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**Sucroferric oxyhydroxide + calcium carbonate** is a combination therapy used as a **phosphate binder** in patients undergoing hemodialysis who have **hyperphosphatemia** (elevated serum phosphate levels often seen in chronic kidney disease)[1]. - **Sucroferric oxyhydroxide (PA21)** is an iron-based, non-calcium phosphate binder that binds dietary phosphate in the gastrointestinal tract to reduce absorption and serum phosphorus. - **Calcium carbonate** is a calcium-based phosphate binder also used to bind dietary phosphate in the gut. This combination leverages the efficacy of both agents to maintain target serum phosphorus concentrations, reduce pill burden and mitigate risks associated with high calcium load (arterial calcification)[1]. **Mechanism of action:** - Sucroferric oxyhydroxide acts by complexing phosphate ions in the gastrointestinal tract, thereby reducing phosphate absorption. - Calcium carbonate binds dietary phosphate, forming insoluble complexes that are then excreted. Indication: Control of hyperphosphatemia in patients receiving hemodialysis for end-stage renal disease[1].
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