supplementation are required. |
See section 9.6.4 for such preparations. |
|
First line |
GREEN Cacit® tablets |
Second line |
GREEN Calcium carbonate tablets chewable 1.25g (12.6mmol Ca) (Calcichew®) |
GREEN Calcium glubionate/calcium lactobionate syrup (2.7mmol Ca/5ml) (Calcium-Sandoz®) |
|
|
Injections - for hypocalcaemia, cardiac resuscitation |
GREEN Calcium chloride injection Min-I-Jet® (6.8mmol calcium/10ml) |
RED Calcium chloride injection ampoule (2.5mmol calcium/5ml) |
RED Calcium chloride injection 13.4% ampoule (9.1mmol calcium/10ml) |
RED Calcium gluconate injection 10% (2.2mmol calcium/10ml) |
|
9.5.1.2 Hypercalcaemia and hypercalciuria |
Dehydration should be corrected before other treatment is started. |
> For IV bisphosphonates see section 6.6.2 |
> For calcitonin see section 6.6.1 |
> For corticosteroids see section 6.3 |
|
Cinacalcet for the treatment of secondary hyperparathyroidism in patients with end-stage renal disease on maintenance |
dialysis therapy |
> Cinacalcet is not recommended for the routine treatment of secondary hyperparathyroidism in patients with |
end-stage renal disease on maintenance dialysis therapy. |
> Cinacalcet is recommended for the treatment of refractory secondary hyperparathyroidism in patients with end-stage |
renal disease (including those with calciphylaxis) only in those: |
> who have 'very uncontrolled' plasma levels of intact parathyroid hormone (defined as greater than 85 pmol/litre [800pg/ml]) that are refractory to standard therapy, and a normal or high adjusted |
serum calcium level, and |
> in whom surgical parathyroidectomy is contraindicated, in that the risks of surgery are considered |
> Response to treatment should be monitored regularly and treatment should be continued only if a reduction in |
the plasma levels of intact parathyroid hormone of 30% or more is seen within 4 months of treatment, |
including dose escalation as appropriate. |
RED Cinacalcet f/c tablets 30mg, 60mg,90mg (NHS England Commissioned) |
|
Secondary Hyperparathyroidism in adults with Chronic Kidney Disease on haemodialysis - NICE TA448 |
Etelcalcetide is recommended as an option for treating secondary hyperparathyroidism in adults with chronic kidney disease |
on haemodialysis, only if: |
> treatment with a calcimimetic is indicated but cinacalcet is not suitable and |
> the company provides etelcalcetide with the discount agreed in the patient access scheme |
RED Etelcalcetide 2.5mg, 5mg, 10mg solution for injection (CCG Commissioned) |
|
9.5.1.3 Magnesium |
Return to main page |
GREEN Magnesium glycerophosphate chewable tablets 95mg (4mmol Mg2+) PRESCRIBE BY BRAND - MagnaPhate® |
RED Magnesium sulphate injection 10% 10ml (1gram) ampoule | RED Magnesium sulphate injection 50% | 2ml (1gram) ampoule | 10ml (5gram) ampoule | 10ml (5gram) prefilled syringe | |
|
Note: Magnesium sulphate 1gram is equivalent to Mg2+ approx. 4 mmol. For intravenous injection concentration of magnesium |
sulphate should not exceed 20%. |
|
Magnesium Aspartate (Magnaspartate®) |
This product is a ‘food for special medical purposes’ and is indicated for the management of magnesium deficiency. It is available |
as an oral powder, containing magnesium-L- aspartate 6.5 g (10 mmol Mg2+)/sachet, at a net price 10-sachet pack = £7.95. It can |
be prescribed on FP10 prescriptions in primary care, and is now available from Alliance Healthcare, or directly from KoRa |
Healthcare, Co Dublin, Ireland, UK Tel: 0845-3038631. It will be used where there is intolerance or poor response to other oral |
magnesium products, to prevent use of intravenous magnesium where appropriate. |
AMBER Magnesium Aspartate sachets (Magnaspartate®) |
|
9.5.2 Phosphorous |
9.5.2.1 Phosphate supplements |
GREEN Phosphate-Sandoz® effervescent tablets (16.1mmol phosphate) |
RED Phosphates intravenous infusion (100mmol/litre phosphate) 500ml |
|
9.5.2.2 Phosphate binding agents |
AMBER Calcium acetate tablets 475 mg (Renacet®) |
AMBER Calcium acetate 435mg/235mg (OsvaRen®) |
AMBER Calcium acetate 1g tablets (Phosex®) |
AMBER Sevelamer carbonate tablets 800mg Prescribe generically as 'Sevelamar carbonate' - see switch leaflet |
RED Lanthanum carbonate (patients on dialysis) Prescribe generically NHS England commissioned |
AMBER Lanthanum carbonate (hyperphosphataemia with CKD and not on dialysis as per NICE CG157 ) |
500mg, 750mg, 1g tablets . Prescribe generically |
|
Also Adcal® and Calcichew® see section 9.5.1.1 |
Return to main page |
|
9.5.3 Fluoride |
When the fluoride content of drinking water is less than 700micrograms per litre (0.7 parts per million), daily administration |
of fluoride tablets or drops provides suitable supplementation. |
Provision of such supplements should be via the dentist and patients should have regular 6 monthly visits to monitor oral health. |
|
High Strength Fluoride Toothpaste |
Primary Care Prescribing |
The Position Statement for the Prescribing of High Strength Fluoride Toothpaste, [dental prescribing only] in primary care is available <click here> |
BLACK Duraphat® 5000 [High Fluoride Toothpaste] - Dental Prescribing only in primary care |
|
Head and neck cancer patients [Max Fax: Restricted to dental care in cancer patients] |
In a small group of patients who are post radiotherapy for head and neck cancer, the high strength fluoride toothpaste will be initiated by secondary care specialists / consultants [Max Fax]. |
|
AMBER Duraphat® 5000 [High Fluoride Toothpaste] |
|
'Mouth Care for Head and Neck Chemotherapy/ Radiotherapy Patients' - Patient Information Leaflet <click here>. |
Return to main page |
|
9.5.4 Zinc |
Zinc should only be given where there is good evidence of deficiency. |
GREEN Zinc Sulphate tablets effervescent 125mg (45mg zinc) Return to main page | | , | The material in this section is aimed at health care professionals, but is information currently held in the public domain | members of the public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service | Email: info.elmmb@nhs.net | Copyright© 2016 -2023 East Lancashire Medicines Management Board | All rights reserved. Disclaimer/Terms and conditions | | | | | | | | | | |
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