Formulary
Vadadustat: Indications, Dosing, Side Effects and Interactions
Vadadustat is a hypoxia-inducible factor, prolyl hydroxylase inhibitor (HIF-PHI), which stimulates a coordinated erythropoietic response, thereby increasing...
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Vadadustat: Indications, Dosing, Side Effects and Interactions
Vadadustat is a hypoxia-inducible factor, prolyl hydroxylase inhibitor (HIF-PHI), which stimulates a coordinated erythropoietic response, thereby increasing...
Drug action
Vadadustat is a hypoxia-inducible factor, prolyl hydroxylase inhibitor (HIF-PHI), which stimulates a coordinated erythropoietic response, thereby increasing iron mobilisation and haemoglobin production.
Indications and dose
**Symptomatic anaemia associated with chronic kidney disease in patients on chronic maintenance dialysis (initiated by a specialist)**
- **Adult** (By Mouth): Initially 300 mg once daily, dose to be adjusted in increments of 150 mg, and increased no more frequently than every 4 weeks, to achieve or maintain a haemoglobin concentration of 10 to 12 g/dL. For further information on dose titration and treatment interruption, or converting patients from an epoetin-consult product literature. Usual maintenance 150-600 mg once daily. Consider discontinuation of treatment if adequate increase in haemoglobin concentration not achieved in 24 weeks.
Cautions
Major adverse cardiovascular events; seizures (history of, or risk factors for); thromboembolic events (history of, or risk factors for)
Side effects
Common or very common Constipation; cough; diarrhoea; embolism and thrombosis; headache; hypersensitivity; hypertension; hypotension; nausea; seizure; vomiting Frequency not known Cerebrovascular insufficiency; hepatocellular injury; myocardial infarction
Interactions
**Severe interactions:**
- Table 2: Potential clinically significant drug interactions between vadadustat and BCRP substrates Co-administered medicinal product Effect on concentration Clinical comment Sulfasalazine 4.5-fold ...
**Other interactions (25):**
- Vadadustat was an inducer of CYP2B6 in in vitro experiments.
- Effect of other medicinal products on the pharmacokinetics of vadadustat Iron supplements, phosphate binders and other medicinal products whose primary component consists of multivalent cations.
- Co-administration with oral iron supplements (e.g., ferric citrate, ferrous sulphate, sodium ferrous citrate), products whose primary component consists of iron, iron-containing phosphate binders...
- The co-administration of each oral iron-based drug reduced the bioavailability of vadadustat up to 90% and 92% in terms of the AUC and C max .
- The co-administration of non-iron-containing phosphate binders reduced the bioavailability of vadadustat up to 55% and 52% for AUC and C max .
- Vafseo should be administered at least 1 hour before oral iron supplements, products whose primary component consists of iron or iron-containing phosphate binders.
Pregnancy
Use only if potential benefit outweighs risk (limited information available). M
Breast feeding
Avoid (no information available). M
Hepatic impairment
Avoid in severe impairment (no information available). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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