sucroferric oxyhydroxide
sucroferric oxyhydroxide
(soo-kroe-fer-ik ox-ee-hye-drox-ide),Velphoro
(trade name)Classification
Therapeutic: electrolyte modifiersPharmacologic: phosphate binders
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (phosphorous lowering)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO | within 4 wk | 12–16 wk | length of treatment |
Contraindications/Precautions
Adverse Reactions/Side Effects
Gastrointestinal
- discolored feces (most frequent)
- diarrhea
- nausea
- unpleasant taste
Interactions
Drug-Drug interaction
Should 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.Route/Dosage
Availability
Nursing implications
Nursing assessment
- 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 Diagnoses
Deficient knowledge, related to medication regimen (Patient/Family Teaching)Implementation
- 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.
Patient/Family Teaching
- 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.
Evaluation/Desired Outcomes
- Decreased serum phosphorous levels.