daily dosage of Lokelma contains a total of 1,200 milligrams (mg) of sodium.
What might help
If you have edema during Lokelma treatment, consider the following tips to help relieve your symptoms:
- propping up your feet
- wearing compression stockings
- decreasing your salt intake
If swelling happens, it’s best to talk with your doctor. They’ll likely recommend lab tests and an office visit so they can prescribe a medication to help remove extra fluid from your body.
Low blood potassium
Lokelma may cause blood potassium to get too low, which is called hypokalemia. When blood potassium drops too low, it may cause a heart attack and lead to death. You might feel symptoms when your potassium gets really low. Symptoms to watch for include:
- nausea and vomiting
- pounding heart
- muscle aches or spasms, most likely in the legs or back
- dizziness or a spinning feeling in your head
- severe muscle weakness
- trouble breathing
If you’re getting hemodialysis (a special treatment to filter your blood), you have a higher risk of very low potassium levels with Lokelma.
What might help
If you notice symptoms of low blood potassium, call your doctor right away. If your symptoms are severe, they’ll likely recommend a hospital visit for an immediate dose of potassium and a Lokelma dosage adjustment.
Keeping track of side effectsDuring your Lokelma treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were taking when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how your symptoms affected your daily activities
- what other medications you were taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help them learn more about how Lokelma affects you. They can then use this information to adjust your treatment plan if needed.
Lokelma can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Lokelma is a good treatment option for you.
Talk with your doctor about your health history before starting Lokelma. Be sure to tell them if any of the following factors apply to you:
- ongoing constipation
- blocked intestine
- history of problems with bowel not working after surgery
- history of edema (fluid buildup in your body)
- kidney disease
- hemodialysis
- heart failure
- previous allergic reaction to Lokelma
- pregnancy
- breastfeeding
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.



