Cavsamir Dosage/Direction for Use

Starting Dose: One or two 800-mg tab 3 times daily with meals.
Because of the rapid disintegration of the carbonate salt tablet and its rapid reaction with the hydrochloric acid in the stomach, the dosing of sevelamer is anticipated to be similar to that of the hydrochloride salt.
Patients Not Taking a Phosphate Binder: Recommended Starting Dose: 800-1600 mg, which can be administered as 1 or 2 sevelamer 800-mg tablets, with meals based on serum phosphorus level. The table as follows provides the recommended starting doses of sevelamer for patients not taking a phosphate binder. (See Table 1.)

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Patients Switching From Sevelamer Hydrochloride: For patients switching from sevelamer hydrochloride, sevelamer carbonate should be prescribed on a gram per gram basis. Further titration to the desired phosphate levels may be necessary. The highest daily dose of sevelamer carbonate studied was 14 g in chronic kidney disease (CKD) patients on dialysis.
Patients Switching From Calcium Acetate: In a study in 84 CKD patients on hemodialysis, a similar reduction in serum phosphorus was seen with equivalent doses (approximately mg for mg) of sevelamer hydrochloride and calcium acetate. Table 2 gives recommended starting doses of CAVSAMIR based on a patient's current calcium acetate dose. (See Table 2.)

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Dose Titration for All Patients Taking sevelamer: The dose should be increased or decreased by 1 tab/meal at 2-week intervals, as necessary, with the goal of controlling serum phosphorus within the target range of 1.13-1.78 mmol/L.
Patients taking Sevelamer should adhere to their prescribed diets.
Paediatric population: The safety and efficacy of sevelamer carbonate has not been established in pediatric patients. Sevelamer is not recommended for use in children below 18 years.
For paediatric patients the oral suspension should be administered, as tablet formulations are not appropriate for this population.
Route of administration: For oral use.
Tablets should be swallowed intact and should not be crushed, chewed, or broken into pieces prior to administration.