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.
Should be taken with food.
Patients w/ hypophosphataemia or bowel obstruction.
Patients w/ dysphagia, swallowing disorders, severe GI motility disorders, active inflammatory bowel disease or major GI tract surgery. Pregnancy and lactation.
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.
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.
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.
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