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Sevelamer Medication: Uses, Dosage, and Phosphate Binding
Sevelamer: Key Points and Overview
Sevelamer is a medication used to manage elevated phosphate levels in individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD). It works by binding to phosphate in the digestive tract, preventing its absorption into the bloodstream. This helps lower the risk of complications such as bone disease and cardiovascular problems. Sevelamer is typically prescribed alongside other treatments, and it’s important to follow your healthcare provider’s instructions closely.
Sevelamer Medication Names
US Brand Name: Renvela
Generic Name: Sevelamer
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name will be shown in parentheses.
Pharmacologic Category: Phosphate Binder
Sevelamer belongs to a class of medications known as phosphate binders, which are used to control high phosphate levels in patients with kidney disease.
Sevelamer Dosage and Administration
Sevelamer is prescribed to treat conditions related to kidney disease and elevated phosphate levels. Always follow your doctor’s instructions when taking this medication. If you have any questions about your dosage, consult one of our telemedicine providers promptly.
Sevelamer Dosage for Chronic Kidney Disease (CKD)
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels.
Sevelamer Dosage for End-Stage Renal Disease (ESRD)
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels.
Sevelamer for Hyperphosphatemia (High Phosphate Levels)
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels.
Sevelamer for Secondary Hyperparathyroidism
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate and parathyroid hormone levels.
Sevelamer for Renal Osteodystrophy
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels and bone health.
Sevelamer for Cardiovascular Disease
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels and cardiovascular risk factors.
Sevelamer for Diabetes Mellitus
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels and blood sugar control.
Sevelamer for Hypertension (High Blood Pressure)
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels and blood pressure control.
Sevelamer for Metabolic Acidosis
Initial dose: 800 to 1600 mg taken orally three times a day with meals. The dose may be adjusted based on your blood phosphate levels and acid-base balance.
Sevelamer Dosage Forms and Strengths
Sevelamer is available in the following forms:
- Tablet: 800 mg
- Powder for oral suspension: 0.8 g and 2.4 g packets
How to Take Sevelamer: Administration Instructions
Sevelamer should be taken with meals to effectively bind phosphate from the food you consume. Swallow the tablet whole; do not crush, chew, or break it. If you are using the powder form, mix it with water as directed by your healthcare provider. It’s essential to take Sevelamer exactly as prescribed to manage your phosphate levels effectively.
Sevelamer Contraindications
A contraindication is a specific condition or situation where a particular medication should not be used because it may cause harm. If you have any of the following conditions, Sevelamer may not be safe for you. Always consult your healthcare provider before starting any new medication, and consider scheduling a telemedicine appointment with one of our providers to discuss your options.
Bowel Obstruction: Sevelamer is contraindicated in patients with bowel obstruction, as it can worsen the blockage, potentially leading to severe complications such as perforation or infection.
Hypophosphatemia (Low Phosphorus Levels): Since Sevelamer lowers phosphorus levels, it should not be taken if your phosphorus levels are already too low. This could result in dangerously low phosphorus levels, which are essential for bone health and energy production.
Known Hypersensitivity to Sevelamer: If you have a known allergy to Sevelamer or any of its components, taking this medication could trigger an allergic reaction, which may include symptoms such as rash, swelling, or difficulty breathing.
Sevelamer Drug Interactions
Sevelamer may interact with other medications, potentially affecting their effectiveness or increasing the risk of side effects. Be sure to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Sevelamer:
Levothyroxine (Synthroid): Sevelamer can reduce the absorption of levothyroxine, a medication used to treat hypothyroidism, making it more challenging to manage your thyroid condition.
Ciprofloxacin (Cipro): Sevelamer can interfere with the absorption of ciprofloxacin, an antibiotic, reducing its effectiveness in treating infections.
Mycophenolate Mofetil (CellCept): Sevelamer may reduce the absorption of mycophenolate mofetil, a drug used to prevent organ rejection after a transplant, increasing the risk of rejection.
Anticonvulsants (e.g., Phenytoin, Dilantin): Sevelamer may reduce the effectiveness of anticonvulsants, increasing the risk of seizures.
Sevelamer in Pregnancy
Is it safe to take Sevelamer during pregnancy? The safety of Sevelamer in pregnant women has not been thoroughly studied. However, because Sevelamer is not absorbed into the bloodstream, it is generally considered to pose a low risk to the developing baby. Despite this, it is essential to discuss the potential risks and benefits with your healthcare provider before taking Sevelamer during pregnancy. If you’re pregnant or planning to become pregnant, consider scheduling a telemedicine appointment with one of our providers to review your treatment plan and ensure it’s the best option for you.
Sevelamer While Breastfeeding
Is it safe to take Sevelamer while breastfeeding? Similar to pregnancy, the safety of Sevelamer during breastfeeding has not been extensively researched. Since Sevelamer is not absorbed into the bloodstream, it is unlikely to pass into breast milk. However, it’s always advisable to consult your healthcare provider to carefully weigh the potential risks and benefits. If you’re breastfeeding and need guidance, our telemedicine providers are available to help you make an informed decision.
Estimated Cost of Sevelamer Medication
The cost of a 30-day supply of Sevelamer without insurance can vary. With a GoodRx coupon, the price typically ranges from $50 to $150, depending on the dosage and the pharmacy. It’s a good idea to compare prices at different pharmacies and take advantage of available discount programs to reduce out-of-pocket expenses. If you need more information on Sevelamer’s cost and availability, our team can assist you in finding the most affordable options.
Possible Alternatives to Sevelamer
If Sevelamer is not the right option for you, or if you’re interested in exploring other treatments, there are alternative medications and lifestyle changes that may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine visit with one of our providers to explore these options further.
Chronic Kidney Disease (CKD)
Alternatives to Sevelamer include other phosphate binders like calcium acetate (PhosLo) or lanthanum carbonate (Fosrenol). Managing CKD often involves dietary changes, such as reducing phosphorus intake by limiting dairy products, processed foods, and certain meats.
End-Stage Renal Disease (ESRD)
For patients with ESRD, phosphate binders like calcium carbonate (Tums) or aluminum hydroxide (Amphojel) may be used as alternatives. Dialysis is also a critical part of managing ESRD, and adhering to dietary restrictions on phosphorus is essential for effective treatment.
Hyperphosphatemia
In addition to Sevelamer, other phosphate binders like aluminum hydroxide or lanthanum carbonate can help lower phosphorus levels. Reducing dietary phosphorus intake is also a key component of managing hyperphosphatemia.
Secondary Hyperparathyroidism
Treatment options for secondary hyperparathyroidism include vitamin D analogs like calcitriol or paricalcitol (Zemplar), as well as medications like cinacalcet (Sensipar), which help regulate parathyroid hormone levels.
Renal Osteodystrophy
Managing renal osteodystrophy often involves controlling phosphorus levels with phosphate binders and supplementing with calcium and vitamin D. Weight-bearing exercises may also support bone health and improve overall outcomes.
Cardiovascular Disease
Lifestyle changes, such as adopting a heart-healthy diet and engaging in regular exercise, are important for managing cardiovascular disease. Medications like statins (e.g., atorvastatin, Lipitor) can help lower cholesterol, and maintaining good blood pressure control is also crucial.
Diabetes Mellitus
Managing diabetes involves controlling blood sugar levels through medications like metformin (Glucophage) or insulin, along with lifestyle changes such as following a balanced diet and incorporating regular physical activity.
Hypertension
Alternatives for managing high blood pressure include medications like ACE inhibitors (e.g., lisinopril, Zestril) or calcium channel blockers (e.g., amlodipine, Norvasc). Lifestyle modifications, such as reducing salt intake and increasing physical activity, are also important for effective blood pressure management.
Metabolic Acidosis
Sodium bicarbonate or other alkalinizing agents may be used to manage metabolic acidosis. Dietary changes, such as reducing protein intake, can also play a role in managing this condition.
Recent Updates on Sevelamer Research
Recent studies have continued to explore the benefits of Sevelamer beyond its role as a phosphate binder. Some research suggests that Sevelamer may offer additional cardiovascular benefits, such as reducing inflammation and lowering cholesterol levels in patients with chronic kidney disease. Ongoing studies are also investigating whether Sevelamer can help reduce the risk of vascular calcification, a common complication in patients with kidney disease. While these findings are promising, more research is needed to confirm these potential benefits. If you’re interested in learning more about the latest research on Sevelamer, consider scheduling a telemedicine consultation with one of our providers to discuss how these findings might impact your treatment plan.
