I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: General Discussion => Topic started by: calypso on November 09, 2010, 08:39:31 AM

Title: Phosphate binders
Post by: calypso on November 09, 2010, 08:39:31 AM
When do you take your phosphate binders? Before or after a meal?

My phosphorous is running a bit high so instead of taking it before meals neph said take all of my phosphate binders after a meal. So when do you take them? And how is your phosphorous level? When I was on PD my phosphorous levels were actually a bit low, now on hemo it's on the high side.
Title: Re: Phosphate binders
Post by: boswife on November 09, 2010, 10:47:06 AM
Hubbys #'s on HD were just a tiny bit high.  He started on binders and was told to take them before meals or during.  He usually takes before but it seems for the small amount he needed to get it lowered, it's taking 3 pills each meal to have it where it's suppose to be.  Wonder if he should be taking at a different time as well.
Title: Re: Phosphate binders
Post by: Tracy on November 09, 2010, 01:24:24 PM
I take my during (2 at each meal).  Mine numbers are in the parameters. 
Title: Re: Phosphate binders
Post by: RichardMEL on November 09, 2010, 05:55:13 PM
during for mine. My understanding is you can take them within 30 mins either side of a meal and they will still be reasonably effective, but it is best to have them WITH the food to get the max binding. Only if I get a snack or something and don't have one on me do I try to get one within 30 mins, otherwise I don't bother (too late)
Title: Re: Phosphate binders
Post by: greg10 on November 09, 2010, 06:42:25 PM
Blend the phosphate binder with your food and drink the shake.  This way the binder starts working before you even take a bite :)

But seriously, some people have trouble chewing and swallowing large pills and chalky tablets (calcium or lanthanum carbonate) and blending the carbonate based binder with a shake (protein or juice) is a good way of taking the pills.  These binders are most effective in an acidic environment of the stomach and sometimes an acidic drink such as fruit juice may also help.  The only draw back with blending is that when you chew, your saliva is also a major source of phosphate release.  Therefore drinking without chewing may decrease the effectiveness of the binder - but you can circumvent that problem with chewing gum.  In fact there are phosphate binder chewing gum trials using chitosan as a binder, but that is another story.
Title: Re: Phosphate binders
Post by: Bruno on November 10, 2010, 09:24:14 PM
Always during a meal...I take 3 daily and crunch them with whatever I'm eating. I can tell they are working because I crap like a Clydesdale...and don't mention breaking wind...I'm trying to be polite here.
(I'm secretly rather proud)
Title: Re: Phosphate binders
Post by: Des on November 11, 2010, 01:41:35 AM
Now I have picked up another problem with this.

The calcium in my binders has caused kidney stones --- now I need to find another one. :waiting;
Title: Re: Phosphate binders
Post by: Hazmat35 on November 11, 2010, 11:00:03 AM
My numbers are great!  I take mine about 1/2 way through each meal - 2 Tabs per meal. 
Title: Re: Phosphate binders
Post by: Desert Dancer on November 11, 2010, 12:53:12 PM
My dietician told me to take my binders at the start of meals, so I usually take a few bites and then take my binders. I take two binders with each meal (which comes out to two binders a day) and so far my phosphorus has gone UP, not down. I may need to up the dose or change the way I take them; I'll see how my next set of labs comes out before I broach the subject with the dietician.
Title: Re: Phosphate binders
Post by: RichardMEL on November 11, 2010, 07:48:27 PM
Now I have picked up another problem with this.

The calcium in my binders has caused kidney stones --- now I need to find another one. :waiting;

See if they can get you on a non calcium based binder - the obvious thought is Renagel, but it may not be available in RSA :( Let us know!
Title: Re: Phosphate binders
Post by: murf on November 18, 2010, 06:14:11 PM
Take one caltrate before I eat and twp renagel during the meal. Does work except when I am naughty and forget. That always seems to happen when I go our for a meal. Not deliberate, just keep forgetting to put them in my pocket.
Title: Re: Phosphate binders
Post by: cookie2008 on November 18, 2010, 07:05:32 PM
I take mine during meals but they upset my stomach bad.
Title: Re: Phosphate binders
Post by: Riki on November 18, 2010, 11:19:36 PM
I usually take them during the meal.. cuz that just happens to be when I'm thinking of it.. If I wait until I"m finished eating, then I"l probably forget.  It also helps with swallowing the foolish things, if I've had a little bit to eat first.  I take 2 calcium carbonate pills and 2 renagel with every meal.

is it just me, or do renegel have the tiniest hint of peppermint to them?
Title: Re: Phosphate binders
Post by: RichardMEL on November 19, 2010, 02:04:47 AM
I'd ask the doc why you're on a mix of caltrate AND renagel. That doesn't make a lot of sense to me, unless they're using that to up your calcium a bit, but I would have though calcitricol would do for that (that's what I'm on).

btw I was told to chew the caltrate in with my food - that was disgusting! I hated the chalky taste in my mouth - it ruined everything. I was SO glad when they told me I could give that the flick and just take Renagel!
Title: Re: Phosphate binders
Post by: Henry P Snicklesnorter on November 19, 2010, 03:50:53 AM
.
Title: Re: Phosphate binders
Post by: -Lady Noir- on November 19, 2010, 10:46:55 AM
Mikes phosphate level used to on the high side, when he took them after his meals. The doctor advised this.
The nutritionist however, said if you crush or chew them and have them after the first few mouthfuls they work more effectively. His bloods showed this was true  ;D

Good luck!
Title: Re: Phosphate binders
Post by: RightSide on November 19, 2010, 02:43:52 PM
I take my binders before, but just a little bit before.

Mostly I cook my own meals, so I take my binders just when I'm taking the food out of the oven.  It's just a few minutes from then to my sitting down at the dinner table to eat it.
Title: Re: Phosphate binders
Post by: murf on November 19, 2010, 03:01:33 PM
Maybe. because caltrate and renagel work in different ways. Caltrate absorbs phosphorous whilst Renagel woks likes a magnet and attracts phosphorous.
Title: Re: Phosphate binders
Post by: Riki on November 20, 2010, 01:51:08 PM
Renegel is a new thing here.  Most of us are on it, if we can afford it, but we've only started it in the last year or so.  The owners of the store my mom works at canceled their insurance last month, so Mom got the prescription refilled early.  I have about a 4 months supply.  After that, I"m done with it cuz we can't afford it.
Title: Re: Phosphate binders
Post by: calypso on November 20, 2010, 02:09:50 PM
Thanks everyone for all the replies. I was on Renagel for 6 years till switching to hemo last year, switched to Renvela a few months ago. I don't notice any difference. They are made by the same company anyway.
Title: Re: Phosphate binders
Post by: RenalSurvivorDotCA on November 21, 2010, 05:07:15 PM
Renegel is a new thing here.  Most of us are on it, if we can afford it, but we've only started it in the last year or so.  The owners of the store my mom works at canceled their insurance last month, so Mom got the prescription refilled early.  I have about a 4 months supply.  After that, I"m done with it cuz we can't afford it.

Riki, Does PEI not cover the dialysis drugs? I don't pay a cent for dialysis-related drugs. I thought all the provinces were the same?
Title: Re: Phosphate binders
Post by: thegrammalady on November 21, 2010, 05:38:25 PM
before i started nocturnal i was taking 4 renegel everytime i put anything in my mouth. after starting nocturnal my phos started dropping and for a while i didn't take any binders. then for a few months i took one and now am again not taking any.  the key to any binder is not just meals but any time you eat. if you take binders with dinner and then 3 hours later have pie you need to take more binders.  if you forget when you eat and remember an hour later, forget it it's too late. same with something to drink. example if you have a soda with phos, say a coke in the afternoon, you need your binders.
Title: Re: Phosphate binders
Post by: casper2636 on November 23, 2010, 05:42:47 AM
I'm so shocked that some many people are chewing their binders...I'm looking at my RENVELA bottle right now and on the side as a waring it says "do not chew or crush before swallowing", besides saying that it can cause constipation and/or diarrhea. Did I miss the boat on some better info? :secret;