Sodium zirconium cyclosilicate is used to treat hyperkalemia (high levels of potassium in the blood). Sodium zirconium cyclosilicate is not used for emergency treatment of life-threatening hyperkalemia because it takes some time to work. Sodium zirconium cyclosilicate is in a class of medications called potassium removing agents. It works by removing excess potassium from the body.

Sodium zirconium cyclosilicate comes as a powder in a packet to mix with water and take by mouth with or without food. When starting treatment with sodium zirconium cyclosilicate, it should be taken three times a day for up to 48 hours. After that, it is usually taken once a day or once every other day. Take sodium zirconium cyclosilicate at around the same time every day, or every other day, depending on your response to the medication. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sodium zirconium cyclosilicate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Take any other medications at least 2 hour before or 2 hours after you take sodium zirconium cyclosilicate because sodium zirconium cyclosilicate can interfere with absorption of other medications.

You will need to mix the powder with water right before you take it. To mix the powder, follow these steps:

1. Empty the packet(s) of sodium zirconium cyclosilicate powder into a cup of 3 tablespoons (45 mL) or more of water.
2. Stir and drink immediately.
3. If any powder remains in the cup, add more water, then stir and drink.
4. Repeat as needed until no powder remains to be sure you received the full dose.

Your doctor may increase your dose, but not more than once every 7 days, depending on the results of your laboratory tests.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking sodium zirconium cyclosilicate,

• tell your doctor and pharmacist if you are allergic to sodium zirconium cyclosilicate, any other medications, or any of the ingredients in sodium zirconium cyclosilicate powder. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have severe constipation, a blockage in your bowels or other bowel problems, or if you have or have ever had heart or kidney disease. Also tell your doctor if you have ever been advised by a healthcare professional to have only a certain amount of sodium or salt in your diet.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking sodium zirconium cyclosilicate, call your doctor.

If your doctor prescribes a low-potassium, low-salt or low-sodium diet be sure to follow these instructions carefully.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Sodium zirconium cyclosilicate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• swelling of arms, legs, stomach, or any other part of the body

Sodium zirconium cyclosilicate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the packet it came in, sealed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body’s response to sodium zirconium cyclosilicate.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.