A Comparison of the Phosphorus Content in Prescription Medications for Hemodialysis Patients in Japan

• Published in: YAKUGAKU ZASSHI Vol. 137; no. 7; pp. 903 - 908
• Main Authors: Hirayama, Fumitoshi, Iohara, Daisuke, Otagiri, Masaki, Anraku, Makoto, Zingami, Sachiko, Maruyama, Toru, Shimoishi, Kazuki, Uto, Ayako, Kadowaki, Daisuke
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Pharmaceutical Society of Japan 01.07.2017; Pharmaceutical Society of Japan
• Subjects: Amlodipine - chemistry; branded; Drugs, Generic - chemistry; generic; hemodialysis; Humans; Japan; Paroxetine - chemistry; phosphorus; Phosphorus - adverse effects; Phosphorus - analysis; Phosphorus, Dietary - adverse effects; Phosphorus, Dietary - analysis; prescribed medication; Prescription Drugs - chemistry; Renal Dialysis; hemodialysis; branded; prescribed medication; generic; phosphorus
• ISSN: 0031-6903; 1347-5231; 1347-5231
• DOI: 10.1248/yakushi.17-00006

A high dietary intake of phosphorus is considered to be a significant health threat for hemodialysis (HD) patients. Prescription medications, which might be a major source of phosphorus, is largely unrecognized in Japan. However, the amount of phosphorus indicated on the package label, is not quantified. In this study, the phosphorus content of 22 of the most widely prescribed medications that are used in conjunction with HD therapy were examined and differences between branded and generic prescription medications were compared. All samples were selected from medications that are typically prescribed for HD patients. The samples were ground prior to analysis. Phosphorus was measured using the Wako L-Type Phosphate method. All instruments used in the study were calibrated according to the manufacturers' specifications. Amlodipine (15 mg/tablet) and paroxetine (30.0 mg/tablet) were found to contain higher contents of phosphorus than the medications tested. Differences in phosphorus content between branded and generic drugs was also determined. The phosphorus content of all generic paroxetine preparations was significantly lower than the values for identical branded medications. On the other hand, the phosphorus content of several generic amlodipine preparations were significantly different from those of similar, branded preparations. Specific information regarding the phosphorus content of prescribed medications used by HD patient needs to be made available to the dialysis community.