sodium zirconium cyclosilicate at a glance
Medicine class
Selective gastrointestinal potassium binder
Licensed use
Treatment of hyperkalaemia in adults
Form
Powder mixed with water to make an oral suspension
Food
Can be taken with or without food
Important monitoring
Blood potassium and signs of fluid retention or worsening heart failure
Sodium
This formulation is high in sodium, which matters particularly with heart failure or a low-salt diet
What is sodium zirconium cyclosilicate used for?
The selected product is licensed for:
Treatment of hyperkalaemia—an abnormally high blood potassium level—in adults, including adults receiving chronic haemodialysis.
How does sodium zirconium cyclosilicate work?
Its microscopic pores preferentially trap potassium in exchange for sodium and hydrogen ions throughout the gastrointestinal tract. It remains in the gut and leaves in stools with captured potassium, reducing potassium in the gut and then in the blood.
sodium zirconium cyclosilicate preparations and strengths
Oral suspension
Route: Oral
Strengths: 5 g, 10 g
How to take sodium zirconium cyclosilicate
Empty the prescribed sachet contents into a glass containing approximately 45 mL of still water. Stir well and drink while cloudy; the powder does not dissolve. Stir again if it settles, and rinse the glass with more water if needed so no powder remains. It may be taken with or without food. Ask a pharmacist whether other oral medicines need to be taken separately.
Use the entire prescribed sachet contents.
Drink the suspension promptly while cloudy.
Tell radiology staff that you take it before an abdominal X-ray.
sodium zirconium cyclosilicate side effects
Common or expected effects
- Constipation
- Blood potassium becoming too low, which may cause tiredness, muscle weakness or cramps
- Fluid retention or swelling, commonly affecting the feet or ankles
- Worsening of pre-existing heart failure
Get urgent medical advice
- Severe symptoms of low potassium, such as marked weakness, cramps, palpitations or breathing difficulty
- Worsening breathlessness, swelling or rapid weight gain in someone with heart failure
- Sudden or severe abdominal pain, which needs assessment because the risk of intestinal perforation is uncertain
sodium zirconium cyclosilicate in pregnancy
There are no adequate data from pregnant women. The UK product information advises avoiding sodium zirconium cyclosilicate during pregnancy as a precaution; contact the prescriber if pregnant, planning pregnancy or pregnancy is suspected.
sodium zirconium cyclosilicate while breastfeeding
Because sodium zirconium cyclosilicate is not systemically absorbed, exposure through breast milk is expected to be negligible and effects on the infant are not anticipated. The UK product information states that it can be used while breastfeeding.
sodium zirconium cyclosilicate interactions
It can temporarily raise stomach pH and alter absorption of some oral medicines. Check administration timing with a pharmacist or prescriber.
Tacrolimus
Exposure may be reduced, so administration should be separated and transplant monitoring requirements followed.
Azole antifungals such as ketoconazole, itraconazole and posaconazole
Raised stomach pH may reduce or alter absorption, so administration should be separated.
Certain HIV treatments
Absorption of pH-dependent medicines such as atazanavir or rilpivirine may be altered, so administration should be separated.
Common questions about sodium zirconium cyclosilicate
Answers are fully visible for fast scanning and source review.
Does sodium zirconium cyclosilicate remove potassium from the blood directly?
No. It remains in the gastrointestinal tract, binds potassium there and increases its removal in stools; blood potassium then falls.
Is sodium zirconium cyclosilicate absorbed into the body?
Clinical studies indicate that it is not systemically absorbed and is recovered through the gastrointestinal tract.
Does sodium zirconium cyclosilicate dissolve in water?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.