Frequently asked questions

What is the indication for Velphoro?

Velphoro® (sucroferric oxyhydroxide) is a phosphate binder indicated for the control of serum phosphorus levels in patients with chronic kidney disease on dialysis.1

How does Velphoro work?

In vitro studies have shown that up to 96% of available phosphate is bound by Velphoro, then eliminated in the feces. Reduction in serum phosphorus and calcium-phosphorus levels results from the subsequent reduced dietary phosphate binding.1

How does Velphoro differ from other phosphate binders?

Velphoro is the most potent phosphate binder on a gram-to-gram comparison basis.2,3 Use of Velphoro has been shown to reduce the phosphate-binder pill burden for patients on dialysis by ~50%, while doubling the percentage of patients who achieve serum phosphorus levels of <5.5 mg/dL.4,5

How is Velphoro administered?

Velphoro is a berry-flavored chewable tablet, not intended to be swallowed whole. Velphoro can also be broken or crushed. The initial starting dose for Velphoro is one 500-mg tablet, 3 times a day, with meals. Monitor serum phosphorus levels and titrate the dose of Velphoro in increments or decrements of 1 tablet per day as needed.

Velphoro must be administered with meals. No additional fluids are needed beyond those customarily taken by the patient. If a dose is missed, resume Velphoro with the next meal. Do not attempt to replace the missed dose.1

What is the safety profile of Velphoro?

Adverse events with Velphoro are usually mild and transient, and similar to those of sevelamer, as seen in a 55-week, open-label, active-controlled, parallel-design safety and efficacy study of 968 hemodialysis patients, and 86 peritoneal dialysis patients. Adverse reactions in >5% of patients taking Velphoro included diarrhea (24%), discolored feces (16%), and nausea (10%). The majority of cases of diarrhea were mild, transient, and resolved without intervention. Additional reported reactions include tooth discoloration and rash.1

Are there any contraindications for Velphoro?

There are no contraindications for Velphoro.

What are the drug-drug interactions with Velphoro?

Velphoro has no interaction with commonly prescribed oral drugs, including oral calcitriol. Velphoro can be administered with levothyroxine, as long as the doses are separated by 4 hours. For medications where a reduction in bioavailability would have significant effect, consider separating the administration of the two drugs, taking into account absorption characteristics of the second medication.1

Is Velphoro accessible and affordable?

Velphoro is available through commercial and Medicare Part D pharmacy benefit plans. Most patients pay less than $10/month for Velphoro. Most commercially insured patients pay $0 with the Velphoro co-pay savings card. Velphoro Access Solutions offers additional programs that can help patients pay for their Velphoro.


References: 1. Velphoro® [package insert]. Waltham, MA: Fresenius Medical Care North America: 2018. 2. Gutekunst L. An update on phosphate binders: a dietitian's perspective. J Ren Nutr. 2016;26(4):209-218. 3. Wilhelm M, Gaillard S, Rakov V, Funk F. The iron-based phosphate binder PA21 has potent phosphate binding capacity and minimal iron release across a physiological pH range in vitro. Clin Nephrol. 2014;81(4):251-258. 4. Coyne D, Ficociello LH, Parameswaran V, et al. Real-world effectiveness of sucroferric oxyhydroxide in patients on chronic hemodialysis: a retrospective analysis of pharmacy data. Clin Nephrol. 2017;88(2):59-67. 5. Kendrick J, Parameswaran V, Ficociello LH, et al. One-year historical cohort study of the phosphate binder sucroferric oxyhydroxide in patients on maintenance hemodialysis. J Ren Nutr. 2019;29(5):428-437.