II. Indications
III. Technique
- Take Phosphate Binders with food
- Take other medications at least one hour before or 3 hours after Phosphate Binders
IV. Preparations: Calcium based
-
Calcium Carbonate (e.g. Tums)
- Effective and inexpensive, but increases Serum Calcium
- Starting dose: 3 tabs daily (increase up to 17 tabs/day in some cases)
-
Calcium Acetate (e.g. Phoslo, phoslyra)
- Effective and inexpensive, but increases Serum Calcium (less than Calcium Carbonate)
- Starting dose: 3 tabs daily
V. Preparations: Non-Calcium based agents
- Sevelamer HCl (RenaGel)
- Less effective than Calcium-based binders and expensive, but does not increase Serum Calcium
- Risk of Metabolic Acidosis
- Starting dose: 3-12 tabs daily (increase to 9 tabs/day or more in some cases)
- Sevelamer Carbonate (Renvela)
- Less effective than Calcium-based binders and expensive (but less expensive than RenaGel)
- However, does not increase Serum Calcium, unlike Calcium-based binders
- Does not cause Metabolic Acidosis unlike Sevelamer HCl (RenaGel)
- Starting dose: 3-6 tabs daily (increase to 9 tabs/day or more in some cases)
- Less effective than Calcium-based binders and expensive (but less expensive than RenaGel)
- Lanthanum Carbonate (Fosrenol)
- Effective and does not increase Serum Calcium, but expensive (more than Sevelamer)
- Starting dose: 3 tabs daily
VI. Preparations: Iron Containing Phosphate Binders
- Sucroferric oxyhydroxide (Velphoro)
- Effective and does not increase Serum Calcium, but expensive
- Increases iron levels minimally (less than ferric citrate)
- Starting dose: 3 tabs daily
- Ferric Citrate (Auryxia)
- Effective and does not increase Serum Calcium, but expensive
- Increases iron levels and reduces need for IV iron requirements and Erythropoietin (e.g. Epogen)
- Starting dose: 6 tabs daily (maximum 12 tabs/day)
VII. References
- (2019) Presc Lett 26(9):53
- (2015) Presc Lett 22(8)
- Hutchison (2009) Kidney Int 75:906-14 +PMID:19279554 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| sevelamer (on 9/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| SEVELAMER 0.8 GM POWDER PACKET | Generic | $3.10 each |
| SEVELAMER 2.4 GM POWDER PACKET | Generic | $3.55 each |
| SEVELAMER CARBONATE 800 MG TAB | Generic | $0.23 each |
| SEVELAMER HCL 800 MG TABLET | Generic | $3.36 each |
| lanthanum (on 10/19/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LANTHANUM CARB 1,000 MG TB CHW | Generic | $7.20 each |
| LANTHANUM CARB 500 MG TAB CHEW | Generic | $6.84 each |
| renvela (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| RENVELA 800 MG TABLET | Generic | $0.23 each |
| velphoro (on 9/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| VELPHORO 500 MG CHEWABLE TAB | $16.23 each | |
| auryxia (on 1/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| AURYXIA 210 MG TABLET | $7.02 each | |