Phosphate binders are used to prevent and treat stomach ulcers, esophageal reflux or heartburn and the reduction of hyperphosphatemia or the increased amount of phosphorous in the blood in patients with kidney failure. Though the FDA approves phosphate binders for use in large animals only, it has been commonly used for treatment in small animal medicine.
Use With Caution with Phosphate Binders
Antacids should always be used under the direction of a veterinarian even with over the counter versions, since the use of some antacids can prove fatal. Antacids are used for the prevention and/or treatment of stomach disorders and to lower high phosphorous levels in dogs experiencing kidney failure.
Common side effects are:
- Constipation
- Diarrhea
- Lack of appetite
- Muscle weakness
- Electrolyte imbalances due to levels of aluminum, magnesium, potassium and sodium contained in the antacids
Common warnings and/or cautions include:
- Do not use magnesium type products in cases of kidney failure
- Use aluminum type products cautiously in dogs with stomach obstruction or emptying disorders
- Use caution with calcium and/or aluminum type products in cases of kidney disease
- Use caution in using with restricted quantities of potassium or sodium diets
- Do not use with nursing or pregnant animals
- Long term use can damage kidneys
- Aluminum containing products can cause thinning of the bones, aluminum toxicity or muscle weakness
- Can interact adversely with certain medications and foods, such as abnormal heart rhythms
- Can interfere with the absorption of certain medications
Phosphate Binders Can Benefit Dogs With Kidney Disease
Phosphorous binders can aid maintaining blood phosphorous levels in dogs with kidney disease. The goal is to ensure that phosphorous levels reach no higher than 4.5 in dogs with early stage kidney disease, 5.0 for dogs with moderate stage kidney disease and 6.0 for dogs with late stage kidney disease.
Phosphorous binders come in powders, capsules or suspensions and must be stored at room temperature. Treatment dosages depend upon the stage of kidney disease, the size of the dog and the response to the treatment. It may be difficult to administer dosages since the phosphorous binders do not have a pleasant taste.
Phosphate Binders Drug Interactions
Antacids may prevent the absorption of tetracycline antibiotics.
Antacids may decrease the absorption or the effects of the following:
- Captopril
- Chlordiazepoxide
- Cimetidine
- Chloroquine
- Corticosteroids
- Digoxin
- Indomethicin
- Iron salts
- Isoniazid
- Ketoconazole
- Nitrofurantoin
- Penicillamine
- Phenytoin
- Pancreatic enzymes
- Phenothiazines
- Ranitidine
- Valproic acid
Antacids may increase the absorption or the effects of the following:
- Apirin
- Dicumarol
- Flecainide
- Guanidine
- Sympathomimetics (ephedrine)
Always consult a veterinarian before administering any medications to a pet, especially if he is already taking other medications as an interaction between medications can cause adverse side effects and even death. Even over-the-counter medications can interact with prescription medications with adverse side effects. If any serious side effects are observed, seek immediate medical attention.