soo-kroe-FER-ik ox-ee-hye-DROX-ide

Therapeutic Classification: electrolyte modifiers

Pharmacologic Classification: phosphate binders

• Control of elevated serum phosphorus levels in patients with chronic renal disease currently on dialysis.

• Binds dietary phosphorus in the GI tract via ligand exchange.

• Decreased serum phosphorus levels and sequelae of hyperphosphatemia.

Absorption: Phosphate binding is local with no systemic absorption. Minimal amounts of released iron may be absorbed.

Distribution: Unknown.

Metabolism/Excretion: Action is local, no metabolism. Bound phosphate is excreted in feces.

Half-life: Unknown.

(phosphorus lowering)

Contraindicated in:

• None noted.

Use Cautiously in:

• Peritonitis (from peritoneal dialysis), significant hepatic/gastric disorders, following major GI surgery, history of hemochromatosis/diseases of iron accumulation
• OB: Not systemically absorbed (minimal risk of fetal exposure)
• Lactation: Not systemically absorbed (not likely to appear in breast milk)
• Pedi: Safety and effectiveness not established in children.

GI: discolored feces, diarrhea, nausea, unpleasant taste.

Drug-Drug:

• Should not be used concurrently with levothyroxine due to interference with phosphorus homeostasis; administer ≥4 hr before sucroferric oxyhydroxide.
• May ↓ absorption and effectiveness of aspirin, cephalexin, and doxycycline; administer ≥1 hr before sucroferric oxyhydroxide.

• PO (Adults): 500 mg 3 times daily (with meals) initially, may be titrated by 500 mg/day at weekly intervals depending on serum phosphorus; usual range is 1500–3000 mg/day in 3 divided doses.

• Chewable tablets (wild berry-flavored): 500 mg;

• Monitor for abdominal pain or discomfort. Sucroferric oxyhydroxide causes discolored (black) stool and may mask GI bleeding. Medication does not effect guaiac based (Hemoccult) or immunological based (iColoRectal and Hexagon Opti) fecal occult blood tests.

• Monitor serum phosphorus levels and dose of sucroferric oxyhydroxide. Dose is titrated in increments of 500 mg (1 tablet) per day as needed until acceptable serum phosphorus level (≤5.5 mg/dL) is reached. Monitor periodically thereafter. May begin titration 1 wk after start of therapy and adjust at weekly intervals.
  • Monitor effect and iron homeostasis in patients with peritonitis during peritoneal dialysis, significant hepatic or gastric disorders, following major gastrointestinal surgery, or with a history of hemachromatosis or other diseases with iron accumulation.

• PO: Administer 3 times daily with meals. Tablets must be chewed; do not swallow whole. Tablets may be crushed prior to swallowing. No additional fluid is required above usual amount taken.

• Instruct patient to take medication as directed. Omit missed doses; resume medication with next meal; do not double doses.
• Advise patient to to take aspirin, cephalexin, and doxycycline at least 1 hr before and levothyroxine at least 4 hr before sucroferric oxyhydroxide.
• Advise female patient to notify health care professional if pregnancy is planned or suspected.

• Decreased serum phosphorus levels.

Velphoro

NDC Code^*

• 49230- Fresenius Medical Care North America
  • 49230-645- Velphoro
    • 49230-645-51- 1 BOTTLE in 1 CARTON (49230-645-51) > 90 TABLET, CHEWABLE in 1 BOTTLE