Phosphate binders

[calypso]

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.

[boswife]

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.

[Tracy]

I take my during (2 at each meal).  Mine numbers are in the parameters. 

[RichardMEL]

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)

[greg10]

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.

[Bruno]

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)

[Des]

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.

[Hazmat35]

My numbers are great!  I take mine about 1/2 way through each meal - 2 Tabs per meal. 

[Desert Dancer]

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.

[RichardMEL]

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.

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!

[murf]

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.

[cookie2008]

I take mine during meals but they upset my stomach bad.

[Riki]

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?

[RichardMEL]

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!

[Henry P Snicklesnorter]

.

[-Lady Noir-]

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 

Good luck!

[RightSide]

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.

[murf]

Maybe. because caltrate and renagel work in different ways. Caltrate absorbs phosphorous whilst Renagel woks likes a magnet and attracts phosphorous.

[Riki]

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.

[calypso]

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.

[RenalSurvivorDotCA]

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?

[thegrammalady]

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.

[casper2636]

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?