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Indications and Dosage
Oral
Hyperphosphataemia in patients with chronic renal failure Adult: In patients on haemodialysis or peritoneal dialysis: Initially, 1,500 mg (as Fe) daily in 3 divided doses. Titrate in increments or decrements of 500 mg at intervals of at least 1 week according to serum-phosphate concentration. Maintenance: 1,500-2,000 mg daily in divided doses. Max: 3,000 mg daily.
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Contraindications
Haemochromatosis and other Fe accumulation disorders.
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Special Precautions
Patient with history of peritonitis within the last 3 months; gastrointestinal disorder or post major gastrointestinal surgery. Hepatic impairment.
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Adverse Reactions
Significant: Discoloured faeces, diarrhoea.
Gastrointestinal disorders: Nausea, constipation, vomiting, dyspepsia, abdominal pain or discomfort, flatulence, tooth and tongue discolouration, abdominal distention, gastritis, dysphagia, GERD. General disorders and administration site conditions: Product taste abnormal, fatigue. Metabolism and nutrition disorders: Hypercalcaemia, hypocalcaemia. Nervous system disorders: Headache. Reproductive system and breast disorders: Dyspnoea. Skin and subcutaneous tissue disorders: Pruritus, rash. |
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Patient Counseling Information
This drug may cause discolouration of faeces.
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Monitoring Parameters
Monitor serum phosphorus, Ca and PTH.
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Drug Interactions
May decrease the serum concentrations of doxycycline, acetylsalicylic acid, cefalexin and levothyroxine.
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Action
Description:
Mechanism of Action: Sucroferric oxyhydroxide binds phosphate in aqueous environment in the gastrointestinal tract by ligand exchange between hydroxyl groups and/or water in sucroferric oxyhydroxide and dietary phosphate. The bound phosphate is eliminated via faeces. Decreased serum phosphate levels and calcium-phosphorus product levels results in reduced dietary phosphate absorption. Pharmacokinetics: Absorption: Not systemically absorbed. The active moiety, polynuclear iron (III)-oxohydroxide (pn-FeOOH), is not absorbed and metabolised. Mononuclear iron species (degradation product) can be released from pn-FeOOH surface and be absorbed. Distribution: pn-FeOOH is distributed to target organs (e.g. liver, spleen, bone marrow) and incorporated into RBCs. Metabolism: pn-FeOOH (active moiety) cannot be metabolised. Excretion: Via faeces (as bound phosphate). |
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Storage
Store below 30°C. Protect from moisture.
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MIMS Class
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ATC Classification
V03AE05 - sucroferric oxyhydroxide ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.
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References
Anon. Sucroferric Oxyhydroxide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/06/2019. Buckingham R (ed). Sucroferric Oxyhydroxide . Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/06/2019. Joint Formulary Committee. Sucroferric Oxyhydroxide . British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/06/2019. Velphoro Tablet, Chewable (Fresenius Medical Care North America). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/06/2019.
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