calcium acetate (Eliphos, PhosLo, Phoslyra, Calphron)

Dosing and uses of Eliphos, PhosLo (calcium acetate)

• Adult
• Pediatric
• Geriatric

 

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%)