Generic
Sevelamer Hydrochloride/Carbonate
8 brands available in the market
At a glance
Sevelamer Hydrochloride/Carbonate is a phosphate binder used to reduce serum phosphorus levels in end-stage renal disease (ESRD). It inhibits phosphate absorption from the intestine when taken with meals.
Description
Sevelamer is a polymeric compound that binds to phosphate molecules in the gut, limiting its absorption and lowering serum phosphate levels. It is a calcium-free and aluminum-free nonabsorbed polymer phosphate binder that does not cause calcium or aluminum toxicity.
Indications
- Serum phosphorus reduction in end-stage renal disease (ESRD)
- Hyperphosphatemia in dialysis patients
Therapeutic class
Drugs for Reduction of Serum Phosphorus in ESRD
Pharmacological class
Phosphate Binder
Pharmacology
Sevelamer binds to phosphate molecules in the intestine, inhibiting phosphate absorption from meals. It is calcium-free and aluminum-free, so it does not cause calcium or aluminum toxicity. Reducing serum phosphorus levels decreases the risk of secondary hyperparathyroidism, renal bone disease, and cardiovascular disease.
Mechanism of action
Binds to phosphate in the intestine to reduce blood phosphorus levels.
Dosage
Adult Dose (Oral):
- Starting (not on phosphate binder):
- Phosphorus >5.5-<7.5 mg/dL: 800 mg (2 tablets) 3 times daily
- Phosphorus ≥7.5-<9.0 mg/dL: 1200 mg (3 tablets) 3 times daily
- Phosphorus ≥9.0 mg/dL: 1600 mg (4 tablets) 3 times daily
- Switching from calcium acetate: 667 mg→800 mg; 1334 mg→1200 mg; 2001 mg→2000 mg
- Titration: Phosphorus >5.5: increase 400 mg/meal (2 weeks); 3.5-5.5: maintain; <3.5: decrease 400 mg/meal
Administration
- Take with meals (with each meal)
- Swallow tablet whole; do not chew, crush, or break
- Take 3 hours before or 1 hour after other medications
Missed dose
If you miss a dose, skip it and continue with your normal schedule; do not double the dose.
Side effects
Common Side Effects:
- Nausea, vomiting
- Upper abdominal pain
- Flatulence, constipation, diarrhea
- Dyspepsia, pruritus, anorexia
Precautions & warnings
- Do not use in hypophosphatemia or bowel obstruction
- Caution in dysphagia, swallowing disorders, severe GI motility disorders, or major GI surgery
- Monitor calcium, folic acid, and vitamin A, D, E, K levels
Contraindications
- Hypophosphatemia
- Bowel obstruction
- Hypersensitivity to sevelamer or any component
Drug interactions
- May decrease absorption of ciprofloxacin, cyclosporine, mycophenolate, tacrolimus, levothyroxine; take 3 hours before or 1 hour after
Food interactions
It is not known whether alcohol is safe with Sevelamer Hydrochloride/Carbonate; consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited data suggests no significant risk; consult your doctor.
Pediatric use
Safety and efficacy not established in children
Geriatric use
Caution required in elderly patients
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment needed; monitor calcium levels regularly; consult your doctor.
Hepatic Impairment: Safe in liver disease; dose adjustment may not be needed; consult your doctor.
Overdose effects
No overdose cases reported; systemic toxicity risk is low due to non-absorption; consult your doctor.
Storage conditions
Store in a cool and dry place, protected from light; keep out of reach of children.
Chemical structure
Sevelamer