What Is Velphoro? Uses, Dosage, and What You Need to Know in 2026

If you or someone you care for has chronic kidney disease (CKD) and is on dialysis, your doctor may have prescribed Velphoro to help control phosphorus levels. Here's a plain-English guide to what Velphoro is, what it does, how to take it, and what you need to know in 2026.

What Is Velphoro?

Velphoro is the brand name for sucroferric oxyhydroxide, a type of medication called a phosphate binder. It is a brown, circular, chewable tablet embossed with 'PA 500' on one side. Each tablet contains 500 mg of iron in the form of sucroferric oxyhydroxide.

Velphoro was approved by the FDA in November 2013. It is manufactured and distributed by Fresenius Medical Care North America, one of the world's largest kidney care companies. There is no generic version available as of 2026.

What Is Velphoro Used For?

Velphoro is FDA-approved for one indication: the control of serum phosphorus levels in adults and pediatric patients 9 years of age and older with chronic kidney disease (CKD) on dialysis.

This matters because people with CKD who are on dialysis often develop hyperphosphatemia — abnormally high phosphorus levels in the blood. When kidneys fail, they lose the ability to filter excess phosphorus. This leads to a dangerous cycle: high phosphorus pulls calcium out of bones (weakening them), causes calcium-phosphorus deposits in blood vessels and organs, and dramatically raises the risk of heart attack, stroke, and death.

Velphoro works during meals to intercept phosphorus before it can be absorbed into your blood — keeping your levels in the safe range.

What Does Velphoro Look Like and How Do I Take It?

Velphoro comes as a round, brown chewable tablet. You must chew it or crush it before swallowing — never swallow it whole. The tablet has a berry flavor to make chewing easier.

Key rules for taking Velphoro:

• Always take with a meal. Velphoro only works when food — specifically phosphorus from food — is present in your gut. Taking it without eating is not effective.

• Chew or crush. The tablet must be broken down before swallowing so it can interact with phosphorus throughout the gut. A pill crusher works well if chewing is difficult.

• If you miss a dose: Skip it — do not double up at the next meal. Take Velphoro with your next meal as usual.

• Store properly. Keep at room temperature (59–86°F / 15–30°C). Keep the bottle tightly closed to protect from moisture.

How Much Velphoro Will I Take? (Dosage)

Your nephrologist will determine your dose based on your serum phosphorus lab results. Standard dosing:

• Adults and patients 12 years and older: Starting dose is 1 tablet (500 mg) three times daily with meals (1,500 mg/day total). Your doctor may adjust up or down by 1 tablet per day, as often as weekly, based on your phosphorus levels.

• Pediatric patients 9 to under 12 years: Starting dose is 1 tablet two times daily with meals (1,000 mg/day). Titrated weekly as needed.

• Maximum dose: 6 tablets (3,000 mg) per day, divided across meals.

One of Velphoro's biggest advantages over other phosphate binders is its low pill burden. Many patients need only 1 tablet per meal — compared to 3-4 tablets per meal with sevelamer. This makes adherence much easier.

What Are the Most Important Things to Know Before Taking Velphoro?

• Tell your doctor if you take levothyroxine (Synthroid) — take it at least 4 hours before Velphoro to prevent a dangerous absorption interaction

• Tell your doctor about any history of hemochromatosis, liver disease, or GI disorders

• Black stools are normal and expected — this is the iron in Velphoro, not bleeding

• Your teeth may stain over time — brush after taking the tablet

• You will need regular blood tests to monitor your phosphorus levels and adjust your dose

For a detailed look at side effects and drug interactions, see our full guides on Velphoro side effects.