• Hossam Aboelyazeed B. Sc. Pharmaceutical Sciences, Faculty of Pharmacy, Tanta University, Egypt
  • Sahar El-haggar Faculty of Pharmacy, Tanta University, Egypt
  • Kamal Okasha Professor of Internal medicine and Nephrology, Faculty of Medicine, Tanta University, Egypt


Objective: The purpose of this study was to compare the effect of famotidine versus omeprazole on the efficacy of calcium carbonate as a phosphate binder in the hemodialysis patient.

Methods: From February 2014 to June 2014 a total number of 64 patients of both sexes were recruited from the department of renal dialysis, Tanta University Hospital, Egypt. Patients categorized into 3 groups. Group I (control group) consisted of 20 Patients (10) females and (10) males take calcium carbonate (caco3) (2.5–4 g/d) only, Group II consisted of 21 Patients (13) females and (8) males take the same dose of caco3 with famotidine 10 mg/d and Group III consisted of 23 Patients (8) females and (15) male take the same dose caco3 with omeprazole 20 mg/d.

Results: All data are expressed as the mean±SD. Group II showed a significant increase (p<0.05) in serum phosphorus at 3rd mo with significant decreased (p<0.05) in serum calcium comparing with pre-treatment. Group III showed no significant change (p>0.05) in serum calcium, phosphorus and parathyroid hormone (PTH) comparing with pre-treatment. Both groups (II and III) showed a significant decrease in alkaline phosphatase (ALP) (p<0.05).

Conclusion: Co-administration of famotidine with calcium carbonate aggravates hyperphosphatemia and this may increase the incidence of complications. The efficacy of calcium carbonate as a phosphate binder was not affected by co-administration of omeprazole.

Keywords: Famotidine, Hyperphosphatemia, Haemodialysis, Omeprazole


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1.Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG and Chertow GM. Mineral metabolism, mortality and morbidity in maintenance hemodialysis. J Am SocNephrol. 2004; 15: 2208–18.

2.Terai K, Nara H, Takakura K et al. Vascular calcification and secondary hyperparathyroidism of severe chronic kidney disease and its relation to serum phosphate and calcium levels. Br J Pharmacol. 2009; Apr; 156(8):1267-78.

3.Jono S, McKee MD, Murry CE, Shioi A,Nishizawa Y and Mori K , Phosphate regulation of vascular smooth muscle cell calcification, Circ Res. 2000; 87: 10–17.

4.Slatopolsky E, Weerts C and Lopez-Hilker S. Calcium carbonate as a phosphate binder in patients with chronic renal failure undergoing dialysis, N Engl J Med. 2005; 3(15): 157–61.

5.National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003; 42(4 Suppl 3):S1-201.

6.Takahashi N, Yuasa S, Hitomi H et al. Effects of histamine H2-receptor antagonists on the phosphorus binding ability of phosphate binders in hemodialysis patients. Nihon Jinzo Gakkai Shi. 1996; Dec; 38(12):610-17.

7.Stern J and Lewis WHP. The colorimetric estimation of calcium in serum with ocresolphthalein complexone, ClinChemActa. 1957; 2 (6): 576-580.

8.Sarkar BCR and Chauhan UPS. A new method of determining micro quantities of calcium in biological materials, Anal Biochem. 1967; 20:155-66.

9.Fiske C. H and SubbarowY. The colorimetric determination of phosphorus, BiolChem. 66:375-400, (1925).

10.Goodwin J.F. Quantification of Serum Inorganic Phosphorus, ClinChem. 1970; 16(9):776-780.

11.Fujita H. Uber die microbestimmung der Bult phosphatase, Biochem, 30: 69, (1939).

12.Bowers GN and McCOMBR B. A continuous spectrophotometric method for measuring the activity of serum Alk.phos, ClinChem. 1966; 12:70-89.

13.Armitage EK. Parthyrin metabolism and methods for assay, ClinChem. 1986; 3232: 418- 24.

14.Kao PC, Grant CS, Klee GG and Khosla S. Clinical performance of parathyroid hormone immunometric assays, Mayo ClinProc. 1992; 67:637-45.

15.Matsunaga C, Izumi S, Furukubo T, Satoh M, Yamakawa T, Uchida T, Kadowaki D and Hirata S. Effect of famotidine and lansoprazole on serum phosphorus levels in hemodialysis patients on calcium carbonate therapy, Clin Nephrol. 2007; Aug; 68(2):93-8.

16.Takahashi N, Shoji T, Hirohata M et al .The effects of histamine H2-receptor antagonists on the phosphorus binding ability of calcium carbonate in hemodialysis patients, J JpnSoc Dial Ther. 1999; 28:1069–1074.

17.Goss S, Lemons KA, Kerstetter JE and Bogner RH. Determination of calcium salt solubility with changes in pH and P (CO(2)), simulating varying gastrointestinal environments , J Pharm Pharmacol. 2007; 59:1485–92.

18.Bricker NS. on the pathogenesis of the uremic state. An exposition of the trade-off hypothesis, N Engl J Med, 286: 1093– 1099, (2007).

19.Kinjo M, Setoguchi S and Solomon DH. Antihistamine therapy and bone mineral density: analysis in a population-based US sample, Am J Med. 2008; 121:1085–91.

20.Hardy P, Hottelart C, OprisiuR et al. Role of calcium carbonate administration timing in relation to food intake on its efficiency in controlling hyperphosphatemia in patients on maintenance hemodialysis, Artif Organs. 2002; 22:564–8.

21.Osler P, Raniga P and Farrington K. Effect of omeprazole on the phosphate-binding capacity of calcium carbonate (letter to the editor), Nephron. 1995; 69:89–90.

22.Graziani G, Badalamenti S and Como G. Calcium and phosphate plasma levels in dialysis patients after dietary Ca-P overload. Role of gastric acid secretion, Nephron. 2002; 91: 474–9.

23.Carr C and Shangraw R. Nutritional and pharmaceutical aspects of calcium supplementation, Am Pharm. 2005; 27:49–50, 54– 57.

24.Straub DA. Calcium supplementation in clinical practice: a review of forms, doses, and indications, NutrClinPract. 2010; 22:286– 96.

25.YX Yang and DC Metz. Peptic ulcer disease, Diagnosis and Management In: Al-Kawas F (ed.), Gastrointestinal Diseases: an Endoscopic Approach, 2ndEdn, SLACK Incorporated, USA. 2002, PP.385-410.

26.Mizunashi K, Furukawa Y, Katano K and Abe K. Effect of omeprazole an inhibitor of H+/ K+-ATPase, on bone resorption in humans, Calcif Tissue Int. 2009; 53: 21-5.

27.Hilliard SD. O’Donnell JF and Schenker S, on the nature of the inhibitor of urinary alkaline phosphatase, ClinChem. 1998; 11:570 –574.
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How to Cite
Aboelyazeed, H., S. El-haggar, and K. Okasha. “COMPARATIVE STUDY BETWEEN THE EFFECT OF HISTAMINE RECEPTOR ANTAGONISTS OF TYPE II (FAMOTIDINE) AND PROTON PUMP INHIBITORS (OMEPRAZOLE) ON THE EFFICACY OF CALCIUM CARBONATE AS PHOSPHATE BINDER IN HAEMODIALYSIS PATIENT”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 9, no. 8, Aug. 2017, pp. 10-14, doi:10.22159/ijpps.2017v9i8.12072.
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