NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Prescribing
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9 Nutrition and blood

9.5 Minerals

9.5.1 Calcium and magnesium

9.5.1.1 Calcium supplements

Preferred list
CALCIUM GLUCONATE (INJECTION)

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/5046.htm

CALCIUM CHLORIDE (INJECTION)

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/5045.htm

Total Formulary

9.5.1.2 Hypercalcaemia and hypercalciuria

Total Formulary
CINACALCET

Restrictions: Restricted to specialist initiation for the treatment of secondary hyperparathyroidism in end stage renal disease in accordance with local protocol. The SMC has not recommended its use for the reduction of hypercalcaemia in patients with primary hyperparathyroidism for whom parathyroidectomy is not clinically appropriate or is contraindicated.

Prescribing Notes:

All monitoring and review related to this medicine is to be carried out at specialist renal clinics.

9.5.1.3 Magnesium

Total Formulary
MAGNESIUM ASPARTATE DIHYDRATE (MAGNASPARTATE) (sachets)

Prescribing Notes:

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

CO-MAGALDROX

Restrictions: Restricted to specialist initiation.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/2018.htm

MAGNESIUM HYDROXIDE

Restrictions: Restricted to specialist initiation.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/2245.htm

MAGNESIUM SULPHATE

Restrictions: Restricted to specialist initiation.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/33361.htm

9.5.2 Phosphorus

9.5.2.1 Phosphate supplements

Preferred list
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: http://www.medicinescomplete.com/mc/bnf/current/5061.htm

9.5.2.2 Phosphate-binding agents

Preferred list
Total Formulary
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: http://www.medicinescomplete.com/mc/bnf/current/130067.htm

ALUMINIUM HYDROXIDE

Restrictions: Restricted to specialist initiation.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/5063.htm

CALCIUM CARBONATE

Restrictions: Restricted to specialist initiation.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/5066.htm

SEVELAMER HYDROCHLORIDE (RENAGEL) (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.

SEVELAMER CARBONATE (RENVELA) (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: http://www.medicinescomplete.com/mc/bnf/current/85892.htm

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.

9.5.3 Fluoride

Total Formulary
SODIUM FLUORIDE

Restrictions: Restricted to specialist initiation.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/5071.htm

9.5.4 Zinc

Total Formulary
ZINC SULPHATE

Prescribing Notes:

For treatment of proven zinc deficiency only.

BNF Link: http://www.medicinescomplete.com/mc/bnf/current/5084.htm

9.5.5 Selenium