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Phosphate Binders

About your medicine

Phosphate is a mineral that affects the health of bones. When someone has kidney failure they tend to have high phosphate levels. This puts them at risk of bone problems. Too much phosphate in your body can also make you itchy.

Treatment includes eating a diet low in phosphate (click here for more details on Diet) and taking phosphate binders. Dialysis treatment also helps to remove some phosphate.

There are several types of phosphate binder available. Your doctor and dietician will help to decide which one is best for you to take depending on blood results and how easy you find it to take your tablets.

  • Alucap (aluminium hydroxide) is a phosphate binder which contains aluminium. It is very effective at binding phosphate, but if taken over a long period of time, aluminium can build up in the body, possibly causing memory problems. Your doctor will measure your aluminium levels if you take Alucaps. Side effects of Alucaps include constipation. Alucaps should be swallowed whole 10-15 minutes before meals.
  • Calcichew is a phosphate binder which contains calcium. Side effects include a chalky taste in the mouth, or sometimes the level of calcium in your blood can rise. Calcichew should be chewed and taken 10-15 minutes before meals
  • Phosex (calcium acetate) is another phosphate binder which contains calcium. It should be swallowed whole and taken 10-15 minutes before meals.
  • Renagel (sevelamer) is a phosphate binder which doesn’t contain calcium or aluminium. The tablets should be swallowed whole with meals.
  • Fosrenol (lanthanum) is a phosphate binder which doesn’t contain calcium or aluminium. It should be chewed and taken immediately after meals. Side effects include feeling sick if taken before food.

Reducing the amount of phosphate in your body can only be done in combination with controlling your diet, these tablets will not work alone.

Taking your medicine

These tablets are best taken about 10 minutes before meals. You should chew the tablets before swallowing, or let them dissolve in your mouth. Alucaps, Renagel and Phosex should be swallowed whole.

Phosphate binders only work if taken with foods containing phosphate.

They should be taken with meals or snacks which include meat, fish, eggs, cheese, milk or pulses.

They should not be taken with meals or snacks which do not include protein foods, such as toast, jam or salad sandwiches, biscuits or fruit.

This may mean that you take more binders with a main meal or include one with a snack. You should still aim to take the total number prescribed each day.

Taking phosphate binders with other medicines

Phosphate binders should not be taken at the same time as iron tablets, or some antibiotics, as this makes both ineffective. Take binders before a meal and iron tablets one hour after the meal.

Only take tablets prescribed for you by your doctor. Some medicines such as indigestion remedies contain calcium or Aluminium and should not be taken as well as binders.

Check with your pharmacist before taking any new medicines.

Unwanted effects

The most common side effects with these tablets are constipation or diarrhoea, feeling sick and a chalky taste in your mouth.

If you really do not like the taste, most phosphate binders can be swallowed whole, 15 minutes before meals. Fosrenol should always be taken after meals.

Storing your medicine

Store the tablets in their original packet in a cool, dry place out of the reach of children. Only remove the tablets from the container when it is time to take them.

This webpage only gives a brief outline of some of the more important points about phosphate binders. If you would like any further information, ask your doctor, pharmacist, dietician or nurse.

More information on Calcium and Phosphate control is available elsewhere on this website. Click here to view.

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

NKF Controlled Document No. 82: Phosphate Binders written: 15/07/2002 last reviewed: 05/05/2014