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Effect of LOKELMA on other medicinal products: As LOKELMA is not absorbed or metabolised by the body and does not meaningfully bind other medicinal products, there are limited effects on other medicinal products.
LOKELMA can transiently increase gastric pH by absorbing hydrogen ions that can lead to changes in solubility and absorption kinetics for co-administered drugs with pH-dependent bioavailability. Therefore, LOKELMA should be administered at least 2 hours before or 2 hours after oral medications with clinically meaningful gastric pH dependent bioavailability.
Examples of drugs that should be taken 2 hours before or after LOKELMA to avoid possible raised gastric pH drug interaction are listed as follows: (See Table 4.)
Click on icon to see table/diagram/imageLOKELMA can be co-administered without spacing of dosing times with oral medications that do not exhibit pH-dependent bioavailability.
In a clinical drug-drug interaction study conducted in healthy subjects, co-administration LOKELMA with amlodipine, dabigatran, clopidogrel, atorvastatin, furosemide, glipizide, warfarin, losartan, or levothyroxine did not result in clinically meaningful drug-drug interactions. Consistent with co-administration of dabigatran with other gastric acid modifiers, dabigatran Cmax and AUC values were approximately 40% lower when co-administered with sodium zirconium cyclosilicate. No dose adjustments or separation of the time of dosing are required for these drugs.
In another drug-drug interaction study in healthy volunteers, co-administration of LOKELMA 15 g with tacrolimus 5 mg resulted in a decreased tacrolimus AUC and Cmax by 37% and 29% respectively. Therefore, tacrolimus should be taken at least 2 hours before or after LOKELMA. In the same study, co-administration of LOKELMA and cyclosporin did not show a clinically meaningful interaction.
