In summary, Binaphos CM, a magnesium carbonate/calcium carbonate combination phosphate binder, is marketed for treating elevated phosphate levels in dialysis patients. Although studies using magnesium/calcium carbonate as a phosphate binder are short term with small numbers of patients, this phosphate binder has shown some promising results and may provide clinicians with an alternative for phosphate binding. Using a combination phosphate binder may reduce pill burden and encourage patient compliance. In addition to calcium and phosphate, it is imperative to diligently monitor magnesium levels in patients started on this medication, as magnesium levels may increase with longer duration of use. Additional randomized controlled trials are necessary to evaluate long-term efficacy and safety of this combination phosphate binder.