A dearth of data: the problem of phosphorus in prescription medications

Kidney International
Richard A ShermanToros Kapoian

Abstract

A high dietary intake of phosphorus is considered by most to be a significant health threat for dialysis patients. Efforts to include the phosphorus content of foods on the nutrition label in the US have, to date, been fruitless. Another source of phosphorus, largely unrecognized, is prescription medications. These may contain phosphorus as indicated on their package label; the amount is not quantified. We examined the labels of the branded forms of 200 of the most widely prescribed medications in Dialysis Clinic centers in the United States and found that 23 (11.5%) contained phosphorus. A sampling of different doses and manufacturers (generic and branded) of these drugs was analyzed for phosphorus content and found levels as high as 111.5 mg/dose (40 mg paroxetine). Notable were the phosphorus content of a generic 10 mg lisinopril (32.6 mg) and a generic 10 mg amlodipine (40.1 mg). The significant potential for iatrogenic injury accruing from the use of these drugs warrants efforts at remediation. Specific information on the phosphorus content of medications used by dialysis population needs to be made available to the dialysis community.

References

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Citations

Feb 18, 2016·Kidney International·Domenico SantoroGianluca Trifirò
Oct 27, 2016·Journal of Nephrology·Adamasco CupistiMaria Francesca Egidi
Oct 25, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Michael CoplandJose A Morfin
Nov 22, 2016·Nature Reviews. Nephrology·Marc G VervloetUNKNOWN ERA–EDTA Working Group on Chronic Kidney Disease–Mineral and Bone Disorders and the European Renal Nutrition Working Group
May 23, 2018·Expert Opinion on Drug Safety·Fabio CarfagnaFrancesco Locatelli
Jul 11, 2018·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Nobuo NaganoTetsuya Ogawa
Jul 5, 2017·Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan·Kazuki ShimoishiMasaki Otagiri
Nov 1, 2015·Therapeutic Innovation & Regulatory Science·Richard A ShermanToros Kapoian

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