Inophos 400 mg is an oral phosphate binder specifically formulated to reduce elevated serum phosphorus levels in patients with end-stage renal disease (ESRD). It is particularly useful for individuals undergoing dialysis who are at risk of complications associated with chronic kidney disease (CKD), such as secondary hyperparathyroidism, renal bone disease, and vascular calcification. Inophos is a calcium-free and aluminum-free non-absorbed polymer, which prevents systemic toxicity while effectively controlling phosphorus levels.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Drugs for reduction of serum phosphorus in patients with ESRD

Indications

Inophos 400 mg is indicated for:

• Reduction of serum phosphorus in patients with ESRD

• Management of hyperphosphatemia in dialysis patients

• Prevention of secondary complications associated with uncontrolled serum phosphorus, including cardiovascular disease and bone disorders

Pharmacology

Inophos 400 mg contains Sevelamer, a non-absorbed polymer that binds dietary phosphate in the gastrointestinal tract. By inhibiting intestinal absorption of ingested phosphate, it lowers serum phosphorus levels without contributing to calcium or aluminum overload. This mechanism helps prevent the development of secondary hyperparathyroidism, renal bone disease, and vascular calcification, which are common complications of ESRD.

Dosage & Administration

For dialysis patients not previously on a phosphate binder:

• Serum phosphorus >5.5 and <7.5 mg/dL: 800 mg (2 tablets) three times daily with meals

• Serum phosphorus ≥7.5 and <9.0 mg/dL: 1200 mg (3 tablets) three times daily with meals

• Serum phosphorus ≥9.0 mg/dL: 1600 mg (4 tablets) three times daily with meals

For patients switching from calcium acetate to Sevelamer:

• Calcium Acetate 667 mg (1 tablet) → Sevelamer 800 mg (2 tablets)

• Calcium Acetate 1334 mg (2 tablets) → Sevelamer 1200 mg (3 tablets)

• Calcium Acetate 2001 mg (3 tablets) → Sevelamer 2000 mg (5 tablets)

Titration Guidelines:

• Serum phosphorus >5.5 mg/dL: increase by 400 mg (1 tablet) per meal every 2 weeks

• Serum phosphorus 3.5–5.5 mg/dL: maintain dose

• Serum phosphorus <3.5 mg/dL: decrease by 400 mg per meal

Dosage should be taken with meals, and titration should aim to maintain serum phosphorus ≤5.5 mg/dL.

Drug Interactions

• Studied with ciprofloxacin, digoxin, warfarin, enalapril, metoprolol, and iron

• May interfere with absorption of some medications if taken simultaneously; separate administration is recommended

Contraindications

• Hypophosphatemia

• Bowel obstruction

• Hypersensitivity to Sevelamer or any excipients

Side Effects

Common adverse effects include:

• Dyspepsia, nausea, vomiting, constipation, diarrhea

• Abdominal distension, pruritus, fatigue, anorexia, arthralgia
  Rare but serious:

• Ileus, bowel obstruction, bowel perforation, peritonitis

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Pregnancy & Lactation

• Pregnancy Category C: Use only if potential benefit justifies the risk

• Limited data on use during breastfeeding; use only if clinically necessary

Precautions & Warnings

• Caution in patients with GI motility disorders, severe constipation, dysphagia, or major GI surgery

• Monitor serum phosphorus regularly

• Since Sevelamer is not systemically absorbed, risk of systemic toxicity is low

Storage Conditions

• Store in a cool, dry place below 30°C

• Keep in original packaging and protect from moisture

Mode of Action

Inophos 400 mg binds dietary phosphate in the gut, reducing intestinal absorption and lowering serum phosphorus. Its calcium- and aluminum-free composition prevents complications such as hypercalcemia and aluminum toxicity, making it safe for long-term use in CKD patients.