Generic Phoslo (Calcium Acetate)

Introduction

Phoslo is a prescription pill that contains the active ingredient calcium acetate (667 mg per tablet). It belongs to the class of oral phosphate binders and is primarily used to control elevated serum phosphorus in adults with chronic kidney disease (CKD) who are receiving dialysis. The medication is marketed by [manufacturer name if known] and is available as a single-strength tablet. In addition to its approved use for hyperphosphatemia, calcium acetate has been investigated in several off-label settings, which are discussed later in this article.

What is Phoslo?

Phoslo is the generic version of well-known calcium acetate products, containing the active compound calcium acetate. Our online pharmacy provides this generic alternative as a cost-effective treatment option. Calcium acetate is an inorganic salt that binds dietary phosphate in the gastrointestinal tract, forming insoluble calcium phosphate that is eliminated in the feces. The drug is classified as an oral phosphate binder and is listed in the United States Pharmacopeia (USP) as a calcium-based phosphate-binding agent. The product is manufactured by [manufacturer] and has been approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of hyperphosphatemia in adult dialysis patients.

How Phoslo Works

When calcium acetate reaches the stomach and small intestine, it dissociates into calcium ions and acetate anions. The free calcium ions react with dietary phosphate (PO₄³⁻) to form calcium phosphate, a compound that is poorly absorbed and is expelled in the stool. By reducing the amount of phosphate that enters the systemic circulation, serum phosphorus levels decline. This helps to prevent secondary hyperparathyroidism and vascular calcification, two major complications of CKD.

The onset of phosphate-binding activity occurs within minutes after oral ingestion, and the binding effect persists for the duration of gastrointestinal transit, typically 4-6 hours. Calcium acetate is not absorbed in clinically significant amounts; excess calcium is excreted renally, and the acetate component is metabolized to carbon dioxide and water. The drug’s elimination half-life is not applicable because it acts locally in the gut and is not systemically cleared.

Conditions Treated with Phoslo

Approved indication - Hyperphosphatemia in adult dialysis patients

• Why it works: In end-stage renal disease, the kidneys cannot excrete phosphate efficiently. Phoslo binds the phosphate that is ingested with meals, lowering serum phosphorus to target levels (<5.5 mg/dL in most guidelines). Maintaining phosphorus within the recommended range reduces the risk of bone disease, cardiovascular calcification, and mortality.

Secondary indications (supported by regulatory labeling)

• Control of secondary hyperparathyroidism: By lowering phosphorus, calcium acetate indirectly reduces parathyroid hormone (PTH) stimulation.
• Adjunct to dietary phosphate restriction: Phoslo is used together with low-phosphate diets and dialysis modalities to achieve optimal phosphorus control.

Off-Label and Investigational Uses of Phoslo

• Peritoneal dialysis (PD) patients: Although the formal label focuses on hemodialysis, several clinical series have reported the safe use of calcium acetate in PD to manage hyperphosphatemia when other binders are unavailable.
• Hyperphosphatemia in non-dialysis CKD stages 3-5: Small observational studies suggest calcium acetate can modestly lower phosphorus in predialysis patients, but regulatory approval is limited to dialysis.
• Adjunctive therapy for hyperkalemia: Calcium acetate provides a modest bicarbonate load due to acetate metabolism, occasionally being used in combination with other agents to correct mild metabolic acidosis that can accompany hyperkalemia. This practice remains investigational.

All off-label applications should only be undertaken under direct supervision of a qualified healthcare provider. The safety and efficacy of these uses have not been formally evaluated by the FDA or EMA.

Is Phoslo the Right Medication for You?

Phoslo is appropriate for adult patients who:

• Have chronic kidney disease and are on regular hemodialysis or peritoneal dialysis.
• Exhibit persistently high serum phosphorus despite dietary counseling.
• Have no uncontrolled hypercalcemia (serum calcium >10.2 mg/dL) or severe vascular calcification, conditions in which additional calcium load could be harmful.

The drug may be unsuitable for:

• Patients with known hypersensitivity to calcium acetate or any tablet excipients.
• Individuals with severe hypercalcemia, active kidney stones, or a history of calcium-based gout.
• Patients taking aluminum-containing antacids, which can increase the risk of aluminum toxicity when combined with calcium acetate.

Clinicians often select calcium acetate when a patient prefers a calcium-based binder over sevelamer or lanthanum, or when cost considerations are paramount.

Risks, Side Effects, and Interactions

Common

• Hypercalcemia: Elevated serum calcium, especially when dietary calcium intake is high.
• Constipation: Calcium salts can reduce intestinal motility.
• Flatulence or abdominal discomfort: Resulting from the acetate component.

Rare

• Hypophosphatemia: Over-binding may lead to low phosphorus, causing muscle weakness or bone demineralization.
• Hypermagnesemia: Calcium acetate can bind phosphate and indirectly affect magnesium handling in rare cases.

Serious

• Severe hypercalcemia: May present with lethargy, cardiac arrhythmias, or nephrocalcinosis; requires urgent medical attention.
• Vascular or soft-tissue calcification: Chronic excess calcium can deposit in arteries, promoting cardiovascular disease.

Drug-Drug Interactions

• Aluminum-containing antacids: Co-administration may increase aluminum absorption, risking neurotoxicity.
• Iron supplements (ferrous sulfate): Calcium can reduce iron absorption; separate dosing by at least 2 hours.
• Tetracycline antibiotics: Calcium chelation reduces tetracycline bioavailability; stagger administration.

Drug-Food Interactions

• High-calcium foods or supplements: May augment the calcium load and increase hypercalcemia risk.
• Phosphate-rich meals: The binding capacity of a single tablet is limited; patients should follow dietary phosphate guidelines for optimal effect.

Use: Dosing, Missed Dose, Overdose

Standard dosing - The usual starting dose for adult dialysis patients is 667 mg (one tablet) taken with each main meal (three times daily). Dose adjustments are guided by serum phosphorus and calcium levels, with a typical maintenance range of 667 mg to 200 mg per day (1-3 tablets per meal).

Missed dose - If a dose is forgotten, take it as soon as remembered if it is still within the current meal window. Do not take a double dose to compensate for the missed tablet.

Overdose - Signs of calcium acetate overdose include nausea, vomiting, severe constipation, and hypercalcemia. In suspected overdose, seek immediate medical care; treatment may involve intravenous fluids and measures to lower serum calcium (e.g., bisphosphonates).

Administration tips -

• Swallow the tablet whole with a full glass of water; crushing may alter release characteristics.
• Take with meals to maximize phosphate binding.
• Avoid concurrent alcohol intake exceeding moderate levels, as alcohol can increase gastrointestinal irritation.
• Do not operate heavy machinery if experiencing significant gastrointestinal side effects until symptoms resolve.

FAQ

• What should I do with Phoslo when travelling internationally?   Store the tablets in their original packaging, protected from excessive heat and moisture. Carry a copy of the prescription and a letter from your physician, as some countries require documentation for import of prescription medicines.

• Can I take Phoslo with calcium-rich antacids?   Co-administration can lead to excess calcium intake and increase hypercalcemia risk. If an antacid is necessary, separate dosing by at least two hours and discuss the plan with your healthcare provider.

• How does the tablet appearance help me confirm I have the right product?   Phoslo tablets are round, bicolored (typically white on one side and light blue on the other), and debossed with “667 mg” and the imprint “PH”. Verify these markings against the packaging insert before use.

• Are there any inactive ingredients that could cause allergic reactions?   The formulation contains microcrystalline cellulose, magnesium stearate, and a small amount of titanium dioxide as a colorant. Patients with known sensitivity to these excipients should avoid the product and discuss alternatives with their clinician.

• What is the shelf life of Phoslo, and how should I store it?   Phoslo tablets have a shelf life of 24 months from the date of manufacture. Store them at room temperature (15 °C-30 °C) in a dry place, away from direct sunlight and moisture.

• Do urine drug tests detect calcium acetate?   Calcium acetate is not a substance screened for in standard urine drug testing panels, as it is a mineral supplement rather than a controlled or illicit drug.

• How does Phoslo compare to sevelamer in terms of phosphate binding capacity?   Calcium acetate generally provides a higher phosphate binding capacity per gram of active ingredient compared with sevelamer, but it adds calcium to the body, which may be disadvantageous for patients at risk of hypercalcemia.

• Can Phoslo be used in patients undergoing kidney transplantation?   Post-transplant patients often experience fluctuating phosphorus levels; calcium acetate may be used temporarily if hyperphosphatemia persists, but clinicians usually prefer non-calcium binders to avoid additional calcium load.

• What precautions are needed for patients with heart failure?   Excess calcium can contribute to vascular calcification, potentially worsening cardiovascular disease. Heart-failure patients should have their serum calcium and phosphorus monitored closely while on calcium acetate.

• Is Phoslo safe for people on a low-phosphate diet?   Phoslo is intended to complement dietary phosphate restriction, not replace it. Even on a low-phosphate diet, the drug helps achieve target phosphorus levels, but patients should continue to follow dietary recommendations to avoid excessive calcium intake.

Glossary

Phosphate Binder

A medication that binds dietary phosphate in the gut to form insoluble complexes that are eliminated in the feces, thereby lowering serum phosphorus.

Hypercalcemia

An abnormally high concentration of calcium in the blood, which can cause neurological, cardiovascular, and renal complications.

Secondary Hyperparathyroidism

Excessive secretion of parathyroid hormone (PTH) in response to chronic kidney disease-related disturbances in calcium, phosphorus, and vitamin D metabolism.

Bioavailability

The proportion of an administered drug that reaches systemic circulation in an active form; for calcium acetate, systemic bioavailability is negligible because its action is local in the gastrointestinal tract.

Buying Phoslo from Our Online Pharmacy

Patients who encounter limited access, high out-of-pocket costs, or privacy concerns can obtain Phoslo through our online pharmacy. We source the medication directly from licensed, audited manufacturers, ensuring the product meets stringent quality standards at a price close to the manufacturer’s cost.

• Affordability: Generic calcium acetate is offered at a reduced cost compared with branded equivalents, helping to alleviate financial burden.
• Verified Quality: Every batch is verified for potency and purity by third-party laboratories before shipment.
• Discreet Delivery: Orders are packaged in unmarked, secure parcels and delivered within 7 days for express service or approximately 3 weeks for standard airmail, respecting patient confidentiality.
• Global Reach: Our pharmacy broker service collaborates with overseas licensed pharmacies, providing access to medications that may not be stocked locally.

By choosing our online pharmacy, you receive a reliable, cost-effective, and private solution for obtaining Phoslo when conventional channels are insufficient.

Disclaimer

The information presented about Phoslo is intended for general educational purposes only and does not substitute personalized medical advice. Treatment decisions, including those concerning off-label applications, must be made under the guidance of a qualified healthcare professional. Readers are presumed to be competent adults capable of making informed health choices. Our online pharmacy supplies Phoslo to individuals who may experience limited availability through traditional pharmacy channels, insurance formularies, or who seek cost-efficient generic alternatives. Always discuss any medication changes with your clinician before initiating, adjusting, or discontinuing therapy.