Fosfamer Dosage/Direction for Use

General: Adults and Elderly (>65 years): Patients Not Taking a Phosphorus Binder: The recommended starting dose for patients not taking a phosphate binder is 800 to 1600 mg, which can be administered as one to two Sevelamer carbonate 800 mg tablets with each meal based on serum phosphorus level. (See Table 1.)

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Patients Switching From a Calcium-Based Binder: When patients are converting from a calcium based phosphate binder, Sevelamer hydrochloride should be given in equivalent doses on a mg for mg weight basis compared to the patient's previous calcium based phosphate binder. Table 2 gives recommended starting doses of Sevelamer Carbonate based on a patient's current calcium acetate dose. (See Table 2.)

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Dose Titration for All Patients Taking Sevelamer Carbonate: Serum phosphorus levels should be closely monitored and the dose of Sevelamer Carbonate adjusted accordingly with the goal of lowering serum phosphorus to 1.78 mmol/L (5.5 mg/dL) or less. Serum phosphorus should be tested every 2 to 3 weeks until a stable serum phosphorus level is reached, and on a regular basis thereafter.
Special Populations: Use in Children: The safety and efficacy of Sevelamer Carbonate has not been established in patients below the age of 18 years.
Use in the Elderly: Same as adults.
Administration: Route of administration is oral.
Sevelamer Carbonate 800 mg tablets can be taken three times per day with meals at a dosage based on individual patient requirements to control phosphate levels. Tablets should be swallowed intact and should not be crushed, chewed, or broken into pieces prior to administration.