Phosphate binders help remove excess phosphate from your body. Side effects generally include digestive disorders that affect your stomach. It’s important to follow your healthcare provider’s directions when you take phosphate binders. If you stop taking phosphate binders, you’re at a greater risk for serious conditions such as bone fractures, heart disease and stroke.
Phosphate (phosphorus) binders are medications that help lower phosphate levels in your body. Phosphate is a mineral that helps with several functions in your body, but if you have too much of it in your bloodstream, it can cause problems. Your healthcare provider may recommend phosphate binders as treatment.
Phosphate binders are available over-the-counter or by prescription from a healthcare provider. You shouldn’t take phosphate binders without first talking to a healthcare provider.
Another name for phosphate binders is phosphorus binders.
Phosphate is a type of electrolyte. Electrolytes are minerals that have a natural positive or negative charge when dissolved in water or other body fluids, such as blood. Your body needs phosphate to help form your bones and teeth. It also helps your cells produce energy and form cell membranes and deoxyribonucleic acid (DNA).
Your body gets phosphates through the foods or drinks you ingest. Whatever phosphates your body doesn’t absorb leaves your body through your urine (pee) or poop. If your body doesn’t release the extra phosphate, it can build up in your blood or kidneys and create issues.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Your healthcare provider may recommend phosphate binders if you have too much phosphate in your blood (hyperphosphatemia). You’re more likely to have hyperphosphatemia if you have chronic kidney disease (CKD) or kidney failure.
Hyperphosphatemia is a complication of CKD. Phosphate binders help prevent the progression of bone disorders that develop from hyperphosphatemia (chronic kidney disease-mineral and bone disorder, or CKD-MBD).
A typical phosphate level for adults is between 2.8 and 4.5 milligrams per deciliter (mg/dL). A typical phosphate level for children is between 4.0 to 7.0 mg/dL. However, different laboratories may use different measuring techniques. Ask your healthcare provider to explain your phosphate levels and their measuring techniques.
The following foods and drinks have high levels of phosphates:
Yes, healthcare providers commonly prescribe phosphate binders to treat hyperphosphatemia.
There are many different types of phosphate binders. They include:
Healthcare providers commonly recommend calcium carbonate. However, medical research suggests that phosphate binders that contain calcium may increase the risk of mineral deposits on the walls of your blood vessels (vascular calcifications). Vascular calcifications increase your risk of developing blood clots or strokes. Because of this risk, your provider may recommend a phosphate binder that doesn’t contain calcium, such as sevelamer.
Healthcare providers once thought niacin (vitamin B3) and chitosan chewing gum could naturally reduce phosphates in your blood. But medical research shows that chitosan chewing gum doesn’t reduce phosphate levels, and niacin alone can’t adequately reduce phosphate absorption.
Before taking a phosphate binder, tell your healthcare provider about any prescription or over-the-counter medications you’re taking. These include herbal supplements and vitamin supplements. Combining these medications and phosphate binders may affect how well they work.
If your healthcare provider prescribes a phosphate binder, they’ll instruct you on how to take the medication, including how many to take. Depending on what type of phosphate binder you take, you may:
Your body absorbs phosphates in the jejunum (pronounced “juh-JOO-nuhm”). The jejunum is the middle part of your small intestine, after your stomach. When you take phosphate binders with meals or snacks, they attach (bind) to extra phosphates in your stomach before they reach your jejunum, which prevents some phosphates from entering your blood. The extra phosphate then leaves your body when you poop.
Talk to a healthcare provider. You’re at a greater risk of hyperphosphatemia if you have CKD (chronic kidney disease), so you may need to take phosphate binders long term.
The primary benefit of phosphate binders is that they lower the amount of phosphates in your body, which helps prevent hyperphosphatemia.
Phosphate binder complications may include:
If you stop taking phosphate binders, you may experience the following symptoms:
Most people who have hyperphosphatemia don’t have any symptoms. However, phosphate binders start to lower your phosphate levels within 24 hours.
Talk to your healthcare provider if any phosphate binder side effects become severe. Hyperphosphatemia can also remove calcium from your bones and blood, which may cause hypocalcemia. Talk to your provider if you have any hypocalcemia symptoms, including:
A note from Cleveland Clinic
Phosphate is a type of electrolyte that helps form bones, teeth, cell membranes and DNA. It also helps generate energy in your cells. But too much phosphate can damage your body. Phosphate binders can help lower your phosphate levels. Talk to a healthcare provider before you take phosphate binders. They’ll work with you to find the right type of phosphate binder to reduce your levels.
Last reviewed by a Cleveland Clinic medical professional on 02/16/2023.
Learn more about our editorial process.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy