Question:

can fosrenol and renvela be combined to control phosphorus blood levels?

I currently use maximum fosrenol dose daily and have elevated phosphorus level (840 for three months)

Answer:

Thank you for contacting Net Wellness. Fosrenol® and Renvela® are both phosphate binding drugs that are typically used to manage phosphorus levels in patients with End Stage Renal Disease. These drugs work by binding to phosphate in your digestive tract. The phosphate then is removed from your body when you have a bowel movement. The overall effect is a reduction in your phosphorus blood level.

The goal of phosphorus blood levels for dialysis patients is in the range of 3.5-5.5 mg/dL. This goal is achieved by restricting dietary phosphorus and by use of phosphate-binding drugs. There are two major classes of phosphate binding drugs -those that contain calcium and those that do not.

Fosrenol® and Renvela® belong to the non-calcium-containing class. Although there are no interactions between the two drugs, these drugs are not used together for any added benefit, since they belong to the same class and work the same way. These drugs are rather expensive, and there is not a clinical or cost benefit for combining the two. Sometimes Fosrenol® is combined with a calcium-containing phosphate binder (such as PhosLo®) in patients who need to further lower their phosphorus levels. Fosrenol® is typically dosed in the range of 1500mg-3000mg total daily (500mg-1000mg with each meal). Doses up to 3750mg per day have been studied. To get the best benefit from Fosrenol®, take it consistently as directed with your meals and try not to miss doses. Fosrenol® is a chewable tablet and it is important to chew the tablets completely and not swallow a whole tablet.

Renvela ® is typically dosed based upon blood phosphorus levels. A typical daily dose is 2400mg-4800mg per day (800mg-1600mg with each meal). Renvela ® is available in tablet or powder forms. The tablets should be swallowed whole—not chewed, split, or crushed. The powder form should be mixed with 2 tablespoons of water and drank within 30 minutes of mixing. Renvela ® works best when taken consistently and with meals.

On this site, Net Wellness experts try to answer general questions about health. Only a physician familiar with your medical history, lab values, and other medications can help determine the proper dose for your Fosrenol® and decide whether or not another phosphate-binding medication should be changed in your regimen.

Submitted by Renae Linder, PharmD Candidate The Ohio State University College of Pharmacy

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