Renvela: Adult Dosing

Dosage forms: 800

hyperphosphatemia, dialysis pts

800-1600 mg PO tid

Start: 800 mg PO tid if PO4 = 5.5-7.5 mg/dL; 1600 mg PO tid if >7.5 mg/dL; Max: 14 g/day; Info: give w/ meals; give other drugs 1h before or 3h after; adjust by 800 mg tid q2wk to keep PO4 3.5-5.5 mg/dL; 800 mg = 667 mg calcium acetate

renal dosing

no adjustment

hepatic dosing

not defined

Renvela: Peds Dosing

This information is currently unavailable or not applicable for this drug.

Renvela: Contraindications/Cautions

• hypersens. to drug/class/compon.
• hypophosphatemia
• intestinal obstruction
• caution if swallowing disorder
• caution if GI motility disorder
• caution if constipation, severe
• caution if major GI tract surgery

Renvela: Drug Interactions

Monitor/Modify Tx

• antiarrhythmics, class I

• antiarrhythmics, class III

• anticonvulsants

• ciprofloxacin

• levothyroxine

Renvela: Adverse Reactions

Serious Reactions

• fecal impaction
• ileus (rare)
• intestinal obstruction (rare)
• intestinal perforation (rare)

Common Reactions

• vomiting
• nausea
• diarrhea
• dyspepsia
• abdominal pain
• flatulence
• constipation

Renvela: Safety Monitoring

Pregnancy: C

Lactation: Safety Unknown

Monitoring Parameters: Cl, HCO3; folic acid; 25-hydroxycalciferol; PT/aPTT

Renvela: Pharmacology

Metabolism: none; CYP450: none; Info: no systemic absorption

Excretion: feces; Half-life: unknown

Class: Electrolytes/Acid-Base

Mechanism Of Action
binds intestinal phosphate (cationic polymer)

Renvela: Manufacturer/Pricing

Manufacturer: Genzyme Corp. DEA/FDA: Rx

Renvela: Patient Education

• Generic Name: sevelamer

• Pronounced: se VEL a mer

• Brand Name: Renagel

What is the most important information I should know about sevelamer?

You should not take this medication if you are allergic to sevelamer, or if you have a low blood level of phosphorus (hypophosphatemia), or a blockage in your intestines.

Before taking sevelamer, tell your doctor if you have trouble swallowing, severe constipation, a digestive disorder of your stomach or intestines, or if you have recently had stomach or intestinal surgery.

Avoid taking any other medicines within 1 hour before or 3 hours after you take sevelamer. Sevelamer can bind to other medications and make them less effective.

Before taking sevelamer, tell your doctor if you are taking ciprofloxacin (Cipro), a heart rhythm medication, or a seizure medication.

Do not take calcium or other mineral supplements without your doctor's advice. Use only the specific type of calcium or mineral supplement your doctor recommends.

What is sevelamer?

Sevelamer is a phosphate binder. Sevelamer helps prevent hypercalcemia (high levels of calcium in the body) caused by elevated phosphorus.

Sevelamer is used to reduce blood levels of phosphorus in people with chronic kidney disease who are on dialysis.

Sevelamer may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking sevelamer?

You should not take this medication if you are allergic to sevelamer, or if you have:

• a low blood level of phosphorus (hypophosphatemia); or
• a blockage in your intestines.

Before taking sevelamer, tell your doctor if you are allergic to any drugs, or if you have:

• trouble swallowing;
• severe constipation;
• a digestive disorder of your stomach or intestines; or
• if you have recently had stomach or intestinal surgery.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether sevelamer passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take sevelamer?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take sevelamer with meals.

Do not crush, chew, or break the sevelamer tablet. Swallow the pill whole. Sevelamer tablets expand when they are wet, and breaking or crushing the pill may make it harder to swallow.

To be sure this medication is helping your condition and not causing harmful effects, your blood may need to be tested on a regular basis. Do not miss any scheduled appointments.

Sevelamer may be only part of a complete program of treatment that also includes a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must eat or avoid to help control your condition.

Store sevelamer tablets at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Since sevelamer is not absorbed by the body, an overdose of this medication is not likely to cause life-threatening symptoms.

What should I avoid while taking sevelamer?

Avoid taking any other medicines within 1 hour before or 3 hours after you take sevelamer. Sevelamer can bind to other medications and make them less effective.

Do not take calcium or other mineral supplements without your doctor's advice. Use only the specific type of calcium or mineral supplement your doctor recommends.

What are the possible side effects of sevelamer?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• severe stomach pain or constipation;
• fever, chills, body aches, flu symptoms;
• feeling like you might pass out;
• sudden numbness or weakness anywhere in your body; or
• wheezing, chest tightness, trouble breathing.

Less serious side effects may include:

• headache;
• nausea, vomiting, upset stomach;
• diarrhea, constipation, gas;
• cough, sore throat;
• arm or leg pain;
• itching; or
• constipation.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect sevelamer?

The following drugs can interact with sevelamer. Tell your doctor if you are taking any of these:

• ciprofloxacin (Cipro);
• a heart rhythm medication; or
• a seizure medication.

This list is not complete and there may be other drugs that can interact with sevelamer. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about sevelamer.

---

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Renvela: Pill Pictures

This information is currently unavailable or not applicable for this drug.