netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.05.02.02  Expand sub section  Phosphate-binding agents
 note 
Calcium Acetate tablets  (Phosex®)

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First Choice Calcium 6.2mmol per tab
Sevelamer carbonate tabs, sachets

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Second Choice
High Cost Medicine
Red
Note: sachets approved for patients with swallowing difficulties only
   
Lanthanum carbonate tablets

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Third Choice
High Cost Medicine
Red
RENAL CONSULTANTS ONLY
For patients who cannot tolerate calcium containing phosphate binders or have pre existing hypercalcaemia.

Not to be used in combination with sevelamer.
   
Sucroferric oxyhydroxide (Velphoro)

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Fourth Choice
Red
RENAL CONSULTANTS ONLY
Last line treatment option for patients who cannot tolerate calcium containing phosphate binders or have pre existing hypercalcaemia.

Not to be used in combination with sevelamer or lanthanum. See APC recommendation (link below)

Link  Sucroferric oxyhydroxide (Velphoro® ) 500mg chewable tablets for the treatment of hyperphosphatemia in adult renal dialysis patients    
Aluminium Hydroxide capsules (Alu-Cap®)

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Formulary
   
Calcium Carbonate chewable tablets  (Adcal®)

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Formulary Calcium 15mmol per tab

Can be used as an alternative if calcium acetate is not tolerated or patients find it unpalatable
   
Calcium Carbonate suspension 600mg/5 mL

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Restricted Drug Unlicensed Phosphate binding renal patients

Ca2+ = 15mmol/5mL
   
Calcium Carbonate tablets  (Ca2+ 3mmol)

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Restricted Drug Unlicensed Phosphate binding renal patients
   
 ....
Key
note Notes First Choice Item First Choice item
Section Title Section Title (top level) Non Formulary Item Non Formulary section
Section Title Section Title (sub level)
Cytotoxic Drug
Cytotoxic Drug
Restricted Drug
Restricted Drug
CD
Controlled Drug
Unlicensed Drug
Unlicensed
High Cost Medicine
High Cost Medicine
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Link to SPCs
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Link to adult BNF
Track Changes
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Cancer Drugs Fund
Cancer Drugs Fund
   

 

Traffic Light Status Information

Status Description
  Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
  Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
  Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
  Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
  Green   Specialist and non-specialist initiation  
  Grey   Not recommended for prescribing  

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