9.5. Minerals
9.5.1. Calcium and magnesium
9.5.1.1. Calcium supplements
9.5.1.2. Hypercalcaemia and hypercalciuria
Restrictions:
Restricted to specialist initiation for the treatment of secondary hyperparathyroidism in end stage renal disease in accordance with local protocol.
Prescribing Notes:
All monitoring and review related to this medicine is to be carried out at specialist renal clinics.
Use of cinacalcet for the following indicaitons is not recommended for use by the SMC:
- Secondary hyperparathyroidism (HPT)
- Treatment of secondary HPT in aduts with end-stage renal disease (ESRD) on maintenance dialysis therapy
- Treatment of secondary HPT in children aged 3 years and older with ESRD on maintenance dialysis therapy in whom secondary HPT is not adequately controlled with standard of care therapy
- Parathyroid carcinoma and primary HPT in adults; reduction of hypercalcaemia in adults with
- Parathyroid carcinoma
- Primary HPT for whom parathyroidectomy would be indicated on the basis of serum calcium levels, but in whom parathyroidectomy is not clinically appropriate or is contraindicated.
9.5.1.3. Magnesium
Prescribing Notes:
It is important to establish the underlying cause of the hypomagnesaemia, rather than simply treating the deficiency.
Prescribing Notes:
It is important to establish the underlying cause of the hypomagnesaemia, rather than simply treating the deficiency.
9.5.2. Phosphorus
9.5.2.1. Phosphate supplements
Prescribing Notes:
Each tablet contains the equivalent of 16.1mmol of phosphate, 20.4mmol of sodium and 3.1mmol of potassium
9.5.2.2. Phosphate-binding agents
Restrictions:
Restricted to specialist initiation. Restricted to use as a second line agent in patients where a non-aluminium, non- calcium phosphate binder is required on the recommendation of a consultant nephrologist.
Prescribing Notes:
For the relevant SMC advice click here
Restrictions:
Restricted to second-line therapy for the management of hyperphosphataemia in adults receiving haemodialysis on the recommendation of consultant nephrologists. Use in the control of hyperphosphataemia in adults receiving peritoneal dialysis is not recommended by SMC and remains non-Formulary.
Restrictions:
The use in controlling phosphate levels in adult chronic kidney disease (CKD) patients on haemodialysis or peritoneal dialysis is restricted to second-line therapy where a non-calcium phosphate binder is required.