Sucroferric Oxyhydroxide (Oral)

Sucroferric oxyhydroxide helps lower the amount of phosphorous in your blood by attaching itself to the phosphates in your body and helping you dispose of them through your stools. Taken orally, in the form of a chewable tablet, it is used by patients with chronic kidney disease and those who are on dialysis.

Overview

Sucroferric oxyhydroxide, otherwise known by its brand name Velphoro, is a medicine that can lessen the amount of phosphorous reducing tablets a patient needs to take by offering them one chewable tablet that is taken once with every meal.

Acting as a phosphate binder, this medicine attaches to the phosphates in a patient's body by helping them to be disposed of through the digestive system. This is achieved by being passed through the digestive tract once attached to the Sucroferric oxyhydroxide, and then being removed from the body in the stool.

By taking sucroferric oxyhydroxide, patients can avoid hyperphosphatemia, which is an unpleasant result of having abnormally high levels of phosphate in the blood. Hyperphosphatemia is often the consequence of kidney disease and dialysis does not necessarily help to avoid it. That is why many patients undergoing dialysis are also prescribed phosphorus reducing medication. In most cases, the number of tablets that a patient will need to take to lower their blood phosphate levels are large. Sucroferric oxyhydroxide offers a more manageable alternative that can be easily incorporated into a daily routine and help a patient achieve their daily phosphorus goal.

Conditions treated

  • Chronic kidney disease.
  • Hyperphosphatemia.

Type of medicine

  • Phosphate binder.

Side effects

The most common side effects of taking sucroferric oxyhydroxide tend to be gastrointestinal-related, with 43% of people undergoing its year-long clinical trials experiencing an adverse gastrointestinal reaction. The most commonly reported side effects are diarrhea and discoloured or dark feces. In most patients, the diarrhea was mild, taking place shortly after the beginning of treatment with sucroferric oxyhydroxide, and disappearing with prolonged treatment and as the body became adjusted. For those taking sucroferric oxyhydroxide there is a high possibility that you may experience these side effects, however, they should be mild and not cause much bother or impact on your routine. If you happen to become concerned with any of these reactions, they worsen or do not stop after an extended period of time, it is best to discuss them with your doctor.

Other, less common reactions to this medication include nausea, a rash and tooth discoloration. Excluding tooth discoloration, these should disappear once the body becomes adjusted to the treatment. If you begin to feel concerned by any effects that you may be having with this medication, make sure to address them to your healthcare professional. They may also have advice on how to manage or alleviate any side effects that you may experience.

Serious adverse reactions are very unlikely when taking sucroferric oxyhydroxide, with just 0.36% of its trialled patients experience them. If you experience any difficulties with breathing, chest pain, swelling of the lips or throat, laboured breathing or a tight feeling in your chest, it is important that you seek medical advice immediately as these could be signs of a possible allergic reaction.

Dosage

The dose for sucroferric oxyhydroxide differs from patient to patient and will need to be determined by your doctor.

For adults who are taking this medicine to control phosphorus levels in chronic kidney disease and who are on dialysis, a recommended amount of 500 mg should be taken three times a day. Your doctor may adjust this dose to ensure that your phosphorus levels reach their target but as a rule of thumb, the dose should never exceed 3000 mg each day.

For children who are also affected by chronic kidney disease and are on dialysis, the dose must be decided by your doctor.

It is vital that you take this medicine exactly as your doctor has directed. Taking it more often or for a longer period of time than your doctor ordered can increase the chance of negative side effects and health problems. You must also make sure to only ever take sucroferric oxyhydroxide at mealtimes with food, as to do otherwise may have serious implications.

The tablets are easy to take and must be chewed rather than swallowed whole. They have a pleasant fruity taste that makes them inoffensive and effortless to take. In the medicine's studies, it appeared that for the majority of people, three to four tablets were enough per day, to reach their phosphorus goal.

Interactions

Even though sucroferric oxyhydroxide has a low chance of interacting with other medications, it is important that your doctor knows of any prescription or over the counter medications that you may be taking in advance to your treatment. It is important to include herbal remedies and vitamins when discussing this with your doctor.

In particular, you should inform your doctor of any medications that may interact with iron. This includes alendronate, doxycycline and levothyroxine. If you are taking any of these medications, it is unlikely that you will be required to discontinue taking them, however, you will need to wait between one and two hours after taking them before you can administer sucroferric oxyhydroxide. Make sure to discuss your options and the method of administering sucroferric oxyhydroxide in depth with your doctor, prior to your treatment beginning.

Warnings

Before taking this medication, it is vital that you communicate any current medication and other health problems clearly to your doctor. This will help avoid any serious interactions and side effects, as well as help to give you the most effective treatment possible. Do not take any new medicines or vitamins until you have discussed them with your doctor and they have been given the go-ahead.

You will be expected to have regular visits to your doctor which will include blood tests. Regular blood tests will make sure that the medicine is working correctly as well as track unwanted effects.

In regards to pregnancy and breastfeeding, sucroferric oxyhydroxide has no known adverse effects. During tests on animals, there were shown to be no risks to fetuses, fertility or breastfeeding, however, to be on the safe side, it is always best to discuss pregnancy or breastfeeding with a doctor before starting medication.

Storage

When storing sucroferric oxyhydroxide, it is important that you keep it away from heat, moisturiser and direct sunlight as this could all damage the active ingredients. It should also be kept from freezing.

It is important that you keep it in a dark place at room temperatures, such as a medicine cabinet or drawer, and that it is stored in a protective container.

The medication will need to be disposed of if it is older than its label expiry date. It must also be disposed of if it appears to have been damaged or tampered with, and made inaccessible to children and vulnerable adults.

Summary

Sucroferric oxyhydroxide can help aid dialysis and improve a patient with chronic kidney disease's health noticeably. By lowering the phosphate in blood, unpleasant symptoms of hyperphosphatemia can be reduced, stopped and managed. The symptoms can cause distress to a person's life with effects such as tingling, muscle cramps, numbness around the mouth, tetany, joint pain and rashes.

The fact that this medication must be taken as part of a regular routine and with meals can cause anxiety to some, as it requires organisation and commitment that may be difficult to manage. However, with the help of your doctor, you can put a routine into place that is easy to remember and practice. Phone alarms, paper reminders and help from family or friends can all play into achieving a successful dosing routine. The fact that the medication is chewable and pleasantly flavoured works in its favour here, making it easier to administer and remember.

Sucroferric oxyhydroxide has a very low risk of serious side effects and problems for the majority of patients. However, it is likely that a patient will experience diarrhea or stool discolouration. While harmless to most and reactions that will disappear once the body adjusts to the medicine, these side effects can cause worry or distress to others. If you notice any side effects that remain persistent, worsen or cause distress, make sure to visit your doctor as soon as possible. It may be that your dose will need to be altered, or that you require additional management or medical assistance.

This medication requires commitment, responsibility and dilgent administration. However, when done correctly, it can make a hugely positive impact to your life. It is also a great alternative to many other phosphate reducing tablets which often require larger amounts and doses throughout a day.

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Last Reviewed:
December 25, 2017
Last Updated:
April 05, 2018
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