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The extra-phosphate intestinal load from medications: is it a real concern?
Adamasco Cupisti1, Diego Moriconi2, Claudia D'Alessandro2
1Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. adamasco.cupisti@med.unipi.it.
Journal of Nephrology
|April 17, 2016
Summary
Medications contain phosphorus excipients in 12.5% of cases, primarily in antidiabetic and antidepressant drugs. This hidden phosphorus load is generally low and manageable for chronic kidney disease patients.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Pharmacy
Background:
- Managing phosphorus load is crucial for chronic kidney disease (CKD)-mineral and bone disorder (MBD).
- Dietary adherence and hidden phosphorus sources pose challenges in CKD management.
- Medications, particularly as excipients, may contribute to phosphorus load.
Purpose of the Study:
- To systematically screen medications for phosphorus (P) as an excipient.
- To identify potential oral therapies for CKD patients containing P excipients.
Main Methods:
- Screened 311 active pharmaceutical ingredients (APIs) and 3763 medications.
- Utilized the Anatomical Therapeutic Chemical (ATC) international classification system.
Main Results:
- 19.3% of APIs and 12.5% of medications contained P as an excipient.
- Highest prevalence in oral antidiabetic (23.8%), antidepressant (19.2%), and antihypertensive (17.5%) medications.
- Calcium hydrogen phosphate was the most common form (77.7%).
Conclusions:
- The prevalence of phosphorus-containing medications is relatively low.
- Phosphorus excipients in medications are generally low and manageable for CKD patients.
- Dietary phosphorus remains the primary concern for hidden phosphorus sources in CKD.
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