Trade Names:Renagel- Tablets (as hydrochloride) 400 mg- Tablets (as hydrochloride) 800 mg
Trade Names:Renvela- Tablets (as carbonate) 800 mg- Suspension, oral (as carbonate) 0.8 g per packet- Suspension, oral (as carbonate) 2.4 g per packet
Decreases intestinal phosphate absorption by binding to phosphate in the GI tract.
Not systemically absorbed.
No data available.Hepatic Function Impairment
No data available.
Reduction of serum phosphorus in patients with chronic kidney disease who are on hemodialysis.
Treatment of hyperuricemia in patients undergoing hemodialysis.
Hypophosphatemia or bowel obstruction.
PO Serum phosphate of more than 5.5 and less than 7.5 mg/dL, start with 800 mg 3 times daily with meals. Serum phosphate of at least 7.5 and less than 9 mg/dL, start with 1,200 or 1,600 mg 3 times daily with meals. Serum phosphate of 9 mg/dL or more, start with 1,600 mg 3 times daily with meals.Sevelamer Carbonate
PO Serum phosphate of more than 5.5 and less than 7.5 mg/dL, start with 800 mg 3 times daily with meals. Serum phosphate 7.5 mg/dL or more, start with 1,600 mg 3 times daily with meals.Switching From Calcium AcetateAdults Sevelamer Hydrochloride
PO Start with 800 mg with meals in patients receiving calcium acetate 667 mg with meals. Start with 1,200 or 1,600 mg with meals for patients receiving calcium acetate 1,334 mg with meals. Start with 2,000 or 2,400 mg with meals for patients receiving calcium acetate 2,001 mg with meals.Sevelamer Carbonate
PO Start with 800 mg with meals in patients receiving calcium acetate 667 mg with meals. Start with 1,600 mg with meals for patients receiving calcium acetate 1,334 mg with meals. Start with 2,400 mg with meals for patients receiving calcium acetate 2,001 mg with meals.Dose TitrationAdults Sevelamer Hydrochloride
PO Serum phosphorus of more than 5.5 mg/dL, increase by 1 tablet per meal at 2-wk intervals. Serum phosphorus of 3.5 to 5.5 mg/dL, maintain current dose. Serum phosphorus of less than 3.5 mg/dL, decrease by 1 tablet per meal.Sevelamer Carbonate
PO Titrate dose by 800 mg 3 times daily with meals at 2-wk intervals as necessary.
Store at 59° to 86°F. Protect from moisture.
Bioavailability of ciprofloxacin may be reduced about 50%, possibly decreasing the clinical effect. If coadministration cannot be avoided, separate the administration by at least 4 h.Mycophenolate
Sevelamer may reduce mycophenolic acid plasma concentrations, decreasing the efficacy. Administer sevelamer 2 h after mycophenolate mofetil.Thyroid hormones (eg, levothyroxine)
The efficacy of thyroid hormones may be decreased, resulting in hypothyroidism. Separate administration by at least 4 h. Monitor TSH levels and the patient for signs of hypothyroidism.
None well documented.
Pruritus, rash (postmarketing).
Vomiting (22%); nausea (20%); diarrhea (19%); dyspepsia (16%); abdominal pain (9%); constipation, flatulence, peritonitis (8%); fecal impaction, ileus, intestinal obstruction, intestinal perforation (postmarketing).
Monitor serum phosphorus calcium, bicarbonate, and chloride levels. Closely monitor patients on peritoneal dialysis to ensure the reliable use of appropriate aseptic technique with the prompt recognition and management of any signs and symptoms associated with peritonitis.
Category C .
Not absorbed systemically.
Safety and efficacy not established.
Use with caution, starting at the low end of the dosing range.
Use with caution in patients with dysphagia, swallowing disorders, severe GI motility disorders, or major GI tract surgery.
Sevelamer hydrochloride reduced vitamin D, E, and K (coagulation parameters) and folic acid levels in rats and dogs.
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