DIURETICS AND SEVELAMER

Sevelamer abolished the diuretic effect of furosemide 250 mg twice daily in a haemodialysis patient. Urine output returned to the patient's normal levels 24 hours after sevelamer was stopped, and the reduction in urine output was not seen when the dosing frequency was altered so that furosemide was taken in the morning and sevelamer at lunch and dinnertime.
If the effect of furosemide seems less than expected, give the furosemide at least 1 hour before or 3 hours after sevelamer.
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