SEVELAMER HYDROCHLORIDE
SEVELAMER HYDROCHLORIDE  (se-vel'a-mer)  Renagel Classifications: electrolyte and water balance agent; phosphate binder; Therapeutic: phosphate binder Pregnancy Category: C |
Availability
403 mg capsules; 400 mg, 800 mg tablets
Action
Polymer that binds intestinal phosphate; interacts with phosphate by way of ion-exchange and hydrogen binding. Advantageously, does not contain aluminum or calcium in treating hyperphosphatemia in end stage kidney failure.
Therapeutic Effect
Indicated by a serum phosphate level ≤6.0 mg/dL.
Uses
Reduction of serum phosphorus in patients with end-stage kidney disease.
Contraindications
Hypophosphatemia; hypersensitivity to sevelamer HCl; fecal impaction; bowel obstruction; hypophosphatemia; appendicitis; dysphagia, GI bleeding, major GI surgery; pregnancy (category C), lactation. Safety and efficacy in children <18 y are not established.
Cautious Use
GI motility disorders; vitamin deficiencies (especially vitamins D, E, and K and folic acid).
Route & Dosage
| Hyperphosphatemia Adult: PO 2 capsules or tablets t.i.d. for serum phosphorus >6 and <7.5 mg/dL; 3 capsules or tablets t.i.d. for serum phosphorus >7.5 and <9 mg/dL; 4 capsules or tablets t.i.d. for serum phosphorus ≥9 mg/dL |
Administration
Oral- Give with meals; do not open or chew capsule.
- Give other oral medications 1 h before or 3 h after Renagel.
- Discard capsules after printed expiration date.
- Store at 15°–30° C (59°–86° F); protect from moisture.
Adverse Effects (≥1%)
Body as a Whole: Headache, infection, pain. CV: Hypertension, hypotension, thrombosis. GI: Diarrhea, dyspepsia, vomiting, nausea, constipation, flatulence. Respiratory: Increased cough.Nursing Implications
Assessment & Drug Effects
- Lab tests: Obtain frequent serum phosphate levels.
Patient & Family Education
- Do not use capsules after printed expiration date.
- Take daily multivitamin supplement approved by physician.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; Prototype drug