Pregnancy: There are no or limited amount of data from the use of sevelamer in pregnant women. Sevelamer has been shown to reduce the absorption of several vitamins including folic acid. The potential risk to humans is unknown. Sevelamer carbonate should only be given to pregnant women if clearly needed and after a careful risk/benefit analysis has been conducted for both the mother and the foetus.
Breast-feeding: It is unknown whether sevelamer/metabolites are excreted in human milk. The non-absorbed nature of sevelamer indicates that excretion of sevelamer in breast milk is unlikely. A decision on whether to continue/discontinue breast-feeding or to continue/discontinue therapy with sevelamer carbonate should be made taking into account the benefit of breast-feeding to the child and the benefit of sevelamer carbonate therapy to the woman.
Fertility: There are no data from the effect of sevelamer on fertility in humans. It has been shown that sevelamer did not impair fertility in male or female rats at exposures at a human equivalent dose 2 times the maximum dose of 13 g/day, based on a comparison of relative BSA.