- Take Phosphate Binders with food
- Take other medications at least one hour before or 3 hours after Phosphate Binders
- 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
- 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
- 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)
- (2019) Presc Lett 26(9):53
- (2015) Presc Lett 22(8)
- Hutchison (2009) Kidney Int 75:906-14 +PMID:19279554 [PubMed]