Sucroferric oxyhydroxide

Generic Medicine Info
Indications and Dosage
Hyperphosphataemia in patients with chronic renal failure
Adult: In patients on haemodialysis or peritoneal dialysis: Initially, 1,500 mg (as Fe) daily in 3 divided doses. Titrate in increments or decrements of 500 mg at intervals of at least 1 week according to serum-phosphate concentration. Maintenance: 1,500-2,000 mg daily in divided doses. Max: 3,000 mg daily.
Haemochromatosis and other Fe accumulation disorders.
Special Precautions
Patient with history of peritonitis within the last 3 months; gastrointestinal disorder or post major gastrointestinal surgery. Hepatic impairment.
Adverse Reactions
Significant: Discoloured faeces, diarrhoea.
Gastrointestinal disorders: Nausea, constipation, vomiting, dyspepsia, abdominal pain or discomfort, flatulence, tooth and tongue discolouration, abdominal distention, gastritis, dysphagia, GERD.
General disorders and administration site conditions: Product taste abnormal, fatigue.
Metabolism and nutrition disorders: Hypercalcaemia, hypocalcaemia.
Nervous system disorders: Headache.
Reproductive system and breast disorders: Dyspnoea.
Skin and subcutaneous tissue disorders: Pruritus, rash.
Patient Counseling Information
This drug may cause discolouration of faeces.
Monitoring Parameters
Monitor serum phosphorus, Ca and PTH.
Drug Interactions
May decrease the serum concentrations of doxycycline, acetylsalicylic acid, cefalexin and levothyroxine.
Mechanism of Action: Sucroferric oxyhydroxide binds phosphate in aqueous environment in the gastrointestinal tract by ligand exchange between hydroxyl groups and/or water in sucroferric oxyhydroxide and dietary phosphate. The bound phosphate is eliminated via faeces. Decreased serum phosphate levels and calcium-phosphorus product levels results in reduced dietary phosphate absorption.
Absorption: Not systemically absorbed. The active moiety, polynuclear iron (III)-oxohydroxide (pn-FeOOH), is not absorbed and metabolised. Mononuclear iron species (degradation product) can be released from pn-FeOOH surface and be absorbed.
Distribution: pn-FeOOH is distributed to target organs (e.g. liver, spleen, bone marrow) and incorporated into RBCs.
Metabolism: pn-FeOOH (active moiety) cannot be metabolised.
Excretion: Via faeces (as bound phosphate).
Store below 30°C. Protect from moisture.
MIMS Class
Other Agents Affecting Metabolism
ATC Classification
V03AE05 - sucroferric oxyhydroxide ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.
Anon. Sucroferric Oxyhydroxide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 03/06/2019.

Buckingham R (ed). Sucroferric Oxyhydroxide . Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 03/06/2019.

Joint Formulary Committee. Sucroferric Oxyhydroxide . British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 03/06/2019.

Velphoro Tablet, Chewable (Fresenius Medical Care North America). DailyMed. Source: U.S. National Library of Medicine. Accessed 03/06/2019.

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