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

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