Generic Name: Sevelamer hydrochloride Brand Name(s): Generics only. No brands available.

Uses

What is Sevelamer hydrochloride used for?

Sevelamer hydrochloride is used to lower high blood phosphorus (phosphate) levels in patients who are on dialysis due to severe kidney disease. Dialysis removes some phosphate from your blood, but it is difficult to remove enough to keep your phosphate levels balanced. Decreasing blood phosphate levels can help keep your bones strong, prevent unsafe buildup of minerals in your body, and possibly decrease the risk of heart disease and strokes that can result from high phosphate levels. Sevelamer works by holding onto phosphate from the diet so that it can pass out of your body.

How should I take Sevelamer hydrochloride?

Take this medication by mouth as directed by your doctor, usually 3 times daily with meals. Swallow the tablet whole. Do not crush, chew, or split the tablet. The dosage is based on your medical condition, any other medications you take to lower your phosphate levels, and your response to treatment. In children, the dosage is also based on body size.

If you are taking the powder form of this medication, check the manufacturer package directions for mixing with water, beverage, or food and taking it within 30 minutes. Follow the directions for the proper amount of water to use for your dose. Stir the mixture well and drink all of it. If the powder settles to the bottom of the cup, stir again right before drinking. You may also mix the powder with a small amount of food or beverage to take as part of a meal. If mixing with food or beverage, do not heat the powder or add to heated foods or liquids.

Take this medication regularly in order to get the most benefit from it. Remember to take it 3 times a day with meals, or on the schedule given to you by your doctor.

How do I store Sevelamer hydrochloride?

Sevelamer hydrochloride is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Sevelamer hydrochloride in the bathroom or the freezer. There may be different brands of Sevelamer hydrochloride that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Sevelamer hydrochloride down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Sevelamer hydrochloride?

Before taking sevelamer, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood phosphorus levels, stomach/intestinal problems (such as blockage, constipation), stomach/intestinal surgeries, swallowing problems (dysphagia).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Sevelamer hydrochloride during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Sevelamer hydrochloride. Sevelamer hydrochloride is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Sevelamer hydrochloride?

Headache, diarrhea, stomach upset, nausea, vomiting, cough, gas, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: problems with your dialysis access site, severe constipation/inability to have a bowel movement, stomach/abdominal pain or swelling.

Get medical help right away if you have any very serious side effects, including: trouble breathing, chest pain, pain/redness/swelling in the lower legs.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Sevelamer hydrochloride?

Sevelamer may interfere with the effectiveness of some drugs (including ciprofloxacin, mycophenolate, thyroid medications such as levothyroxine, among others) by making it more difficult for them to be absorbed by the stomach. Ask your pharmacist about the best times to take your other medications.

Sevelamer hydrochloride may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Sevelamer hydrochloride?

Sevelamer hydrochloride may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Sevelamer hydrochloride?

Sevelamer hydrochloride may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Sevelamer hydrochloride.

What is the dose of Sevelamer hydrochloride for an adult?

Usual Adult Dose for Hyperphosphatemia of Renal Failure

Initial Dosing for patients not on a phosphate binder: 800 mg to 1600 mg orally 3 times a day with meals

Based on serum phosphorus level:

-Phosphorus greater than 5.5 to less than 7.5 mg/dL: 800 mg 3 times a day with meals

-Phosphorus greater than or equal to 7.5 mg/dL: 1600 mg 3 times a day with meals

-Titrate in increments of 800 mg 3 times a day at 2-week intervals with the goal of controlling serum phosphorus within target range.

Average prescribed dose: 7.2 g/day (2.4 g with each meal)

Maximum studied dose: 14 g per day (carbonate); 13 g per day (hydrochloride)

Switching from the hydrochloride salt to carbonate: Use the same dose, however further titration may be necessary to achieve desired phosphorus levels.

Switching from calcium acetate: Substitute approximately mg for mg

Comment: Treatment of hyperphosphatemia includes reduction in dietary intake of phosphate, inhibition of intestinal phosphate absorption with phosphate binders, and removal of phosphate with dialysis.

Use: To control serum phosphorus levels in patients with chronic kidney disease on dialysis.

Renal Dose Adjustments

No adjustment recommended

Dose Adjustments

Dosage should be adjusted based on the serum phosphorus level: Target serum phosphorus level should be 5.5 mg/dL or less:

-Levels greater than 5.5 mg/dL: Increase by 800 mg per meal at 2 week intervals.

-Levels between 3.5 and 5.5 mg/dL: Maintain current dose

-Levels less than 3.5 mg/dL: Decrease 1 tablet per meal

Dialysis

No adjustment recommended

Other Comments

Administration advice:

-Take orally 3 times a day with meals

Concomitant administration of oral medications:

-Patients who are taking concomitant oral medications that may be clinically altered by a reduction in bioavailability should be advised to take these medications at least 1 hour before or 3 hours after taking sevelamer.

Storage requirements:

-Protect from moisture

Reconstitution/preparation techniques: Oral suspension:

-Place the entire contents of packet in a cup and mix with appropriate amount of water (i.e., 0.8 g packet with 30 mL; 2.4 g packet with 60 mL).

-Multiple packets may be mixed together with the appropriate amount of water.

-Stir vigorously before drinking; consume within 30 minutes

-Powder does not dissolve in water.

General:

-Treatment of hyperphosphatemia includes reduction in dietary intake of phosphate, inhibition of intestinal phosphate absorption with phosphate binders, and removal of phosphate with dialysis. This drug taken with meals has been shown to control serum phosphorus concentrations in patients with CKD who are on dialysis.

Monitoring:

-Monitor serum phosphorus levels for efficacy.

-Monitor for constipation.

-Monitor bicarbonate and chloride levels.

-Monitor for reduced folate and vitamin D, E, and K levels.

-Monitor clinical response and/or blood levels of concomitant oral medications that have narrow therapeutic ranges.

Patient advice:

-Instruct patients to take this medication with meals and adhere to their prescribed diets.

-If significant interactions are expected, patients may need to separate administration times of their concomitant medications.

-Instruct patients to report new onset or worsening of constipation promptly.

What is the dose of Sevelamer hydrochloride for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Sevelamer hydrochloride available?

Sevelamer hydrochloride is available in the following dosage forms and strengths:

  • Oral tablet,
  • Oral powder for reconstitution,
  • Oral capsule.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Sevelamer hydrochloride, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 26, 2018 | Last Modified: April 26, 2018

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.