Sucroferric oxyhydroxide

VELPHORO

What it isChewable iron-based phosphate binder; hyperphosphatemia in dialysis.

Why this oneIt generally controls phosphate with a lower pill burden than sevelamer.

What limits itBlack stools and diarrhea are common; minimal iron absorption can still complicate interpretation of iron studies.

FDA-approved for

FDA dosing	Population	Start	Target	Max
Control of serum phosphorus (CKD on dialysis)	Adults & pediatrics ≥12 yr	500 mg TID with meals	1500-2000 mg/day (typical)	3000 mg/day (studied)
Control of serum phosphorus (CKD on dialysis)	Pediatrics 9 to <12 yr	500 mg BID with meals	~1500 mg/day (typical)	3000 mg/day (studied)

Titration Adjust by one 500 mg tablet/day as needed, as often as weekly.

Renal Undefined

Hepatic Undefined

Each tablet contains 500 mg iron; average requirement 1500-2000 mg/day in adults.

Chew or crush tablets; do not swallow whole.
Take with meals.
If daily dose cannot be divided equally, give the larger dose with the largest meal.

Available strengths

Not studied in peritonitis during peritoneal dialysis, significant gastric/hepatic disorders, recent major GI surgery, or iron accumulation disorders (hemochromatosis) — monitor effect and iron homeostasis

Pregnancy Not systemically absorbed; fetal exposure not expected.

Lactation Not systemically absorbed; child exposure not expected.

Sucroferric oxyhydroxide (VELPHORO)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	brand $/mo	CostPlus
500 mg	chew tab	90 TID	—	$1,539.50	not offered

Generic entry2011

NO BOXED WARNINGS

Principal riskBlack stools; interferes with iron studies

Therapeutic safety burden0 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.