Sodium Zirconium Cyclosilicate

How it works

It is an insoluble inorganic cation-exchanger that selectively traps potassium ions in exchange for hydrogen and sodium throughout the gastrointestinal tract, increasing faecal potassium excretion.

Prescribing in practice

• Not for emergency treatment of life-threatening hyperkalaemia because its onset is too slow; use established acute measures first.
• It can bind co-administered oral drugs, so separate the timing of other medicines that depend on gastric pH or could be affected.
• It contributes a sodium load, which warrants caution in patients prone to fluid overload such as those with heart failure.

Monitoring

Monitor serum potassium during treatment and adjust therapy to maintain a normal level, watching also for oedema.

Counselling the patient

• Take as a suspension in water as directed and report swelling, breathlessness or muscle weakness.
• Space other oral medicines apart from this product as advised by your team.

Evidence & guidelines

MHRA and SPC guidance support its use for chronic hyperkalaemia management rather than acute correction.