Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
9. Nutrition and blood

9.5. Minerals

9.5.1. Calcium and magnesium

9.5.1.1. Calcium supplements

Preferred List
CALCIUM GLUCONATE (INJECTION)
CALCIUM CHLORIDE (INJECTION)
Total Formulary
SANDOCAL

9.5.1.2. Hypercalcaemia and hypercalciuria

Total Formulary
Specialist and GP
CINACALCET

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.

BNF Link

9.5.1.3. Magnesium

Total Formulary
MAGNESIUM GLYCEROPHOSPHATE (NEOMAG) (chewable tablets)

Prescribing Notes:

It is important to establish the underlying cause of the hypomagnesaemia, rather than simply treating the deficiency.

BNF Link

MAGNESIUM ASPARTATE DIHYDRATE (MAGNASPARTATE) (sachets)

Prescribing Notes:

It is important to establish the underlying cause of the hypomagnesaemia, rather than simply treating the deficiency.

BNF Link

Specialist and GP
CO-MAGALDROX

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
MAGNESIUM SULPHATE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
MAGNESIUM HYDROXIDE

Restrictions: Restricted to specialist initiation.

BNF Link

9.5.2. Phosphorus

9.5.2.1. Phosphate supplements

Preferred List
Specialist and GP
PHOSPHATE-SANDOZ (Effervescent tablets)

Prescribing Notes:

Each tablet contains the equivalent of 16.1mmol of phosphate, 20.4mmol of sodium and 3.1mmol of potassium

BNF Link

9.5.2.2. Phosphate-binding agents

Preferred List
Specialist and GP
CALCIUM ACETATE
Total Formulary
Specialist and GP
SUCROFERRIC OXYHYDROXIDE (VELPHORO) (chewable tablets)

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.

BNF Link

Specialist and GP
LANTHANUM CARBONATE (chewable tablets, oral powder)

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

BNF Link

Specialist and GP
SEVELAMER (Tablets)

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.

BNF Link

Specialist and GP
CALCIUM CARBONATE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
ALUMINIUM HYDROXIDE

Restrictions: Restricted to specialist initiation.

BNF Link

9.5.3. Fluoride

Total Formulary
Specialist and GP
SODIUM FLUORIDE

Restrictions: Restricted to specialist initiation.

BNF Link

9.5.4. Zinc

Total Formulary
ZINC SULPHATE

Prescribing Notes:

For treatment of proven zinc deficiency only.

BNF Link

9.5.5. Selenium