Topic Discussion: Phosphorus content of prescription Medications

There is a source of dietary phosphorus that has been noted but is largely unrecognized and unquantified—the phosphorus content of prescription medications. That drugs may contain phosphorus is clear, as it is indicated on the list of inert ingredients reported on their package label. Sherman et al few years back did an amazing study that showcased that medication preservatives might have phosphorus content that we don’t recognize. This might be also causing some phosphorus rises in our patients and need for increased binders.

Medication and dose	Manufacturer	Phosphorus content	Amt of Phos binders required additional
Lisinopril 10mg	Qualitest	40.1mg	2
Lisinopril 10mg	Blue Point labs	32.6mg	1.5
Amlodipine 10mg	Greenstone	27.8mg	1
Amlodipine 10mg	Lupin	8.6mg	-
Paroxetine	Glaxosmith Kline	111.5mg	5
Paroxetine	Cadila	22.7mg	1
Renavite	Cypress	37.7mg	1
Renocaps	Nnodum	1.7mg	-

How do we help our patients with this information? Better would be some way of making prescribers aware that their prescribed medications may be high in phosphorus—they are not ‘dialysis safe’. 

Perhaps creating a database of all drugs and their phosphorus content might be useful.  Or is this not consequential to our patients as diet is the biggest factors… the above is just the sample of drugs the author had inquired.. imagine the rest of the medications and other chemotherapy and other anitbiotics we give our patients.