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Iron-based phosphate binder

Sucroferric oxyhydroxide

Brand names: Velphoro

Adult dose

Dose: 500mg PO TDS with meals (chewable); titrate to target phosphate
Route: PO
Frequency: TDS with meals

Clinical pearls

  • Hyperphosphataemia in CKD on dialysis — alternative to calcium-based binders
  • Chew tablets; black stool expected

Contraindications

  • Iron overload (haemochromatosis)
  • Hypersensitivity

Side effects

  • Diarrhoea
  • Discoloured stools (black)
  • Nausea
  • Hyperkalaemia (rare)

Interactions

  • Levothyroxine (separate by 4h)
  • Doxycycline
  • Some antiretrovirals

Monitoring

  • Phosphate
  • Ferritin
  • Calcium
  • PTH

Reference: BNF; NICE NG203; https://bnf.nice.org.uk/drugs/sucroferric-oxyhydroxide/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.