East Region Formulary
NHS Scotland

Hyperphosphataemia

Treatment of hyperphosphataemia in chronic renal impairment
Calcium acetate
Renacet 475mg tablets

Dose as per specialist.

Renacet 950mg tablets

Dose as per specialist.

If calcium acetate is not tolerated.

Calcium carbonate
Adcal 1500mg chewable tablets

Dose as per specialist.

Liquid preparations should only be used when patients cannot tolerate or use solid formulations.

Sevelamer
Sevelamer 800mg tablets

Dose as per specialist.

Sevelamer 2.4g oral powder sachets sugar free

Dose as per specialist.

Sucroferric oxyhydroxide
Sucroferric oxyhydroxide (iron 500mg) chewable tablets

Dose as per specialist.

Liquid preparations should only be used when patients cannot tolerate or use solid formulations.

Lanthanum carbonate
Lanthanum carbonate 500mg chewable tablets

Dose as per specialist.

Lanthanum carbonate 750mg chewable tablets

Dose as per specialist.

Lanthanum carbonate 1g chewable tablets

Dose as per specialist.

Lanthanum carbonate 750mg oral powder sachets

Dose as per specialist.

Lanthanum carbonate 1g oral powder sachets

Dose as per specialist.

Prescribing Notes:

  • Sevelamer carbonate sachets can be used as an alternative to tablet formulations of sevelamer in patients unable to swallow tablets.
  • Sucroferric oxyhydroxide (Velphoro) is an option for patients who are not suitable for treatment with calcium phosphate binders, or have tried other phosphate binders with limited success.

History Notes

05/06/2025

Phosex discontinued, ERWG May 2025

20/04/2023

East Region Formulary content agreed.

Treatment of hyperphosphataemia in chronic renal impairment
Calcium carbonate
Calcichew 500mg chewable tablets

For dose, refer to BNF for Children.

Sevelamer
Sevelamer 800mg oral powder sachets sugar free

For dose, refer to BNF for Children.

Sevelamer 2.4g oral powder sachets sugar free

For dose, refer to BNF for Children.

Sevelamer 800mg tablets

For dose, refer to BNF for Children.

Prescribing Notes:

  • First line phosphate binder for children with normal calcium would be calcium carbonate. If hypercalcaemia, or if calcium carbonate causes hypercalcaemia, or is not tolerated, or not effective, use Sevelamer. 
  • Phosphate binding agents should be taken immediately prior to food, or with feeds in younger patients to bind phosphate in the food.
  • To aid compliance, alternate products can be tried.

History Notes

05/06/2025

Phosex discontinued, ERWG May 2025

10/06/2020

Content migrated from LJF website.