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 Formulary Chapter 9: Nutrition and blood - Full Chapter
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09.05.02.02  Expand sub section  Phosphate-binding agents
Calcium Acetate (Phosex®)
(Tablets)
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First Choice
Amber No SCG

 




    • Generally recommended as first line phosphate binder. More effective than calcichew and less elemental calcium.



 



 

 
Calcium Carbonate (Calcichew®)
(Tablets)
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First Choice
Amber No SCG

  • Calcium-based phosphate binders may be used as the initial binder therapy for patients with chronic kidney disease as they are cheap and relatively efficacious, in conjunction with dietary phosphate restriction, to control phosphorus and parathyroid levels.

  • If hypercalcaemia develops with the use of calcium carbonate, it may be necessary to convert to calcium acetate, a non calcium-containing phosphate binder, or a combination of both.

  • Link to SPC

 
Calcium Salts with magnesium (Osvaren®)
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Second Choice
Amber No SCG

  • Second line phosphate binder after Calcichew or Phosex.

  • Can be prescribed in primary care on hospital initiation.

 
   
Lanthanum (Fosrenol ®)
(Tablet (chewable), oral powder)
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Restricted Drug Restricted
Amber No SCG
High Cost Medicine

  • Initiation and monitoring by consultant nephrologists in patients with ESRF as an alternative agent to sevelamer.

 
   
Sevelamer Carbonate (Renvela®)
(Powder for oral suspension (sachets), Tablets)
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Restricted Drug Restricted
Amber No SCG
High Cost Medicine

 

  • Nephrologists - Renal patients only who require a phosphate-binder but have high serum calcium or Renal patients with vascular calcification (hydrochloride and carbonate salts are on formulary).
 
   
Sevelamer Hydrochloride  (Renagel®)
(Tablets)
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Restricted Drug Restricted
Amber No SCG
High Cost Medicine

 

  • Nephrologists - Renal patients only who require a phosphate-binder but have high serum calcium or Renal patients with vascular calcification (hydrochloride and carbonate salts are on formulary).

 

 

 

 
   
Aluminium Hydroxide (Alu-Cap®)
(Capsules)
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Formulary
Red Hospital

  • Generally reserved for short term use in patients with severe and difficult to control hyperphosphataemia.

 
   
 ....
 Non Formulary Items
Calcium Acetate  (Renacet®)

Track Changes
Non Formulary
Grey
 
Calcium Salts

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Non Formulary
Grey
Brands: Everose®, Osvaren®, Calcium 500® and Adcal®
 
sucroferric oxyhydroxide  (Velphoro®)

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Non Formulary
Grey
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

OTC

Available Over the Counter. Consider Self Care   

Green

Formulary - Can be prescribed in both secondary and primary care.   

Advice

Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

Amber No SCG

Formulary - Specialist initiation without shared care guidance.  

Amber SCG

Formulary - Specialist initiation with shared care guidance.  

Red Hospital

Restricted - Hospital only, not to be prescribed in primary care.  

Switch

Not recommended for prescribing. Switch to alternative cost-effective option.   

Black

Not recommended for prescribing in primary or secondary care.  

Grey

Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

Non Formulary

Non-Formulary (category under review).  

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