skip to main content

Sucroferric Oxyhydroxide Pill Burden — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

EasyHaemodialysisSucroferric Oxyhydroxide Pill BurdenESENeph

A 48-year-old man on haemodialysis has phosphate of 2.2 mmol/L. His phosphate binder is Sevelamer 1200 mg TDS. He finds the large tablet size difficult to swallow and misses doses frequently. He asks about alternative binders. What newer option has a lower pill burden?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Sucroferric oxyhydroxide (Velphoro) – effective at lower pill burden with chewable tablets

Sucroferric oxyhydroxide (Velphoro) is an iron-based non-calcium phosphate binder with high phosphate-binding capacity, allowing effective phosphate control with a lower daily pill burden compared to Sevelamer. It is formulated as chewable tablets. NICE TA834 (2023) supports its use. It can cause dark stools (from iron content) but GI tolerability is generally good. Lanthanum carbonate is another alternative with chewable tablets. Pill burden is a major cause of non-adherence in dialysis patients.

Reference: NICE TA834 2023 – Sucroferric Oxyhydroxide; KDIGO 2017 – CKD-MBD