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Indications and Dosage
Oral
Hyperphosphataemia in patients with chronic renal failure Adult: As sevelamer carbonate or HCl: Initially, 800-1,600 mg tid. Doses should be adjusted based on serum phosphorus level: 5.5-<7.5 mg/dL: 800 mg tid; ≥7.5-<9 mg/dL: 1,200-1,600 mg tid; ≥9 mg/dL: 1,600 mg tid. Maintenance: 800-4,000 mg. Patients switching from Ca acetate based on current dosage: Ca acetate 667 mg is equivalent to sevelamer (carbonate or HCl) 800 mg.
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Administration
Should be taken with food.
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Contraindications
Patients w/ hypophosphataemia or bowel obstruction.
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Special Precautions
Patients w/ dysphagia, swallowing disorders, severe GI motility disorders, active inflammatory bowel disease or major GI tract surgery. Pregnancy and lactation.
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Adverse Reactions
Faecal impaction, hypercalcaemia, oesophageal and dysphagia, diarrhoea, flatulence, ileus, peritonitis, diverticulitis, dyspepsia, intestinal obstruction and perforation, nausea, vomiting, constipation, pruritus, rash.
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Monitoring Parameters
Monitor serum levels of phosphate, Ca, Cl and bicarbonate. Vitamin supplementation due to reduction in vit D, E, K and folic acid absorption. Monitor for signs and symptoms of peritonitis in patients undergoing peritoneal dialysis.
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Drug Interactions
May decrease absorption of ciprofloxacin, ciclosporin, mycophenolate, tacrolimus and levothyroxine. Sevelamer should be given 3 hr before or 1 hr after taking other drugs to minimise potential pharmacokinetic interaction.
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Action
Description: Sevelamer, a polymeric compound, acts by binding to phosphate molecules in the gut, limiting its absorption and thus lowering serum phosphate levels w/o altering Ca, Al, or bicarbonate levels.
Pharmacokinetics: Absorption: Not systemically absorbed. Excretion: Via faeces. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Sevelamer, CID=3085017, https://pubchem.ncbi.nlm.nih.gov/compound/Sevelamer (accessed on Jan. 23, 2020) |
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Storage
Store at 25°C.
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MIMS Class
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References
Anon. Sevelamer . Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/08/2015. Anon. Sevelamer. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/11/2013. Buckingham R (ed). Sevelamer. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/08/2015. Joint Formulary Committee. Sevelamer. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/11/2013. McEvoy GK, Snow EK, Miller J et al (eds). Sevelamer. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). http://www.medicinescomplete.com/mc/ahfs/current/. Accessed 11/08/2015.
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