-
AlternaGEL
- Aluminum based phosphate binder
- aluminum hydroxide
- 300-900mg TID with meals
- risk of aluminum accumulation, no more than 4 weeks
- rarely used
-
PhosLo
Phoslyra
- Calcium based phosphate binder
- Calcium Acetate
- 2001-2668mg TID with meals
- Acetate binds more dietary phos on elemental Ca basis compared to carbonate
-
Tums
- Ca Carbonate
- 500mg TID with meals
-
Velphoro
- Sucroferric oxyhydroxide
- Al and Ca free, some iron based
- 500mg TID with meals
- absorption minimal
-
Auryxia
- Ferric citrate
- Al, Ca free phos binder
- 2g TID with meals up to 12g/day
- iron absorption, dosage reduce of IV iron may be necessary
-
Fosrenol
- Lanthanum Carbonate
- Al, Ca free phos binder
- 500-1000mg TID with meals
- use powder if unable to chew tabs
- medguide required
-
Renvela (tab and powder)
- Sevelamer carbonate
- Al, Ca free phos binder not systemically absorbed
- also lowers TC and LDL by 15-30%
- 800-1600mg TID with meals
-
Renagel (tablet)
- Sevelamer hydrochloride
- Al, Ca free phos binder
- 800-1600mg TID with meals
-
Rocacltrol
- calcitriol (VitD analog)
- cap, soln, inj
- ckd: 0.25-0.5mcg PO daily
- dialysis: 0.5-1mcg po daily or 0.5-4mcg IV 3xweekly
-
Rayaldee
- Calcifediol (VitD analog), ER cap
- prodrug of calcitriol
- CKD stage 3/4: 30mcg QHS
-
Hectorol
- Doxercalciferol (cap, inj), vitd analog
- CKD: 1-3.5mcg po daily
- dialysis: 10-20mcg po 3xweekly or 4-18mcg IV 3xweekly
-
Zemplar
- Paricalcitol (cap, inj), vitd analog
- CKD: 1-2mcg PO daily or 2-4mcg 3xweekly
- dialysis: 2.8-7mcg IV 3xweekly
-
Sensipar
- Cinacalcet (calcimimetic)
- dialysis: 30-180mg po daily with food
- take tab whole, dont crush or chew
-
Parsabiv
- Etelcalcetide (calcimimetic)
- Dialysis: 2.5-15mg IV 3xweekly
- SE: decreased bone turnover, worsening HF, GI bleed
-
Kionex
- Sodium polysterene sulfonate (kayexalate)
- powder, suspension
- PO: 15g, 1-4x/day
- Rectal: 30-50g q6h
- dont mix oral products with sorbitol= GI necrosis
-
Veltassa
- Patiromer (powder) - for hyperkalemia
- 8.4g po once daily with food, max 25.2g
- adjust by 8.4g/d prn at more than 1wk intervals to get desired K.
- give other drugs 3h before or after
- delayed onset of action ~7h
- store in fridge, if at room temp, use within 3mo
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