This medication is considered chemically an iron-based phosphorus group binder, which is specifically used to reduce elevated levels of the phosphorus in the body to a normal level.
Velphoro tablets come in chewable forms that should be chewed or crushed before being taken.
What Is Velphoro Used For?
Velphoro is used to help your kidneys. The kidneys play an important role in balancing the natural chemicals in your body.
Brand Name(s): Velphoro
Drug Availability: Prescription
Administration: Oral
Therapeutic Classification: Phosphate binder
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Sucroferric oxyhydroxide
Dosage Form(s): Chewable tablet
When your kidneys lose their ability to filter out waste or unwanted substances in your blood, a chemical imbalance can occur. This chemical imbalance can cause an increased amount of phosphorus in the body, which could lead to problems in the bones.
Velphoro is a unique medication that reduces the phosphorus absorbed from your food that would have been absorbed into the body’s bloodstream.
How to Take Velphoro
Take Velphoro tablets by mouth and exactly as prescribed by your primary care provider. Velphoro comes in chewable tablets; these should be chewed or crushed and taken with a meal. Do not swallow them whole.
Storage
Store Velphoro in bottles tightly closed at all times to protect them from moisture. It should be kept at room temperature (between 68 and 77 degrees F). If you travel with this medication, you may temporarily keep it stored at temperatures as low as 59 degrees and as high as 86 degrees.
Do not leave your medication in the car overnight, and do not store it in the refrigerator or the bathroom. Keep it in a dry and safe area out of the reach of children and pets to prevent accidental consumption.
What Are the Side Effects of Velphoro?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or a pharmacist. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
This medication works like a magnet in that it binds to the phosphorus in your food to keep it from being distributed throughout the body. You must take your dose with food so that your digestive system eliminates the excess phosphorus.
This medication, like many others, comes with side effects. Possible side effects may be common, serious, or long term. The common side effects are listed below.
Common Side Effects
Common side effects reported with Velphoro include:
Discolored fecesMild diarrheaNausea
Severe Side Effects
Call your healthcare provider immediately if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Swelling of gastrointestinal (GI) tract (peritonitis): The most common symptom is often sudden, extreme abdominal pain that worsens with touch or movement. Severe diarrhea: Symptoms can include abdominal cramping and pain, an urgent need to have a bowel movement, and loose stools. Increased iron levels: Symptoms can include tiredness or weakness, painful joints, loss of interest in sex, abdominal pain, and darkening of the skin (may appear gray, metallic, or bronze). Low phosphorus levels: Symptoms can include muscle weakness, bone pain, seizures, mental confusion, or rhabdomyolysis (serious but rare muscle tissue breakdown that releases protein into the blood).
Dosage: How Much Velphoro Should I Take?
Modifications
No modifications are needed in most circumstances with Velphoro.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (chewable tablets): For control of phosphorus levels in patients with chronic kidney disease on dialysis: Adults—500 milligrams (mg) 3 times a day with food. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day. Children—Use and dose must be determined by your doctor.
Velphoro has shown no relevant evidence of impaired birth or harm to the fetus, and there are no adequate and well-controlled studies in pregnant women. Likewise, it is unlikely to pass through breast milk as the absorption of iron from it is minimal.
However, it is recommended to talk to your healthcare provider if you are pregnant or plan to become pregnant while taking this medication.
Missed Dose
If you miss a dose of Velphoro, do not take it again unless you are about to have a meal. Wait to take your next dose at your next mealtime. Do not take a second dose, as it may provide more harm than good.
If you are unsure how many chewable tablets you have taken, try to write them down or use a pill box to remind yourself to take them only when you are about to have a meal.
Overdose: What Happens If I Take Too Much Velphoro?
There are no reports of Velphoro overdose. However, if you take more than your healthcare provider instructed you to take and experience nausea and severe diarrhea, immediately call 911 or the Poison Control Center.
Precautions
What Are Reasons I Shouldn’t Take Velphoro?
Rarely, allergies or increased sensitivity can occur with Velphoro’s main ingredient, sucroferric oxyhydroxide. If you’ve ever experienced an allergic reaction to sucroferric oxyhydroxide, tell your healthcare provider before starting treatment. You may not be able to take Velphoro.
If someone collapses or isn’t breathing after taking Velphoro, call 911 immediately.
This medicine may discolor your stools black. This is normal and nothing to worry about.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Additionally, you may not be able to take Velphoro if you have a history of:
GI health conditionsLiver problemsHigh levels of iron in the body
What Other Medications Interact With Velphoro?
Velphoro should be carefully administered when taking certain medications. The following medications below should be separated from Velphoro and meals.
Take the following at least one hour before Velphoro:
Vibramycin (doxycycline) Durlaza (aspirin) Keflex (cephalexin)
Take at least four hours before Velphoro:
Synthroid, Ermeza, Euthyrox Levo-T, Levolet, Levoxyl, Thyquidity, Thyro-Tabs, Tirosint, Tirosint-Sol, and Unithroid (levothyroxine)
Combined use of Velphoro and levothyroxine may lower the concentration of levothyroxine in your body. If you take levothyroxine, Velphoro may reduce how well it works.
Other drug interactions may occur. Before starting Velphoro, tell your healthcare provider about all medications you take, including prescription and over-the-counter (OTC) drugs, vitamins, or herbal supplements. Ask them for a complete list of drug interactions and what drugs or substances to avoid.
What Medications Are Similar?
Velphoro is part of a drug class that binds to phosphorus to reduce the amount of phosphorus in the body. Other similar medications do not commonly have an iron base such as this one. Instead, they may contain a calcium base that could be more harmful if you are at risk of high calcium levels.
These medications include:
Calcium carbonateCalcium acetate
Other phosphorus-binding medications include:
Renvela (sevelamer) Magnesium carbonate Lanthanum carbonate BindRen (colestilan) Kiklin (bixalomer) Auryxia (ferric citrate) Niacor or Niaspan (nicotinic acid)
How Can I Stay Healthy While Taking Velphoro?
In addition to following your prescribed treatment regimen, maintain a healthy diet and exercise regularly.
Do not stop taking your prescribed medication if you are not experiencing any severe side effects unless directed by your healthcare provider.
There are many foods rich in phosphorus, and it is important to be aware of foods that may increase the amount of phosphorus in your body while taking this medication. If you are at risk of high phosphorus levels and are taking this medication, you should reduce the consumption of foods high in phosphorus, which include:
Low-fat plain yogurtMilk (2%)Preserved salmonScallops, breaded and friedMozzarella cheesePreserved chicken breast
Instead, increase the amounts of fruits, vegetables, refined grains, and rice.
In advanced chronic kidney disease, working with a registered dietitian and nutritionist is important for optimal nutritional intake. Ask your healthcare provider for a referral.
Exercise is also an essential factor in maintaining overall good health. You can work with your healthcare team on establishing an appropriate exercise plan for you.
The author would like to recognize and thank Jaycob Pena for contributing to this article.
