III. Technique

  1. Take Phosphate Binders with food

IV. Preparations: Calcium based

  1. Calcium Carbonate (e.g. Tums)
    1. Effective and inexpensive, but increases Serum Calcium
    2. Starting dose: 3 tabs daily (increase up to 17 tabs/day in some cases)
  2. Calcium Acetate (e.g. Phoslo, phoslyra)
    1. Effective and inexpensive, but increases Serum Calcium (less than Calcium Carbonate)
    2. Starting dose: 3 tabs daily

V. Preparations: Non-Calcium based agents

  1. Sevelamer HCl (RenaGel)
    1. Less effective than calcium-based binders and expensive, but does not increase Serum Calcium
    2. Starting dose: 3-12 tabs daily (increase to 9 tabs/day or more in some cases)
  2. Sevelamer Carbonate (Renvela)
    1. Less effective than calcium-based binders and expensive, but does not increase Serum Calcium
    2. Starting dose: 3-6 tabs daily (increase to 9 tabs/day or more in some cases)
  3. Lanthanum Carbonate (Fosrenol)
    1. Effective and does not increase Serum Calcium, but expensive
    2. Starting dose: 3 tabs daily

VI. Preparations: Iron Containing Phosphate Binders

  1. Sucroferric oxyhydroxide (Velphoro)
    1. Effective and does not increase Serum Calcium, but expensive
    2. Increases iron levels minimally (less than ferric citrate)
    3. Starting dose: 3 tabs daily
  2. Ferric Citrate (Auryxia)
    1. Effective and does not increase Serum Calcium, but expensive
    2. Increases iron levels and reduces need for IV iron requirements and Erythropoietin (e.g. Epogen)
    3. Starting dose: 6 tabs daily (maximum 12 tabs/day)

VII. References

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Cost: Medications

renagel (on 2/26/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
RENAGEL 400 MG TABLET $3.41 each
RENAGEL 800 MG TABLET $6.80 each
renvela (on 2/26/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
RENVELA 0.8 GM POWDER PACKET $16.33 each
RENVELA 2.4 GM POWDER PACKET $16.47 each
RENVELA 800 MG TABLET $5.45 each
fosrenol (on 7/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
FOSRENOL 1,000 MG TABLET CHEW $10.58 each
FOSRENOL 500 MG TABLET CHEW $10.57 each
velphoro (on 1/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
VELPHORO 500 MG CHEWABLE TAB $10.08 each
auryxia (on 6/30/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
AURYXIA 210 MG TABLET $4.86 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)