Velphoro (Sucroferric Oxyhydroxide) - Oral

What Is Velphoro?

Velphoro (sucroferric oxyhydroxide) is a prescription medication that controls serum phosphorus levels in people with chronic kidney disease.

This medication is considered chemically an iron-based phosphorus group binder, which is specifically used to reduce elevated levels of the phosphorus in the body to a normal level.

Velphoro tablets come in chewable forms that should be chewed or crushed before being taken.

Drug Facts

Generic Name: Sucroferric oxyhydroxide

Brand Name(s): Velphoro

Drug Availability: Prescription

Administration: Oral

Therapeutic Classification: Phosphate binder

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Sucroferric oxyhydroxide

Dosage Form(s): Chewable tablet

What Is Velphoro Used For?

Velphoro is used to help your kidneys. The kidneys play an important role in balancing the natural chemicals in your body.

When your kidneys lose their ability to filter out waste or unwanted substances in your blood, a chemical imbalance can occur. This chemical imbalance can cause an increased amount of phosphorus in the body, which could lead to problems in the bones.

Velphoro is a unique medication that reduces the phosphorus absorbed from your food that would have been absorbed into the body’s bloodstream.

How to Take Velphoro

Take Velphoro tablets by mouth and exactly as prescribed by your primary care provider. Velphoro comes in chewable tablets; these should be chewed or crushed and taken with a meal. Do not swallow them whole.


Store Velphoro in bottles tightly closed at all times to protect them from moisture. It should be kept at room temperature (between 68 and 77 degrees F). If you travel with this medication, you may temporarily keep it stored at temperatures as low as 59 degrees and as high as 86 degrees.

Do not leave your medication in the car overnight, and do not store it in the refrigerator or the bathroom. Keep it in a dry and safe area out of the reach of children and pets to prevent accidental consumption.

How Long Does Velphoro Take to Work?

Velphoro will start to work in the body as soon as you take it with your food.

This medication works like a magnet in that it binds to the phosphorus in your food to keep it from being distributed throughout the body. You must take your dose with food so that your digestive system eliminates the excess phosphorus.

What Are the Side Effects of Velphoro?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or a pharmacist. You may report side effects to the FDA at or 800-FDA-1088.

This medication, like many others, comes with side effects. Possible side effects may be common, serious, or long term. The common side effects are listed below.

Common Side Effects

Common side effects reported with Velphoro include:

  • Discolored feces
  • Mild diarrhea
  • Nausea

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Swelling of gastrointestinal (GI) tract (peritonitis): The most common symptom is often sudden, extreme abdominal pain that worsens with touch or movement.
  • Severe diarrhea: Symptoms can include abdominal cramping and pain, an urgent need to have a bowel movement, and loose stools.
  • Increased iron levels: Symptoms can include tiredness or weakness, painful joints, loss of interest in sex, abdominal pain, and darkening of the skin (may appear gray, metallic, or bronze).
  • Low phosphorus levels: Symptoms can include muscle weakness, bone pain, seizures, mental confusion, or rhabdomyolysis (serious but rare muscle tissue breakdown that releases protein into the blood).

Report Side Effects

Velphoro may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Velphoro Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (chewable tablets):
    • For control of phosphorus levels in patients with chronic kidney disease on dialysis:
      • Adults—500 milligrams (mg) 3 times a day with food. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3000 mg per day.
      • Children—Use and dose must be determined by your doctor.


No modifications are needed in most circumstances with Velphoro.

Velphoro has shown no relevant evidence of impaired birth or harm to the fetus, and there are no adequate and well-controlled studies in pregnant women. Likewise, it is unlikely to pass through breast milk as the absorption of iron from it is minimal.

However, it is recommended to talk to your healthcare provider if you are pregnant or plan to become pregnant while taking this medication.

Missed Dose

If you miss a dose of Velphoro, do not take it again unless you are about to have a meal. Wait to take your next dose at your next mealtime. Do not take a second dose, as it may provide more harm than good.

If you are unsure how many chewable tablets you have taken, try to write them down or use a pill box to remind yourself to take them only when you are about to have a meal.

Overdose: What Happens If I Take Too Much Velphoro?

There are no reports of Velphoro overdose. However, if you take more than your healthcare provider instructed you to take and experience nausea and severe diarrhea, immediately call 911 or the Poison Control Center.

What Happens If I Take Too Much Velphoro?

If you think you or someone else may have overdosed on Velphoro, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Velphoro, call 911 immediately.


Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may discolor your stools black. This is normal and nothing to worry about.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Velphoro?

Rarely, allergies or increased sensitivity can occur with Velphoro's main ingredient, sucroferric oxyhydroxide. If you've ever experienced an allergic reaction to sucroferric oxyhydroxide, tell your healthcare provider before starting treatment. You may not be able to take Velphoro.

Additionally, you may not be able to take Velphoro if you have a history of:

  • GI health conditions
  • Liver problems
  • High levels of iron in the body

What Other Medications Interact With Velphoro?

Velphoro should be carefully administered when taking certain medications. The following medications below should be separated from Velphoro and meals.

Take the following at least one hour before Velphoro:

Take at least four hours before Velphoro:

  • Synthroid, Ermeza, Euthyrox Levo-T, Levolet, Levoxyl, Thyquidity, Thyro-Tabs, Tirosint, Tirosint-Sol, and Unithroid (levothyroxine)

Combined use of Velphoro and levothyroxine may lower the concentration of levothyroxine in your body. If you take levothyroxine, Velphoro may reduce how well it works.

Other drug interactions may occur. Before starting Velphoro, tell your healthcare provider about all medications you take, including prescription and over-the-counter (OTC) drugs, vitamins, or herbal supplements. Ask them for a complete list of drug interactions and what drugs or substances to avoid.

What Medications Are Similar?

Velphoro is part of a drug class that binds to phosphorus to reduce the amount of phosphorus in the body. Other similar medications do not commonly have an iron base such as this one. Instead, they may contain a calcium base that could be more harmful if you are at risk of high calcium levels.

These medications include:

  • Calcium carbonate
  • Calcium acetate

Other phosphorus-binding medications include:

Frequently Asked Questions

  • What is Velphoro used for?

    Velphoro is used to treat high levels of phosphorus in the body in people with chronic kidney disease.

  • How does Velphoro work?

    It works by binding to the phosphorus in your food and helps lower the phosphorus levels in the body by excreting it in the feces.

  • What drugs should not be taken with Velphoro?

    Additional phosphorus-binding medications should not be used with Velphoro, as this may cause low levels of phosphorus in the body and further complications such as bone issues or fractures.

  • How long does it take for Velphoro to work?

    When taken immediately with food, this medication can work as soon as your body starts to digest your food.

  • What are the side effects of Velphoro?

    Velphoro has few side effects, most of which are mild to moderate if taken as prescribed. However, in some cases, you may experience side effects such as diarrhea, discolored feces, and abdominal pain.

  • How to stop taking Velphoro?

    Stop taking Velphoro and contact your healthcare provider immediately if you have severe diarrhea, blood in your feces, severe stomach issues, or develop liver damage signs.

    Do not stop taking your prescribed medication if you are not experiencing any severe side effects unless directed by your healthcare provider. 

  • How can Velphoro help me?

    If you have kidney failure or are on dialysis to help filter your kidneys, Velphoro will help filter out the excess phosphorus in the body obtained from the food you eat daily.

  • Should I stop my other medications while taking Velphoro?

    Do not stop taking your other medications unless directed by your healthcare provider first. Never begin taking a new medication or supplement while taking Velphoro without consulting your healthcare provider.

How Can I Stay Healthy While Taking Velphoro?

In addition to following your prescribed treatment regimen, maintain a healthy diet and exercise regularly.

There are many foods rich in phosphorus, and it is important to be aware of foods that may increase the amount of phosphorus in your body while taking this medication. If you are at risk of high phosphorus levels and are taking this medication, you should reduce the consumption of foods high in phosphorus, which include:

  • Low-fat plain yogurt
  • Milk (2%)
  • Preserved salmon
  • Scallops, breaded and fried
  • Mozzarella cheese
  • Preserved chicken breast

Instead, increase the amounts of fruits, vegetables, refined grains, and rice.

In advanced chronic kidney disease, working with a registered dietitian and nutritionist is important for optimal nutritional intake. Ask your healthcare provider for a referral.

Exercise is also an essential factor in maintaining overall good health. You can work with your healthcare team on establishing an appropriate exercise plan for you.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to recognize and thank Jaycob Pena for contributing to this article.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Velphoro label.

  2. Floege J, Covic AC, Ketteler M, et al. One-year efficacy and safety of the iron-based phosphate binder sucroferric oxyhydroxide in patients on peritoneal dialysis. Nephrol Dial Transplant. 2017;32(11):1918-1926. doi:10.1093/ndt/gfw460

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Hemochromatosis.

  4. National Institutes of Health. Phosphorus.

  5. Ruospo M, Palmer SC, Natale P, Craig JC, Vecchio M, Elder GJ, Strippoli GF. Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD). Cochrane Database Syst Rev. 2018;8(8):CD006023. doi: 10.1002/14651858.CD006023.pub3