Sevelamer


Concise Prescribing Info
Indications/Uses
Hyperphosphataemia in patients w/ chronic renal failure.
Dosage/Direction for Use
Adult : PO As sevelamer carbonate/HCl: Initial: 800-1600 mg tid. Doses should be adjusted based on serum phosphate level. Maintenance: 800-4,000 mg. Patients switching from Ca acetate based on current dosage: Ca acetate 667 mg is equivalent to sevelamer (carbonate/HCl) 800 mg.
Dosage Details
Oral
Hyperphosphataemia in patients with chronic renal failure
Adult: As sevelamer carbonate or HCl: Initially, 800-1,600 mg tid. Doses should be adjusted based on serum phosphorus level: 5.5-<7.5 mg/dL: 800 mg tid; ≥7.5-<9 mg/dL: 1,200-1,600 mg tid; ≥9 mg/dL: 1,600 mg tid. Maintenance: 800-4,000 mg. Patients switching from Ca acetate based on current dosage: Ca acetate 667 mg is equivalent to sevelamer (carbonate or HCl) 800 mg.
Administration
Should be taken with food.
Contraindications
Patients w/ hypophosphataemia or bowel obstruction.
Special Precautions
Patients w/ dysphagia, swallowing disorders, severe GI motility disorders, active inflammatory bowel disease or major GI tract surgery. Pregnancy and lactation.
Adverse Reactions
Faecal impaction, hypercalcaemia, oesophageal and dysphagia, diarrhoea, flatulence, ileus, peritonitis, diverticulitis, dyspepsia, intestinal obstruction and perforation, nausea, vomiting, constipation, pruritus, rash.
MonitoringParameters
Monitor serum levels of phosphate, Ca, Cl and bicarbonate. Vitamin supplementation due to reduction in vit D, E, K and folic acid absorption. Monitor for signs and symptoms of peritonitis in patients undergoing peritoneal dialysis.
Drug Interactions
May decrease absorption of ciprofloxacin, ciclosporin, mycophenolate, tacrolimus and levothyroxine. Sevelamer should be given 3 hr before or 1 hr after taking other drugs to minimise potential pharmacokinetic interaction.
Action
Description: Sevelamer, a polymeric compound, acts by binding to phosphate molecules in the gut, limiting its absorption and thus lowering serum phosphate levels w/o altering Ca, Al, or bicarbonate levels.
Pharmacokinetics:
Absorption: Not systemically absorbed.
Excretion: Via faeces.
Chemical Structure

Chemical Structure Image
Sevelamer

Source: National Center for Biotechnology Information. PubChem Database. Sevelamer, CID=3085017, https://pubchem.ncbi.nlm.nih.gov/compound/Sevelamer (accessed on Jan. 23, 2020)

Storage
Store at 25°C.
References
Anon. Sevelamer . Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/08/2015.

Anon. Sevelamer. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/11/2013.

Buckingham R (ed). Sevelamer. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/08/2015.

Joint Formulary Committee. Sevelamer. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/11/2013.

McEvoy GK, Snow EK, Miller J et al (eds). Sevelamer. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). http://www.medicinescomplete.com/mc/ahfs/current/. Accessed 11/08/2015.

Disclaimer: This information is independently developed by MIMS based on Sevelamer from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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