Inophos 400

Introduction
Inophos 400 is used to treat increased phosphate level in the blood. It is used in patients who are on dialysis due to severe kidney disease. It inhibits the absorption of phosphate from the intestine and lower the phosphate levels in the blood. Inophos 400 should be taken with food. Take it in the dose and duration as advised by your doctor. Take it regularly and at a fixed time each day to get maximum benefit of the medicine. Using of Inophos 400 may cause side effects such as nausea, vomiting, abdominal pain, constipation and diarrhea. You may also develop low levels of calcium, folic acid and vitamins A, D, E and K in your blood. Take necessary supplements as advised by your doctor.

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Uses of Inophos 400
High phosphate levels in blood
Side effects of Inophos 400
Common
Nausea
Vomiting
Upper abdominal pain
Flatulence
Constipation
Diarrhea
How to use Inophos 400
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Inophos 400 is to be taken with food.
How Inophos 400 works
Inophos 400 inhibits the absorption of phosphate from the intestine and lower the phosphate levels in the blood.
What if you forget to take Inophos 400?
If you miss a dose of Inophos 400, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
Inophos 400 is used to control blood phosphate level in patients that are on dialysis treatment.
You must take it with food and stick to the diet prescribed by your doctor.
You may develop low levels of calcium, folic acid, and vitamins A,D,E, and K in your blood. Your doctor may prescribe supplements, if necessary.
Avoid taking any other medicine 1 hour before or 3 hours after taking Inophos 400.
Inform your doctor if you have nausea, vomiting, constipation, pain in the abdomen, or if you have undergone any major stomach surgery.
Brief Description
Indication
Hyperphosphataemia
Administration
Should be taken with food.
Adult Dose
End-Stage Renal Disease Hemodialysis; hyperphosphatemia Initial dose Serum PO4 >9 mg/dL [2.91 mmol/L]: 1600 mg PO q8hr with meals Serum PO4 7.5-9 mg/dL [2.42-2.91 mmol/L]: 1200-1600 mg PO q8hr with meals Serum PO4 5.5-7.5 mg/dL [1.78-2.42 mmol/L]: 800 mg PO q8hr with meals Maintenance dose Serum PO4 >5.5 mg/dL [>1.78 mmol/L]: Increase dose by 400-800 mg per meal Serum PO4 3.5-5.5 mg/dL [1.13-1.78 mmol/L]: Maintain current dose Serum PO4 <3.5 mg/dL [1.13 mmol/L] decrease by 400-800 mg per meal Dosing considerations Titrate dose; increase by 400-800 mg per meal at 2-week intervals; no more than 4 g Switching From Ca-Acetate Substitute 800 mg for 667 mg of Ca-acetate Substitute 1600 for1334 mg of Ca-acetate Substitute 2400 mg for 2001 mg Ca-acetate _ Child Dose Safety and efficacy not established Contraindication Hypophosphatemia or bowel obstruction. Mode of Action Sevelamer, a polymeric compound, acts by binding to phosphate molecules in the gut, limiting its absorption and thus lowering serum phosphate levels w/o altering Ca, Al, or bicarbonate levels. Precaution Patients w/ dysphagia, swallowing disorders, severe GI motility disorders, active inflammatory bowel disease or major GI tract surgery. Pregnancy and lactation. Monitoring Parameters Monitor serum levels of phosphate, Ca, Cl and bicarbonate. Vitamin supplementation due to reduction in vit D, E, K and folic acid absorption. Monitor for signs and symptoms of peritonitis in patients undergoing peritoneal dialysis. Lactation: Not absorbed systemically; not excreted in breast milk _ Side Effect >10% Vomiting (22%),Nausea (20%),Diarrhea (19%),Dyspepsia (16%),Nasopharyngitis (14%),Limb pain (13%),Pruritus (13%),Arthralgia (12%),Bronchitis (11%),Dyspnea (10%),Hypertension (10%) 1-10% Abdominal pain (9%),Constipation (8%),Flatulence (8%),Peritonitis (during peritoneal dialysis: 8%),Hypercalcemia (5-7%) Frequency Not Defined Back pain,Cough,Headache,Pyrexia,Upper respiratory infection,Pruritus,Rash,Intestinal perforation,Fecal impaction,Intestinal obstruction.

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Interaction
May decrease absorption of ciprofloxacin, ciclosporin, mycophenolate, tacrolimus and levothyroxine. Sevelamer should be given 3 hr before or 1 hr after taking other drugs to minimise potential pharmacokinetic interaction.