sucroferric oxyhydroxide(soo-kroe-fer-ik ox-ee-hye-drox-ide),
Pregnancy Category: B
Pharmacologic: phosphate binders
ClassificationTherapeutic: electrolyte modifiers
Pharmacologic: phosphate binders
Control of elevated serum phosphorous levels in patients with chronic renal disease currently on dialysis.
Binds dietary phosphorous in the GI tract via ligand exchange.
Decreased serum phosphorous levels and sequelae of hyperphosphatemia.
Absorption: Phosphate binding is local with no systemic absorption. Minimal amounts of released iron may be absorbed.
Metabolism and Excretion: Action is local, no metabolism. Bound phosphate is excreted in feces.
Time/action profile (phosphorous lowering)
|PO||within 4 wk||12–16 wk||length of treatment|
Contraindicated in: None noted.
Use Cautiously in: Peritonitis (from peritoneal dialysis), significant hepatic/gastric disorders, following major GI surgery, history of hemochromatosis/diseases of iron accumulation; Obstetric: Use during pregnancy only if clearly needed; Pediatric: Safe and effective use in children has not been established.
Adverse Reactions/Side Effects
- discolored feces (most frequent)
- unpleasant taste
Drug-Drug interactionShould not be used concurrently with oral levothyroxine or oral Vitamin D analogs due to interference with phosphorous homeostatis.May ↓ absorption and effectiveness of alendronate or doxycyline, administer 1 hr before sucroferric oxyhydroxide.
Oral (Adults) 500 mg three time daily (with meals) initially, may be titrated by 500 mg/day at weekly intervals depending on serum phosphorous, usual range is 1500–3000 mg/day in three divided doses.
Chewable tabletswildberry: 500 mg
- Monitor for abdominal pain or discomfort. Sucroferric oxyhydroxide causes discolored (black) stool and may mask GI bleeding. Medication does not effect guaiac based (Hemocult) or immunological based (iColoRectal and Hexagon Opti) fecal occult blood tests.
- Lab Test Considerations: Monitor serum phosphorous levels and dose of sucroferric oxyhydroxide. Dose is titrated in increments of 500 mg (1 tablet) per day as needed until acceptable serum phosphorous level (≤5.5 mg/dL) is reached. Monitor periodically thereafter. May begin titration 1 wk after start of therapy and adjust at weekly intervals.
- Monitor effect and iron homeostasis in patients with peritonitis during peritoneal dialysis, significant hepatic or gastric disorders, following major gastrointestinal surgery, or with a history of hemachromatosis or other diseases with iron accumulation.
Potential Nursing DiagnosesDeficient knowledge, related to medication regimen (Patient/Family Teaching)
- Oral: Administer 3 times daily with meals. Tablets must be chewed; do not swallow whole. Tablets may be crushed prior to swallowing. No additional fluid is required above usual amount taken.
- Instruct patient to take medication as directed. Do not attempt to replace missed doses; resume medication with next meal; do not double doses.
- Advise patient to avoid taking levothyroxine and vitamin D analogs during therapy and to take alendronate and doxycycline at least 1 hr before sucroferric oxyhydroxide.
- Advise female patient to notify health care professional if pregnancy is planned or suspected.
- Decreased serum phosphorous levels.