Hyperphosphatemia Medication Choices Flashcards
What kind of medications should be used to treat hyperphosphatemia in ESRD patients?
Phosphate binders
How do phosphate binders work?
Bind dietary phosphate ingested in food to prevent it from being absorbed by the body, and then are eliminated in the feces.
When should phosphate binders be taken?
WITH MEALS
What are the two calcium containing phosphate binders?
Calcium carbonate (TUMS)
Calcium acetate (PhosLo)
What is the dosing of Calcium carbonate (TUMS)?
500mg of elemental Ca three times daily with meals
What is the dosing of Calcium acetate (PhosLo)?
2-3 tablets three times daily with meals
What is the maximum amount of Ca that should be given per day?
1500mg/day
What is the issue with using calcium containing phosphate binders?
They contribute to the soft-tissue calcification problem since they add more calcium into the blood where it is able to interact with phosphorus
What is the preferred non-calcium containing phosphate binder?
Sevelamer carbonate (Renvela)
What are some of the benefits to using Sevelamer?
-Decreases uric acid!
-Decreases LDL by 15-30%
-Has been tested at high doses and is shown to be safe
-No calcium
What is the dosing of sevelamer?
If phos > 5.5 but < 7.5 mg/dL : 800mg tid
If phos > or = 7.5mg/dL: 1600mg tid
What are the two iron containing phosphate binders?
-Sucroferric oxyhydroxide (Velphoro)
-Auryxia (Ferric citrate)
Which iron-containing phosphate binder DOES have an effect on iron stores in the blood?
Auryxia (ferric citrate)
