Indications for LOKELMA:
Limitations of Use:
Not for emergency treatment for life-threatening hyperkalemia due to its delayed onset of action.
Give at least 2hrs before or 2hrs after other oral medications. Mix contents of packet into water. Initially 10g three times daily for up to 48hrs, then 10g once daily. Monitor and adjust dose in 5g increments based on serum potassium level at ≥1-week intervals to obtain desired target range. Usual maintenance range: 5g every other day to 15g daily. Hemodialysis: initially 5g once daily on non-dialysis days; consider 10g once daily if serum potassium >6.5mEq/L. Monitor and adjust dose based on pre-dialysis serum potassium level to obtain desired target range. Usual maintenance range: 5–15g daily.
Avoid in severe constipation, bowel obstruction or impaction, abnormal post-op bowel motility disorders. Monitor serum potassium levels. Monitor for edema esp. if heart failure or renal disease present. Advise patients to adjust dietary sodium, if appropriate. Increase diuretics dose as needed. Hemodialysis: increased risk of hypokalemia due to possible decreased oral intake or diarrhea; adjust dose based on potassium levels.
May reduce absorption and efficacy of other oral medications; separate dosing by at least 2hrs.
Single-use packets—1, 11, 30