Dephos

Indications

Sucroferric Oxyhydroxide is a phosphate binder. It is used to control high blood phosphate levels (hyperphosphataemia) in adults with chronic kidney disease who are on haemodialysis or peritoneal dialysis. Damaged kidneys cannot remove enough phosphate, and high levels over time can weaken bones and harden blood vessels.

How It Works

The tablet contains an iron-based compound that stays in the gut. When chewed and taken with meals, it binds the phosphate in food so that the phosphate passes out in the stool instead of being absorbed into the blood. Very little of the iron is absorbed.

Dosage and Administration

The usual starting dose for adults is 1,500 mg (as iron) a day, taken as 500 mg with each of the three main meals. The doctor adjusts the dose every few weeks according to blood phosphate results; the maximum is usually 3,000 mg a day. The tablet must be chewed or crushed, not swallowed whole, and taken with meals. Not recommended for children unless prescribed by a specialist.

Interactions

Few interactions are known, but phosphate binders can reduce the absorption of some medicines. Medicines such as Levothyroxine, Doxycycline and other oral antibiotics may be advised to be taken at least 1 hour before or 2 hours after this medicine. Tell your doctor about all medicines you take.

Contraindications

• Allergy to Sucroferric Oxyhydroxide or any ingredient
• Haemochromatosis or any other condition with iron build-up in the body

Side Effects

Common side effects include black or dark stools (expected and harmless), diarrhoea, nausea, constipation, vomiting, indigestion, stomach pain and a change in taste. Low blood phosphate can occur if the dose is too high.

Get urgent medical help if you have signs of a serious allergic reaction (swelling of the face or throat, difficulty breathing, widespread rash), vomiting blood, or black tarry stools with severe stomach pain or weakness.

Pregnancy and Lactation

There is little information on use in pregnancy. It should be used only if the doctor decides the benefit is greater than the risk. Because very little is absorbed, it is unlikely to pass into breast milk in meaningful amounts, but ask your doctor before breastfeeding.

Precautions and Warnings

Use with care in people with recent stomach or bowel bleeding, peritonitis, major stomach or bowel surgery, or serious liver disease. Black stools caused by this medicine can hide bleeding in the gut, so report any unusual symptoms. Keep to your kidney diet and attend regular blood tests.

Overdose

Overdose is unlikely to cause iron poisoning because little is absorbed, but it may lower blood phosphate too much. Contact a doctor if a large amount has been taken.

Therapeutic Class

Phosphate binder (iron-based), used in chronic kidney disease.

Storage

Store below 30°C in a dry place, away from light, in the original pack and out of the reach of children.