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Velphoro
Velphoro (generic name: sucroferric oxyhydroxide) is a phosphate binder used to control serum phosphorus levels in patients with chronic kidney disease (CKD) who are on dialysis. Elevated phosphorus levels can lead to serious complications like bone and heart disease in CKD patients, and Velphoro helps by reducing phosphate absorption from the diet. It is commonly prescribed for patients with end-stage renal disease (ESRD) to help maintain healthy phosphate levels.
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Frequently Asked Questions
How long does it take for Velphoro to start lowering phosphate levels?
Velphoro begins to reduce serum phosphate levels within hours of taking a dose, but it may take several weeks of consistent use to see significant changes in lab results.
Can I swallow Velphoro tablets whole?
No, Velphoro tablets should be chewed thoroughly before swallowing. Swallowing the tablet whole may reduce its effectiveness in binding phosphate.
Does Velphoro affect iron levels?
Velphoro contains iron, but it is minimally absorbed by the body. The risk of iron overload is low, but patients with iron overload disorders should be monitored carefully.
Can Velphoro be used in people not on dialysis?
Velphoro is specifically indicated for patients with chronic kidney disease on dialysis. Its use in non-dialysis patients has not been well studied.
What should I do if I miss a dose of Velphoro?
If you miss a dose of Velphoro, take it with your next meal. Do not take extra tablets to make up for the missed dose.
Comprehensive Drug Guide
How Does Velphoro Work?
Velphoro works by binding to dietary phosphate in the gastrointestinal tract, which prevents the phosphate from being absorbed into the bloodstream. The bound phosphate is then excreted in the stool, helping to lower serum phosphate levels in patients with CKD who are on dialysis.
Common Dosages
- Chewable tablet: 500 mg sucroferric oxyhydroxide.
Typical Dosing
- The typical starting dose of Velphoro is 500 mg (one tablet) taken with each meal, for a total of 1,500 mg per day.
- The dose may be adjusted based on serum phosphorus levels, with a typical range of 500 mg to 3,000 mg per day.
Typical Dosing
FDA Approved Indications
- Control of serum phosphorus levels in patients with chronic kidney disease (CKD) who are undergoing dialysis.
Who Shouldn't Take Velphoro?
- Known hypersensitivity to sucroferric oxyhydroxide or any of its components.
- Patients with hemochromatosis or other iron overload conditions should use Velphoro with caution.
Advice From The Pharmacist
- Take Velphoro with meals to ensure it binds to dietary phosphate effectively. Chew the tablet thoroughly before swallowing; do not swallow it whole.
- Continue to follow a low-phosphorus diet while taking Velphoro, as the medication alone may not be sufficient to control phosphorus levels if dietary intake is high.
- Inform your healthcare provider if you experience symptoms of high phosphorus levels, such as itching, muscle weakness, or bone pain.
- Velphoro can cause black or dark stools due to its iron content. This is not harmful but should be noted to avoid confusion with gastrointestinal bleeding.
Side Effects of Velphoro
Common Side Effects
- Diarrhea
- Nausea
- Dark-colored stools
- Constipation
- Abdominal pain
Uncommon/Severe Side Effects
- Allergic reactions (swelling, rash, difficulty breathing).
- High iron levels (though rare with Velphoro as it is minimally absorbed).
Risks and Warnings of Velphoro
- Gastrointestinal Effects: Velphoro may cause gastrointestinal side effects like diarrhea, constipation, or abdominal pain, especially when starting treatment. These effects often improve over time.
- Iron Overload: Although the risk of iron overload is low because Velphoro is not significantly absorbed, patients with iron metabolism disorders (e.g., hemochromatosis) should be monitored carefully.
- Interference with Lab Tests: Velphoro can cause black or dark stools, which may interfere with tests for gastrointestinal bleeding. Inform your healthcare provider if you are scheduled for tests that check for blood in the stool.
Interactions with Velphoro
Common Drug Interactions
- Oral medications: Velphoro may interfere with the absorption of other oral medications if taken at the same time. Take other medications at least 1 hour before or 2 hours after taking Velphoro.
- Iron supplements: Velphoro contains iron, so additional iron supplementation should be monitored closely to avoid excess iron levels.
Alternatives to Velphoro
- Sevelamer carbonate (Renvela): Another phosphate binder used to control serum phosphate levels in CKD patients.
- Lanthanum carbonate (Fosrenol): A phosphate binder that reduces phosphate absorption and is available in chewable tablet form.
- Calcium acetate (PhosLo): A calcium-based phosphate binder used in patients with CKD to control phosphate levels.
