126.96.36.199 Phosphate supplements
- Effervescent tablets containing the equivalent of 16.1mmol phosphate (£16.43 = 100 tablets)
- Vitamin D-resistant hypophosphataemic osteomalacia
- 4–6 tablets daily; child under 5 years 2–3 tablets daily
- Solution 0.5 mmol/ml (unlicensed preparation)
- IV infusion 500ml (Polyfusor®)
- Injection 17.42% 10ml (unlicensed preparation)
188.8.131.52 Phosphate-binding agents
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.
- Tablets calcium acetate 1g (£19.79 = 180 tablets)
- Tablets calcium acetate 500g (unlicensed preparation)
- Initially 1 tablet 3 times daily with meals, adjusted according to serum-phosphate concentration (usual dose 4–6 tablets daily); maximum 12 tablets daily
- Tablets calcium acetate 475mg, 950mg (£18.45 = 200 tablets)
- 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.
- Tablets calcium acetate 435mg plus magnesium 60mg (£24.00 = 180 tablets)
- Initially 1 tablet 3 times daily with meals, adjusted according to serum-phosphate concentration (usual dose 3–10 tablets daily); maximum 12 tablets daily
- Tablets (chewable) 500mg, 750mg, 1g (£182.60 = 90 750mg tablets)
- 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
- Renagel® tablets sevelamer hydrochloride 800mg (£167.04 = 180 tablets)
- 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)
- Tablets 800mg (£48.87 = 180 tablets)
- Usual dose approximately 6g daily in 3 divided doses
- Sevelamer carbonate is not interchangeable with sevelamer hydrochloride. When prescribing please include the correct salt.
- Sevelamer carbonate is licensed for both dialysis and non-dialysis patients.
- Solution for injection vials 10mg in 1ml, 20mg in 1ml, 30mg in 1ml
- NICE HST8: Burosumab (Crysvita) is recommended for treating X-linked hypophosphataemia (XLH) with radiographic evidence of bone disease in children aged 1 year and over, and young people with growing bones (October 2018) (NHS England commissioned)
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