Indications for FOSRENOL:
To reduce serum phosphate in end-stage renal disease.
Take with meals. Chew or crush tabs completely before swallowing. Poor dentition or difficulty chewing tabs: consider using oral pwd form. Oral pwd: sprinkle on small quantity of applesauce or similar food and consume immediately; do not dissolve pwd in liquid for administration. Initially 1.5g/day in divided doses. Titrate at 2–3 wk intervals in increments of 750mg/day based on serum phosphate. Usual range: 1.5g–3g.
Bowel obstruction, including ileus and fecal impaction.
Chew tabs: risk of severe GI obstruction/perforation esp. in abnormal GI anatomy (eg, diverticular disease, peritonitis, history of GI surgery, cancer, ulceration) and hypomotility disorders (eg, constipation, ileus, subileus, diabetic gastroparesis). Monitor for GI disorders; reevaluate if severe constipation or other GI signs/symptoms develop. Do not swallow whole; serious GI complications with unchewed or incompletely chewed tabs. Acute peptic ulcer. Ulcerative colitis. Crohn's disease. Monitor serum phosphate levels. Pregnancy. Nursing mothers.
Separate dosing of drugs that interact with antacids by 2hrs. Antagonizes quinolone antibiotics; give quinolone 1hr before or 4hrs after Fosrenol. If quinolone given for short course, consider eliminating Fosrenol doses scheduled near quinolone intake to improve quinolone absorption. Antagonizes levothyroxine; separate administration by 2hrs, monitor TSH levels. Risk of GI obstruction or perforation with concomitant medications known to potentiate GI effects. Consider monitoring concomitant drugs that have a narrow therapeutic range. May interfere with abdominal x-ray.
Nausea, vomiting, abdominal pain; serious GI effects.
Generic Drug Availability:
Tabs 500mg patient pack (2 x 45 tabs)—1; Tabs 750mg patient pack (6 x 15 tabs)—1; Tabs 1000mg patient pack (9 x 10 tabs)—1; Oral pwd stick pack—10; Oral pwd patient pack (9 x 10 stick packs)—1