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Last updated: Acute Kidney Injury…
on 10 Apr 2017

Sevelamer



Indication
  • Hyperphosphataemia in patients receiving dialysis or patients with CKD with a serum phosphate >1.78 mmol/l
Preparations
  • Non-calcium, non-aluminium containing phosphate binding agent
  • Renagel® (sevelamer hydrochloride): 800 mg tablets
  • Sevelamer hydrochloride may cause metabolic acidosis, which can exacerbate secondary hyperparathyroidism and renal osteodystrophy (Brezina, 2004; De Santo, 2006; Barna, 2010). Sevelamar carbonate has been introduced to avoid this problem. Sevelamer carbonate is also licensed in pre-dialysis patients
  • Renvela® (sevelamer carbonate): 800 mg tablets and 2.4 g sachets of oral powder
  • Prescribe by brand
Contraindications
  • Bowel obstruction, hypophosphataemia, hypersensitivity to Sevelamer or to any of the excipients
Cautions
  • Gastro-intestinal disorders
Side-effects
  • Nausea, headache, abdominal pain
Dose
  • Tablets to be swallowed whole with meals and snacks. Adjust dose according to phosphate levels
  • Renagel (sevelamer hydrochloride): initially 2.4–4.8 g daily in 3 divided doses with meals (and snacks) , adjusted according to serum-phosphate concentration
  • Renvela (sevelamer carbonate): initially 2.4–4.8 g daily in 3 divided doses with meals, adjusted according to serum-phosphate concentration every 2–4 weeks
Dose in renal impairment
  • As in normal renal function
Interactions
  • May reduce levels of ciclosporin, mycophenolate mofetil, tacrolimus and cipropfloxacin
How to Prescribe View Details
Patient comment
  • Swallow the tablets whole with meals and snacks rich in phosphate foods. The powder should be dispersed in 60 mls water and taken within 30 minutes
  • Adhere to the dietary advice from a renal dietician. Phosphate binders work better if taken with foods containing phosphate. They should be taken with meals or snacks which include meat, fish, eggs, cheese, milk or pulses. They should not be taken with meals or snacks which do not include phosphate, such as toast, jam or salad sandwiches, biscuits or fruit

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