A Comparison of the Phosphorus Content in Prescription Medications for Hemodialysis Patients in Japan
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 quanti...
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| Published in | YAKUGAKU ZASSHI Vol. 137; no. 7; pp. 903 - 908 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
Japan
The Pharmaceutical Society of Japan
01.07.2017
Pharmaceutical Society of Japan |
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| Online Access | Get full text |
| ISSN | 0031-6903 1347-5231 1347-5231 |
| DOI | 10.1248/yakushi.17-00006 |
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| Abstract | 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. |
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| AbstractList | 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. 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. 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. |
| Author | Kadowaki, Daisuke Zingami, Sachiko Iohara, Daisuke Hirayama, Fumitoshi Uto, Ayako Maruyama, Toru Shimoishi, Kazuki Otagiri, Masaki Anraku, Makoto |
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| CitedBy_id | crossref_primary_10_1038_s41387_019_0080_2 crossref_primary_10_1053_j_jrn_2020_02_003 crossref_primary_10_5649_jjphcs_44_55 |
| Cites_doi | 10.1093/ndt/13.8.2037 10.2215/CJN.07640711 10.2215/CJN.09250912 10.1038/sj.ki.5001514 10.1038/ki.2013.147 10.1111/j.0894-0959.2004.17308.x 10.1681/ASN.V12102131 10.2215/CJN.00810110 10.1111/j.1525-139X.2011.00849.x 10.1111/sdi.12042 10.1093/ndt/gft280 10.1111/j.1525-139X.2007.00204.x 10.1053/j.ajkd.2014.01.429 10.1056/NEJMoa0706130 10.1111/sdi.12159 10.1681/ASN.2008020159 10.1053/ajkd.1998.v31.pm9531176 10.1038/ki.2015.67 |
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| References | 8) Fouque D., Horne R., Cozzolino M., Kalantar-Zadeh K., Am. J. Kidney Dis., 64, 143-150 (2014). 14) Di Iorio B., Di Micco L., Torraca S., Sirico M. L., Russo L., Pota A., Mirenghi F., Russo D., Clin. J. Am. Soc. Nephrol., 7, 581-587 (2012). 15) Isakova T., Barchi-Chung A., Enfield G., Smith K., Vargas G., Houston J., Xie H., Wahl P., Schiavenato E., Dosch A., Gutiérrez O. M., Diego J., Lenz O., Contreras G., Mendez A., Weiner R. B., Wolf M., Clin. J. Am. Soc. Nephrol., 8, 1009-1018 (2013). 16) Daugirdas J. T., Finn W. F., Emmett M., Chertow G. M., Semin. Dial., 24, 41-49 (2011). 10) Sherman R. A., Ravella S., Kapoian T., Kidney Int., 87, 1097-1099 (2015). 18) Clark S., Farrington K., Chilcot J., Semin. Dial., 27, 42-49 (2014). 5) Ribeiro S., Ramos A., Brandão A., Rebelo J. R., Guerra A., Resina C., Vila-Lobos A., Carvalho F., Remédio F., Ribeiro F., Nephrol. Dial. Transplant., 13, 2037-2040 (1998). 13) Ikizler T. A., Cano N. J., Franch H., Fouque D., Himmelfarb J., Kalantar-Zadeh K., Kuhlmann M. K., Stenvinkel P., TerWee P., Teta D., Wang A. Y. M., Wanner C., Kidney Int., 84, 1096-1107 (2013). 2) Block G. A., Hulbert-Shearon T. E., Levin N. W., Port F. K., Am. J. Kidney Dis., 31, 607-617 (1998). 1) Gutiérrez O. M., Mannstadt M., Isakova T., Rauh-Hain J. A., Tamez H., Shan A., Smith K., Lee H., Thadhani R., Jüppner H., Wolf M., N. Engl. J. Med., 359, 584-592 (2008). 9) Sherman R. A., Semin Dial., 20, 16-18 (2007). 7) Calvo M. S., Uribarri J., Semin. Dial., 26, 54-61 (2013). 3) Ganesh S. K., Stack A. G., Levin N. W., Hulbert-Shearon T., Port F. K., J. Am. Soc. Nephrol., 12, 2131-2138 (2001). 4) Kalantar-Zadeh K., Kuwae N., Regidor D. L., Kovesdy C. P., Kilpatrick R. D., Shinaberger C. S., McAllister C. J., Budoff M. J., Salusky I. B., Kopple J. D., Kidney Int., 70, 771-780 (2006). 6) Goodman W. G., Semin. Dial., 17, 209-216 (2004). 12) Eddington H., Hoefield R., Sinha S., Chrysochou C., Lane B., Foley R. N., Hegarty J., New J., O'Donoghue D. J., Middleton R. J., Kalra P. A., Clin. J. Am. Soc. Nephrol., 5, 2251-2257 (2010). 17) Wang S., Alfieri T., Ramakrishnan K., Braunhofer P., Newsome B. A., Nephrol. Dial. Transplant., 29, 2092-2099 (2014). 11) Moranne O., Froissart M., Rossert J., Gauci C., Boffa J. J., Haymann J. P., M'rad M. B., Jacquot C., Houillier P., Stengel B., Fouqueray B., NephroTest Study Group, J. Am. Soc. Nephrol., 20, 164-171 (2009). 11 12 13 14 15 16 17 18 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 1) Gutiérrez O. M., Mannstadt M., Isakova T., Rauh-Hain J. A., Tamez H., Shan A., Smith K., Lee H., Thadhani R., Jüppner H., Wolf M., N. Engl. J. Med., 359, 584-592 (2008). – reference: 3) Ganesh S. K., Stack A. G., Levin N. W., Hulbert-Shearon T., Port F. K., J. Am. Soc. Nephrol., 12, 2131-2138 (2001). – reference: 12) Eddington H., Hoefield R., Sinha S., Chrysochou C., Lane B., Foley R. N., Hegarty J., New J., O'Donoghue D. J., Middleton R. J., Kalra P. A., Clin. J. Am. Soc. Nephrol., 5, 2251-2257 (2010). – reference: 9) Sherman R. A., Semin Dial., 20, 16-18 (2007). – reference: 16) Daugirdas J. T., Finn W. F., Emmett M., Chertow G. M., Semin. Dial., 24, 41-49 (2011). – reference: 8) Fouque D., Horne R., Cozzolino M., Kalantar-Zadeh K., Am. J. Kidney Dis., 64, 143-150 (2014). – reference: 13) Ikizler T. A., Cano N. J., Franch H., Fouque D., Himmelfarb J., Kalantar-Zadeh K., Kuhlmann M. K., Stenvinkel P., TerWee P., Teta D., Wang A. Y. M., Wanner C., Kidney Int., 84, 1096-1107 (2013). – reference: 7) Calvo M. S., Uribarri J., Semin. Dial., 26, 54-61 (2013). – reference: 11) Moranne O., Froissart M., Rossert J., Gauci C., Boffa J. J., Haymann J. P., M'rad M. B., Jacquot C., Houillier P., Stengel B., Fouqueray B., NephroTest Study Group, J. Am. Soc. Nephrol., 20, 164-171 (2009). – reference: 2) Block G. A., Hulbert-Shearon T. E., Levin N. W., Port F. K., Am. J. Kidney Dis., 31, 607-617 (1998). – reference: 4) Kalantar-Zadeh K., Kuwae N., Regidor D. L., Kovesdy C. P., Kilpatrick R. D., Shinaberger C. S., McAllister C. J., Budoff M. J., Salusky I. B., Kopple J. D., Kidney Int., 70, 771-780 (2006). – reference: 18) Clark S., Farrington K., Chilcot J., Semin. Dial., 27, 42-49 (2014). – reference: 5) Ribeiro S., Ramos A., Brandão A., Rebelo J. R., Guerra A., Resina C., Vila-Lobos A., Carvalho F., Remédio F., Ribeiro F., Nephrol. Dial. Transplant., 13, 2037-2040 (1998). – reference: 14) Di Iorio B., Di Micco L., Torraca S., Sirico M. L., Russo L., Pota A., Mirenghi F., Russo D., Clin. J. Am. Soc. Nephrol., 7, 581-587 (2012). – reference: 6) Goodman W. G., Semin. Dial., 17, 209-216 (2004). – reference: 17) Wang S., Alfieri T., Ramakrishnan K., Braunhofer P., Newsome B. A., Nephrol. Dial. Transplant., 29, 2092-2099 (2014). – reference: 10) Sherman R. A., Ravella S., Kapoian T., Kidney Int., 87, 1097-1099 (2015). – reference: 15) Isakova T., Barchi-Chung A., Enfield G., Smith K., Vargas G., Houston J., Xie H., Wahl P., Schiavenato E., Dosch A., Gutiérrez O. M., Diego J., Lenz O., Contreras G., Mendez A., Weiner R. B., Wolf M., Clin. J. Am. Soc. Nephrol., 8, 1009-1018 (2013). – ident: 5 doi: 10.1093/ndt/13.8.2037 – ident: 14 doi: 10.2215/CJN.07640711 – ident: 15 doi: 10.2215/CJN.09250912 – ident: 4 doi: 10.1038/sj.ki.5001514 – ident: 13 doi: 10.1038/ki.2013.147 – ident: 6 doi: 10.1111/j.0894-0959.2004.17308.x – ident: 3 doi: 10.1681/ASN.V12102131 – ident: 12 doi: 10.2215/CJN.00810110 – ident: 16 doi: 10.1111/j.1525-139X.2011.00849.x – ident: 7 doi: 10.1111/sdi.12042 – ident: 17 doi: 10.1093/ndt/gft280 – ident: 9 doi: 10.1111/j.1525-139X.2007.00204.x – ident: 8 doi: 10.1053/j.ajkd.2014.01.429 – ident: 1 doi: 10.1056/NEJMoa0706130 – ident: 18 doi: 10.1111/sdi.12159 – ident: 11 doi: 10.1681/ASN.2008020159 – ident: 2 doi: 10.1053/ajkd.1998.v31.pm9531176 – ident: 10 doi: 10.1038/ki.2015.67 |
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| Snippet | A high dietary intake of phosphorus is considered to be a significant health threat for hemodialysis (HD) patients. Prescription medications, which might be a... |
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| SubjectTerms | 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 |
| Title | A Comparison of the Phosphorus Content in Prescription Medications for Hemodialysis Patients in Japan |
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