Aluminum hydroxide: evaluation of two dosage forms and two dosing schedules in reducing intestinal phosphate absorption.


Smith DR, Chang BS, Johnson CE




Am J Hosp Pharm


A crossover, randomized, eight-week trial using eight adult volunteers was undertaken to (1) determine the efficacy of aluminum hydroxide in decreasing gastrointestinal phosphate absorption, (2) compare the effectiveness of "with meal" and "between meal" dosing schedules, and (3) compare the effectiveness of the capsule and liquid dosage forms. Four treatments, each with a daily dose of approximately 6 g, were taken on a three-times-a-day regimen. The effectiveness of the treatment regimens was measured by using two variables: the decrease in total urinary phosphorus excretion, and the increase in the percent tubular reabsorption of phosphorus (TRP). Aluminum hydroxide treatment produced a significant change in urinary phosphorus excretion (p less than 0.0005) and in percent TRP (p less than 0.0005). For the study population, total urinary phosphorus excretion was the determining factor in changing the percent TRP. The increase in TRP and the decrease in total urinary phosphorus excretion was of the same degree regardless of dosage form or dosage schedule. Aluminum hydroxide was effective in decreasing phosphorus absorption as measured in this study. It appears that aluminum hydroxide capsules could be used with equal efficacy as the liquid dosage form in controlling hyperphosphatemia in patients with chronic renal failure who will not comply with a treatment program using the liquid.