Table 1.
Main advantages and disadvantages of currently used phosphate binders
| Drug | Usual dose (pill burden)a | Advantages | Disadvantages |
|---|---|---|---|
| Calcium carbonate | 500–1250 mg (3–6 tablets) | Lower pill burden | Calcium overload |
| Calcium acetate | 667 mg (6–12 capsules) | As effective as calcium carbonate | Calcium overload High pill burden |
| Magnesium carbonate | 63 mg (2–6 capsules) | Good GI tolerance, lower pill burden | Hypermagnesemia |
| Sevelamer hydrocloride | 800 mg (6–12 capsules) | ↓ LDL-cholesterol levels, better survival in HD | High pill burden, GI side effects, metabolic acidosis |
| Sevelamer carbonate | 800 mg (6–12 capsules) | ↓ LDL-cholesterol levels, better survival in HD | High pill burden, GI side effects |
| Bixalomer | 250 mg (6–14 capsules) | Good GI tolerance | High pill burden |
| Lanthanum carbonate | 250–1000 mg (3–6 chewable tablets) | Lower pill burden, good GI tolerance | Low solubility Tissue accumulation, eg, bone |
| Ferric citrate | 210 mg (4–5 tablets) | Lower pill burden, ↓ iron suplementation ↓ ESA doses |
GI side effects (mild) |
| Sucroferric oxyhydroxide | 500 mg (2–6 chewable tablets) | Lower pill burden | GI side effects (mild) |
ESA, erythropoiesis stimulating agents; GI, gastrointestinal; HD, hemodialysis; LDL, low-density lipoprotein.
a
Based on package leaftlet information or cited clinical trials.