Velphoro Dosage/Direction for Use

Velphoro is for oral administration only.
Posology: Starting Dose: The recommended starting dose of Velphoro is 1,500mg iron (3 tablets) per day administered as 1 tablet (500mg iron) 3 times daily with meals.
Titration and Maintenance: Serum phosphorus levels must be monitored and the dose of Velphoro up or down titrated in increments of 500mg iron (1 tablet) per day as needed every 1-2 weeks until an acceptable serum phosphorus level is reached, with regular monitoring afterwards.
In clinical practice, treatment will be based on the need to control serum phosphorus levels. In case of hypophosphatemia occurring during the titration and maintenance phase, Velphoro should be down titrated to achieve appropriate serum phosphorus levels.
Based on clinical studies, on average patients required 1,500mg iron to 2,000mg iron (3 to 4 tablets) a day to control serum phosphorus level.
If one or more doses are missed, the normal dose of the medicinal product should be resumed with the next meal.
Maximum tolerated daily Dose: The maximum recommended dose is 3,000mg iron (6 tablets).
Special Populations: Paediatric Population: The safety and efficacy of Velphoro in children below the age of 18 years has not been established.
Elderly population (≥65 years of age): Of the total number of subjects in two active-controlled clinical studies of Velphoro (n=835), 29.7% (n=248) were aged 65 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects.
Renal Impairment: Velphoro is indicated for the control of serum phosphorus levels in adult ESRD patients on haemodialysis or peritoneal dialysis. There is no clinical data available with Velphoro in patients with earlier stages of renal impairment.
Hepatic Impairment: Patients with severe hepatic impairment were excluded from participating in clinical studies with Velphoro. However, no evidence of hepatic impairment or significant alteration of hepatic enzymes were observed in the clinical studies with Velphoro. See further information in Precautions.
Method of Administration: Velphoro is a chewable tablet that must be taken with meals. In order to maximise the adsorption of dietary phosphate, the total daily dose should be divided across the meals of the day. Patients are not required to drink more fluid than they normally would and should adhere to their prescribed diets. Tablets must be chewed or crushed; tablets must not be swallowed whole.