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 |
Ontology: Lanthanum (C0023031)
Definition (NCI) | A silvery white metallic element that belongs to period 6 of the lanthanoids family, with phosphate binding property. Lanthanum, when administered in a salt form, dissociates in acid to release lanthanum ions, which then bind dietary phosphate. This agent inhibits the absorption of phosphate by forming highly insoluble lanthanum-phosphate complexes that reduce concentrations of serum phosphate and calcium phosphate. |
Definition (MSH) | Lanthanum. The prototypical element in the rare earth family of metals. It has the atomic symbol La, atomic number 57, and atomic weight 138.91. Lanthanide ion is used in experimental biology as a calcium antagonist; lanthanum oxide improves the optical properties of glass. |
Definition (CSP) | rare metallic element, symbol La, atomic number 57. |
Concepts | Element, Ion, or Isotope (T196) |
MSH | D007811 |
SnomedCT | 414568004 |
English | Lanthanum, Lanthanum [Chemical/Ingredient], LANTHANUM, La element, lanthanum, La, Lanthanum (substance) |
Swedish | Lantan |
Czech | lanthan |
Finnish | Lantaani |
Russian | LANTAN, ЛАНТАН |
Polish | Lantan |
Norwegian | Lantan |
French | Lanthane |
German | Lanthan |
Italian | Lantanio |
Spanish | lantano (sustancia), lantano, Lantano |
Portuguese | Lantânio |
Ontology: RenaGel (C0526563)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C405346 |
English | RenaGel, Renagel, renagel |
Ontology: sevelamer (C0718050)
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
MSH | C405346 |
SnomedCT | 329195003, 395871000 |
English | sevelamer, sevelamer [Chemical/Ingredient], SEVELAMER, Sevelamer (product), Sevelamer (substance), Sevelamer, poly(allylamine-co-N,N'-diallyl-1,3-diamino-2-hydroxypropane) |
Spanish | sevelámero (producto), sevelámero (sustancia), sevelámero |
Ontology: Phoslo (C0722621)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C120662 |
English | Phoslo, PhosLo, phoslo |
Ontology: Fosrenol (C1174767)
Concepts | Pharmacologic Substance (T121) , Inorganic Chemical (T197) |
MSH | C119467 |
English | Fosrenol |
Ontology: Renvela (C1968327)
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
English | Renvela |
Ontology: Phosphate Binder [EPC] (C2267031)
Concepts | Pharmacologic Substance (T121) |
English | Phosphate Binder [EPC], Phosphate Binder |
Ontology: Phosphate Chelating Activity [MoA] (C2267178)
Concepts | Molecular Function (T044) |
English | Phosphate Binding Activity, Phosphate Chelating Activity [MoA], Phosphate Chelating Activity |
Ontology: Velphoro (C3696395)
Concepts | Pharmacologic Substance (T121) |
English | Velphoro |
Ontology: sucroferric oxyhydroxide (C3696416)
Concepts | Pharmacologic Substance (T121) |
English | sucroferric oxyhydroxide, SUCROFERRIC OXYHYDROXIDE, iron (as sucroferric oxyhydroxide) |