netFormulary South East London Joint Medicines Formulary NHS
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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
Red
High Cost Medicine
Note: sachets approved for patients with swallowing difficulties only 
   
Lanthanum carbonate tablets
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Third Choice
Red
High Cost Medicine
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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Unlicensed Drug Unlicensed

Phosphate binding renal patients

  • 240mg elemental calcium in 5mL
  • Ca2+ = 15mmol/5mL

 

 
   
Calcium Carbonate tablets  (Ca2+ 3mmol)
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Unlicensed Drug Unlicensed Phosphate binding renal patients 
   
 ....
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
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Link to adult 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

Red

Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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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