PhosLo

Phoslo is a prescription phosphate binder medication specifically formulated for patients with end-stage renal disease (ESRD) undergoing dialysis. It works by binding dietary phosphate in the digestive tract, preventing its absorption into the bloodstream. Effective phosphate management is critical in reducing the risk of hyperphosphatemia-related complications, including cardiovascular calcification and secondary hyperparathyroidism. This product is intended for use under strict medical supervision as part of a comprehensive renal care plan.

Features

• Active ingredient: Calcium acetate
• Available in 667 mg gelcaps and tablets
• Designed to bind phosphate in the gastrointestinal tract
• Reduces serum phosphate levels without aluminum accumulation
• Compatible with hemodialysis and peritoneal dialysis regimens
• Manufactured under cGMP standards

Benefits

• Effectively lowers serum phosphate levels in chronic kidney disease patients
• Helps maintain calcium-phosphorus product within target range (<55 mg²/dL²)
• Reduces risk of metastatic calcification and cardiovascular complications
• May help prevent or manage secondary hyperparathyroidism
• Supports overall bone mineral metabolism in renal failure
• Provides predictable phosphate binding with meal-related dosing

Common use

Phoslo is primarily indicated for the control of hyperphosphatemia in patients with end-stage renal disease. It is used when serum phosphate levels exceed 4.5 mg/dL despite dietary phosphate restriction. The medication is typically prescribed as part of a comprehensive management strategy that includes dialysis, dietary modifications, and monitoring of calcium, phosphorus, and parathyroid hormone levels. Clinical studies demonstrate its effectiveness in maintaining phosphorus levels between 3.5-5.5 mg/dL, the target range associated with improved patient outcomes.

Dosage and direction

The initial dosage of Phoslo is typically 2 capsules (1334 mg) with each meal. Dosage should be titrated gradually to achieve target serum phosphorus levels (3.5-5.5 mg/dL) while avoiding hypercalcemia. The medication must be taken with meals to effectively bind dietary phosphate. Maximum recommended daily dose is 12 capsules (8004 mg). For tablet formulation, the equivalent dosage is 2 tablets per meal. Dose adjustments should be based on regular monitoring of serum calcium and phosphorus levels, typically every 2-3 weeks during initial titration and every 1-3 months during maintenance therapy.

Precautions

Regular monitoring of serum calcium and phosphorus levels is essential. Patients should be advised to adhere to prescribed dietary phosphate restrictions. Caution is required in patients with hypercalcemia (serum calcium >10.5 mg/dL) or those with conditions predisposing to hypercalcemia. Use with caution in patients with sarcoidosis or those taking digitalis preparations. Patients should be educated about symptoms of hypercalcemia including nausea, vomiting, anorexia, constipation, and mental status changes. Periodic assessment of parathyroid hormone levels is recommended.

Contraindications

Phoslo is contraindicated in patients with hypercalcemia (serum calcium >10.5 mg/dL). It should not be used in patients with known hypersensitivity to calcium acetate or any component of the formulation. Contraindicated in patients with acute pancreatitis or severe renal impairment not on dialysis. Not recommended for patients with low serum phosphate levels (<2.5 mg/dL). Avoid use in patients with calcium-containing renal stones or history of nephrolithiasis.

Possible side effects

Common side effects include hypercalcemia (especially with excessive dosing), nausea, vomiting, loss of appetite, constipation, and dry mouth. Less frequently, patients may experience headache, weakness, dizziness, or pruritus. Serious side effects requiring immediate medical attention include severe hypercalcemia (serum calcium >12 mg/dL), which may manifest as confusion, lethargy, coma, or cardiac arrhythmias. Long-term use may contribute to vascular and soft tissue calcification. Metabolic alkalosis has been reported in some patients.

Drug interactions

Phoslo may decrease absorption of tetracycline antibiotics, quinolones, iron preparations, and thyroid medications when administered concurrently. Separate administration by at least 2 hours. Concurrent use with calcium channel blockers may potentiate cardiovascular effects. Use with thiazide diuretics may increase risk of hypercalcemia. May interact with digitalis preparations, potentially increasing risk of digitalis toxicity. Concurrent use with aluminum-containing phosphate binders may increase aluminum absorption and toxicity.

Missed dose

If a dose is missed, the patient should take it as soon as remembered with food. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Patients should not double the dose to make up for a missed dose. Consistent dosing with meals is important for effective phosphate control. Healthcare providers should educate patients about the importance of adherence to the prescribed dosing schedule for optimal phosphate management.

Overdose

Overdose may lead to severe hypercalcemia, manifested by nausea, vomiting, anorexia, constipation, dry mouth, thirst, polyuria, lethargy, hypercalciuria, and metastatic calcification. Severe hypercalcemia (serum calcium >14 mg/dL) may cause confusion, delirium, stupor, coma, and cardiac arrest. Treatment involves immediate discontinuation of Phoslo, hydration with saline diuresis, and monitoring of calcium levels. In severe cases, hemodialysis using low-calcium dialysate may be necessary. Patients should be advised to seek immediate medical attention if overdose is suspected.

Storage

Store at controlled room temperature (20-25°C or 68-77°F). Protect from moisture and light. Keep container tightly closed. Do not store in bathroom medicine cabinet due to humidity variations. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Do not transfer to other containers as this may affect stability. Proper storage ensures maintenance of pharmaceutical quality and efficacy throughout the shelf life.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Phoslo is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual patient response may vary. Patients should not adjust dosage without consulting their physician. The complete prescribing information should be consulted before initiating therapy. This summary does not include all possible information about uses, directions, warnings, precautions, interactions, or adverse effects.

Reviews

Clinical studies demonstrate Phoslo’s effectiveness in controlling serum phosphate levels in dialysis patients. In randomized controlled trials, 75-85% of patients achieved target phosphorus levels (3.5-5.5 mg/dL) with appropriate dosing. Nephrologists report reliable phosphate binding capacity with predictable calcium absorption. Patients appreciate the convenient dosing schedule with meals. Some reports note gastrointestinal tolerability concerns, particularly constipation, which often improves with dose adjustment or dietary modifications. Long-term studies show maintained efficacy without significant tolerance development.