Phosphate binders

Phosphate binders are medicines that reduce the amount of phosphate that your body absorbs from food.

What is phosphate?

Phosphate is a mineral which your body needs to make energy and to keep your bones and teeth strong. Healthy kidneys help to control the amount of phosphate in your body. If you have chronic kidney disease (CKD) your kidneys may not remove enough phosphate. This can cause phosphate to build up in your blood. Over time, high phosphate levels can affect your bones and blood vessels. This can lead to a condition called mineral bone disease.

Where does phosphate come from?

We get phosphate from the food we eat.

Phosphate occurs naturally in many foods, including milk, cheese, yoghurt, meat and fish.

Phosphate from plant foods, such as beans, nuts and wholegrains, is not as easily absorbed by your body.

Phosphate is also added to processed foods and drinks. These phosphate additives are easily absorbed by your body and can raise the phosphate level in your blood.

How do phosphate binders work?

Phosphate binders stick to the phosphate in the food in your gut. This stops some of the phosphate being absorbed into your blood. The phosphate then leaves your body in your poo.

Why might I be prescribed phosphate binders?

You may be prescribed phosphate binders if blood tests show that your phosphate level is too high.

Keeping your phosphate level under control is an important part of looking after your bones and blood vessels.

What kinds of phosphate binders are available?

There are different types of phosphate binders. Some need to be chewed, while others are swallowed whole, dissolved in water or sprinkled on your food. Your doctor, dietitian or pharmacist will discuss which type is best for you.

Phosphate binder		When to take	Common side effects
Calcium acetate (Renacet®)	Tablets	Swallow whole when eating or immediately after (some people need to take them with snacks too)	Feeling sick, constipation, wind, bloating, diarrhoea, can raise calcium levels in the blood
Calcium carbonate (Calcichew®)	Tablets	Chew when eating or immediately after	Chalky taste, can raise calcium levels in the blood
Lanthanum (Fosrenol®)	Tablets or powder	Chew during, or just after, eating	Feeling sick if taken on an empty stomach, constipation, abdominal pain
Sevelamer (Renvela®, Renagel®)	Tablets or powder	Swallow whole just before eating	Feeling sick, diarrhoea, abdominal pain

Follow the instructions in the phosphate binder packet carefully. You may need to take more medication with some foods than others depending on what you eat.

How long will I need to take phosphate binders for?

You may need to take phosphate binders for a long time. However, the type and the amount you need may change over time. Talk to your kidney team or pharmacist before making any changes to your phosphate binders.

How will I be monitored if I take phosphate binders?

You will have regular blood tests to check your phosphate level. Your kidney team may also check other blood tests, such as your calcium level. These results help your kidney team decide if your phosphate binder needs to change.

Tell your healthcare team if you are breastfeeding, pregnant or trying to get pregnant as some phosphate binders may affect your baby.

Do I need to change my diet if I am taking phosphate binders?

You may also be advised to make some changes to your diet. Some processed foods and drinks contain phosphate additives, which are easily absorbed by your body. These can include processed meats, processed cheese, some baked goods and cola drinks.

You do not need to avoid all foods that naturally contain phosphate. A kidney dietitian can help you make changes that are right for you.

For more information visit our Kidney kitchen pages

Looking after your medicines

You should store your medicines in their original packet in a cool, dry place, out of the sight and reach of children.

Do not get rid of any unwanted or out-of-date medicines by flushing them down the toilet or throwing them away. Take them to your local pharmacy for safe disposal.