9.5.2 Phosphorus

9.5.2.1 Phosphate supplements

Phosphate-Sandoz®
  • Effervescent tablets containing the equivalent of 16.1mmol phosphate (£16.43 = 100 tablets)

Indication

  • Vitamin D-resistant hypophosphataemic osteomalacia

Dose

  • 4–6 tablets daily; child under 5 years 2–3 tablets daily
Mixed phosphates
  • Solution 0.5 mmol/ml (unlicensed preparation)
Phosphates
  • IV infusion 500ml (Polyfusor®)
Potassium phosphates
  • Injection 17.42% 10ml (unlicensed preparation)

9.5.2.2 Phosphate-binding agents

Aluminium

Alu-Caps® are no longer routinely used as a phosphate binder due to long term aluminium toxity/accumulation exacerbated by renal failure (dementia and anaemia). It also causes constipation.

Calcium

Phosex®
  • Tablets calcium acetate 1g (£19.79 = 180 tablets)
  • Tablets calcium acetate 500g (unlicensed preparation)

Indications

  • Hyperphosphataemia

Dose

  • Initially 1 tablet 3 times daily with meals, adjusted according to serum-phosphate concentration (usual dose 4–6 tablets daily); maximum 12 tablets daily
Renacet®
  • Tablets calcium acetate 475mg, 950mg (£18.45 = 200 tablets)

Indications

  • Hyperphosphataemia

Dose

  • 475–950mg, to be taken with breakfast and with snacks, 0.95–2.85g, to be taken with main meals and 0.95–1.9g, to be taken with supper, dose to be adjusted according to serum-phosphate concentration; maximum 6.65g per day.
Osvaren®
  • Tablets calcium acetate 435mg plus magnesium 60mg (£24.00 = 180 tablets)

Indications

  • Hyperphosphataemia

Dose

  • Initially 1 tablet 3 times daily with meals, adjusted according to serum-phosphate concentration (usual dose 3–10 tablets daily); maximum 12 tablets daily
Lanthanum
  • Tablets (chewable) 500mg, 750mg, 1g (£182.60 = 90 750mg tablets)

Indications

  • Hyperphosphataemia

Dose

  • Usual dose range 1.5–3g daily in divided doses with or immediately after meals, adjusted according to serum-phosphate concentration every 2–3 weeks
Sevelamer hydrochloride
  • Renagel® tablets sevelamer hydrochloride 800mg (£167.04 = 180 tablets)

Indications

  • Hyperphosphataemia

Dose

  • Initially 2.4–4.8g daily in 3 divided doses with meals, adjusted according to serum-phosphate concentration (usual dose range 2.4–12g daily in 3 divided doses)
Sevelamer carbonate
  • Tablets 800mg (£48.87 = 180 tablets)

Indications

  • Hyperphosphataemia

Dose

  • Usual dose approximately 6g daily in 3 divided doses

Notes

  1. Sevelamer carbonate is not interchangeable with sevelamer hydrochloride. When prescribing please include the correct salt.
  2. Sevelamer carbonate is licensed for both dialysis and non-dialysis patients.

 

Home > Formulary > Chapters > 9. Blood and nutrition > 9.5 Minerals > 9.5.2 Phosphorus

 

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