Sodium zirconium cyclosilicate (ZS-9), sold under the brand name Lokelma, is a medication used to treat high blood potassium. Onset of effects occurs in one to six hours. It is taken by mouth.Common side effects include swelling and low blood potassium. Use is likely safe in pregnancy and breastfeeding. It works by binding potassium ions in the gastrointestinal tract which is then lost in the stool.Sodium zirconium cyclosilicate was approved for medical use in the European Union and in the United States in 2018. It was developed by AstraZeneca. Medical use
Sodium zirconium cyclosilicate is used to treat high blood potassium. Onset of effects occurs in one to six hours.One review found a decrease in potassium of 0.17 mEq/L at one hour and 0.67 mEq/L at 48 hours.It appears effective in people with chronic kidney disease, diabetes, and heart failure. Use has been studied for up to a year. Mechanism of action
ZS-9 is a zirconium silicate. Zirconium silicates have been extensively used in medical and dental applications because of their proven safety. 11 zirconium silicates were screened by an iterative optimization process. ZS-9 selectively captures potassium ions, presumably by mimicking the actions of physiologic potassium channels. ZS-9 is an inorganic cation exchanger crystalline with a high capacity to entrap monovalent cations, specifically potassium and ammonium ions, in the GI tract. ZS-9 is not systemically absorbed; accordingly, the risk of systemic toxicity may be minimized. Background
Hyperkalemia is rare among those who are otherwise healthy. Among those who are in hospital, rates are between 1% and 2.5%.
Saizen is a commercial preparation of synthetic somatropin (growth hormone, a.k.a. GH). Manufactured by Merck Serono, Saizen is produced by recombinant DNA technology from a mammalian cell line (mouse C127) that was modified by the addition of the human GH gene, resulting in an identical 191-amino acid sequence and structure. Usage
Saizen is injected. It is intended for long-term treatment of individuals who are growth hormone deficient. Saizen, like all synthetic somatropin, has special importance for children and adolescents whose growth failure is due to inadequate production of growth hormone. Studies have shown that somatropin usage fails to produce athletic performance enhancement despite claims to the contrary. More recently, Saizen has been used in IVF protocols by a few physicians for female patients undergoing infertility treatment in an attempt to increase the number and quality of oocytes retrieved. It affects: 

Tissue growth
Skeletal growth
Cell growth (especially muscle growth)
Organ growthMetabolism
Protein metabolism
Carbohydrate metabolism
Lipid metabolism
Mineral metabolism
Connective tissue and bone metabolismSaizen usage should be performed under the regular guidance of a physician who is experienced in the diagnosis and management of growth hormone deficiency. Individuals with inadequate secretion of growth hormone sometimes experience fasting hypoglycemia that is improved by treatment with growth hormone. Using Saizen may decrease glucose tolerance. Because human growth hormone may induce a state of insulin resistance, patients should be observed for evidence of glucose intolerance. As with all human growth hormone supplementation, Saizen should be used with caution in patients with diabetes mellitus or a family history of diabetes mellitus. See also
Growth hormone treatment

External links
"Somatropin".