calcium acetate (Eliphos, PhosLo, Phoslyra, Calphron)
Classes: PO4 Scavengers; Urea Cycle Disorder Treatment Agents; Calcium Salts
Dosing and uses of Eliphos, PhosLo (calcium acetate)
Adult dosage forms and strengths
capsule/tablet
- 667mg (169mg elemental Ca)
oral solution
- 667mg/5mL (169mg/5mL elemental Ca)
Hyperphosphatemia in End Stage Renal Failure (On Dialysis)
Initial: 2 capsules (1334 mg) PO with each meaL
Increase dose to bring serum phosphate value <6 mg/dL as long as hypercalcemia does not develop
Usual Dose: 3-4 capsules (2001-2868 mg) PO with each meaL
Other Information
Do not give additional calcium supplements
Pediatric dosage forms and strengths
Safety and efficacy not established
Geriatric dosage forms and strengths
Hyperphosphatemia in end stage renal failure (on dialysis)
Initial: 2 capsules (1334 mg) PO with each meaL
Increase dose to bring serum phosphate value <6 mg/dL as long as hypercalcemia does not develop
Usual dose: 3-4 capsules (2001-2868 mg) PO with each meaL
Eliphos, PhosLo (calcium acetate) adverse (side) effects
Frequency not defined
Arrhythmias
Hypomagnesemia
Hypophosphatemia
Hypotension
Nausea
Pruritus (rare)
Weakness
Hypercalcemia
- Anorexia
- Coma
- Confusion
- Delirium
- Headache
- Nausea
- Vomiting
Warnings
Contraindications
Hypersensitivity, renal calculi, hypercalcemia, hypophosphatemia, concurrent calcium supplements
Cautions
Pregnancy
Constipation may occur
Cardiac glycosides; hypercalcemia may aggravate digitalis toxicity
Advise patients to limit intake of oxalate-rich foods (soy, green leafy vegetables, animal protein) to avoid Ca-Oxalate formation
Pregnancy and lactation
Pregnancy category: C
Maintenance of normal serum calcium levels is important for maternal and fetal well being; hypercalcemia during pregnancy may increase risk for maternal and neonatal complications(eg, stillbirth, preterm delivery, neonatal hypocalcemia and hypoparathyroidism);calcium acetate treatment, as recommended, is not expected to harm a fetus if maternal calcium levels are properly monitored during and following treatment
Lactation: unknown
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Eliphos, PhosLo (calcium acetate)
Mechanism of action
Chelates phosphate (& other anions, eg, oxalate) in intestine to form insoluble calcium phosphate, which is excreted in feces.
Pharmacokinetics
Absorption: 30-40%; however it is the unabsorbed drug that binds and removes phosphate
Excretion: Feces and urine (20%)