Medically reviewed by Drugs.com. Last updated on Feb 7, 2019.
(soo kroe FER ik ox ee hye DROX ide)
- Polynuclear Iron (III)-Oxyhydroxide (pn-FeOOH)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet Chewable, Oral:
Velphoro: 500 mg [berry flavor]
Brand Names: U.S.
- Phosphate Binder
Binds phosphate in the aqueous environment of the GI tract via ligand exchange between hydroxyl groups and/or water in sucroferric oxyhydroxide and dietary phosphate. Reduced dietary phosphate absorption results in reduced serum phosphorus levels and calcium-phosphorus product levels.
Not systemically absorbed
Feces (as bound phosphate)
Use: Labeled Indications
Hyperphosphatemia: For control of serum phosphorus levels in patients with chronic kidney disease (CKD) receiving dialysis
There are no contraindications listed in the manufacturer's labeling.
Note: One tablet contains 2.5 g of sucroferric oxyhydroxide which is equivalent to 500 mg of iron.
Hyperphosphatemia: Oral: Initial: One tablet (500 mg iron) 3 times daily with meals. May titrate weekly (beginning 1 week after initiation) in increments or decrements of 500 mg iron per day as needed to appropriate serum phosphorus levels (≤5.5 mg/dL); usual maintenance dose: 3 to 4 tablets (1.5 to 2 g iron/day); doses of up to 6 tablets (3 g iron/day) have been evaluated.
Missed dose: If a dose is missed, resume with next meal; do not replace a missed dose.
Refer to adult dosing.
Tablets must be chewed or crushed; do not swallow whole. Must administer with meals. The total daily dose should be divided among meals.
One tablet contains ~1.4 g of carbohydrates.
Store at 25°C (77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F). Protect from moisture.
Aspirin: Sucroferric Oxyhydroxide may decrease the serum concentration of Aspirin. Management: Administer aspirin at least 1 hour before administration of sucroferric oxyhydroxide. Consider therapy modification
Cephalexin: Sucroferric Oxyhydroxide may decrease the serum concentration of Cephalexin. Management: Administer cephalexin at least 1 hour before administration of sucroferric oxyhydroxide. Consider therapy modification
Levothyroxine: Sucroferric Oxyhydroxide may decrease the serum concentration of Levothyroxine. Management: Administer oral/enteral levothyroxine at least 4 hours before administration of sucroferric oxyhydroxide. No interaction is anticipated with parenteral levothyroxine administration. Consider therapy modification
Tetracyclines: Sucroferric Oxyhydroxide may decrease the serum concentration of Tetracyclines. Management: Administer oral/enteral doxycycline at least 1 hour before sucroferric oxyhydroxide. Specific dose separation guidelines for other tetracyclines are not presently available. No interaction is anticipated with parenteral administration of tetracyclines. Exceptions: Eravacycline. Consider therapy modification
>10%: Gastrointestinal: Diarrhea (6% to 24%), darkening of stools (12% to 16%)
1% to 10%: Gastrointestinal: Nausea (10%)
<1%, postmarketing and/or case reports: Skin rash, dental discoloration
• Gastrointestinal disorders: Patients with significant gastrointestinal (GI) disorders or post major GI surgery were not included in clinical studies; monitor effect and iron homeostasis in these patients.
• Hemochromatosis: Use in patients with a history of hemochromatosis or other conditions associated with iron accumulation has not be studied; monitor effect and iron homeostasis in these patients.
• Hepatic disease: Use in patients with significant hepatic disorders has not been studied; monitor effect and iron homeostasis in these patients.
• Peritonitis: Use in patients with peritonitis during peritoneal dialysis has not been studied; monitor effect and iron homeostasis in these patients.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
Serum calcium, phosphorus, and parathyroid hormone (PTH): Frequency of measurement may be dependent upon the presence and magnitude of abnormalities, the rate of progression of chronic kidney disease (CKD), and the use of treatments for chronic kidney disease-mineral and bone disorder (CKD-MBD) (KDIGO 2017):
CKD stage G3a to G3b: Serum calcium and phosphate: Every 6 to 12 months; PTH: Frequency based on baseline level and progression of CKD
CKD stage G4: Serum calcium and phosphate: Every 3 to 6 months; PTH: Every 6 to 12 months
CKD stage G5 and G5D: Serum calcium and phosphate: Every 1 to 3 months; PTH: Every 3 to 6 months
Pregnancy Risk Factor
Adverse events were not observed in most animal reproduction studies. Maternal systemic absorption of sucroferric oxyhydroxide is low
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience dark stools. Have patient report immediately to prescriber severe nausea, severe vomiting, severe abdominal pain, or severe diarrhea (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about sucroferric oxyhydroxide
Other brands: Velphoro