From the Guidelines
Velphoro (Sucroferric oxyhydroxide) is used to control high phosphorus levels in patients with chronic kidney disease who are on dialysis, as a phosphate binder, attaching to phosphate from food in the digestive tract and preventing its absorption into the bloodstream. This is based on the most recent guidelines for managing bone metabolism and disease in chronic kidney disease, which emphasize the importance of controlling serum phosphorus levels to prevent complications such as bone disease and cardiovascular problems 1.
Key Considerations
- The choice of phosphate binder, including Velphoro, should be determined by patient preference, compliance, comorbid illnesses, side effects, cost, and the ability to control serum phosphorus levels while maintaining the desired calcium-phosphorus product 1.
- Noncalcium, nonmagnesium, non-aluminum phosphate binders, like Velphoro, are recommended as the therapy of choice for controlling serum phosphorus levels in dialysis patients, due to the potential risks associated with long-term use of aluminum-containing phosphate binders 1.
- Regular blood tests are necessary to monitor phosphorus levels and adjust the medication dosage accordingly, to ensure that phosphorus levels are adequately controlled and to minimize the risk of side effects.
Administration and Side Effects
- The typical starting dose of Velphoro is 500 mg (one tablet) taken three times daily with meals, though dosing may be adjusted based on phosphorus levels, with a maximum daily dose of 3000 mg (six tablets).
- Patients should swallow the tablets whole or chew them before swallowing, always taking them with meals.
- Common side effects include discolored (dark) stools and diarrhea, which usually improve over time.
- It is essential to weigh the benefits of using Velphoro against the potential risks and side effects, and to closely monitor patients for any adverse effects 1.
From the FDA Drug Label
Velphoro is indicated for the control of serum phosphorus levels in adults and pediatric patients 9 years of age and older with chronic kidney disease (CKD) on dialysis. Velphoro is a phosphate binder indicated for the control of serum phosphorus levels in adult and pediatric patients 9 years of age and older with chronic kidney disease on dialysis.
Velphoro (Sucroferric oxyhydroxide) is used for the control of serum phosphorus levels in:
- Adults
- Pediatric patients 9 years of age and older with chronic kidney disease (CKD) on dialysis 2, 2, 2.
From the Research
Velphoro (Sucroferric oxyhydroxide) Usage
- Velphoro (Sucroferric oxyhydroxide) is used for the control of serum phosphorus levels in patients with chronic kidney disease (CKD) on dialysis 3.
- It is an iron-based oral phosphate binder, providing an effective and generally well-tolerated noncalcium-based phosphate binder therapy with a lower pill burden than sevelamer carbonate and the potential for improved treatment adherence 3.
- Sucroferric oxyhydroxide has a high phosphate-binding capacity and low iron-releasing properties, making it a promising alternative to other phosphate binders 4.
Benefits and Safety
- Studies have shown that sucroferric oxyhydroxide is generally well tolerated, with the most frequently reported treatment-emergent adverse events being mild, transient diarrhea and discolored feces 3.
- It has been found to be noninferior to sevelamer carbonate in lowering serum phosphorus levels, and has a numerically lower mean daily pill burden and better treatment adherence than sevelamer carbonate 3.
- Long-term administration of sucroferric oxyhydroxide has been associated with modest increases in tissue iron levels and no iron toxicity, making it a safe option for patients with CKD 4.
Comparison to Other Phosphate Binders
- Sucroferric oxyhydroxide has been compared to other phosphate binders, including sevelamer carbonate and lanthanum carbonate, and has been found to have a similar efficacy and safety profile 5.
- It has a lower pill burden than sevelamer carbonate, making it a more convenient option for patients 3.
- The effects of sucroferric oxyhydroxide on patient-important outcomes, such as cardiovascular disease and mortality, are still uncertain and require further study 6.