Sevelamer: Uses, Warnings, Side Effects, Administration and Interactions

It is a phosphate binder. This medicine helps prevent low levels of calcium in the body ( hypocalcemia ) that are caused by increasing levels of phosphorus.

It is also used to control phosphorus levels in people who are on dialysis for chronic kidney disease. The drug may have other uses as well.

Important information

You should not take this medicine if you have a  bowel obstruction .

Warnings

You should make sure that you are not allergic to the drug first, and you should have a discussion with your doctor, before consuming sevelamer, if you experience any of these symptoms / problems:

  • Slow digestion
  • Difficulty to swallow.
  • Severe constipation
  • Stomach disorders
  • Intestinal disorders

Or if you have recently had stomach or intestinal surgery.

The use of this medicine is prohibited for persons under 6 years of age.

Sevelamer and pregnancy

It is not known whether the drug can harm an unborn child, so talk to your doctor about taking sevelamer if you are pregnant or planning to have a child.

There may be a decrease in the levels of certain vitamins or folic acid while taking this medicine in pregnancy, so you need to discuss with your doctor what supplements you need for pregnancy.

Sevelamer and breastfeeding

It is not expected to be harmful to a nursing baby as the drug is not absorbed into the bloodstream.

Side effects of sevelamer

Seek emergency medical attention if you happen to be allergic to the drug. Symptoms of an allergic reaction to sevelamer are:

  • Swelling of the lips, tongue, throat, or face.
  • Hives
  • Difficulty breathing.

Stop taking the medication and contact your doctor if you experience any of the following symptoms:

  • Severe constipation that does not improve and may be accompanied by stomach pains.
  • Black, tarry, or bloody stools.
  • Trouble swallowing or choking.

The most common side effects include:

  • Stomachache.
  • Loss of appetite
  • Upset stomach, bloating, and / or gas.
  • Constipation.
  • Diarrhea.
  • Nausea or vomiting
  • Itching and / or pain in the joints.
  • Feeling tired.

Management

Follow all directions on your prescription label and the directions and orders your doctor gives you. Do not change doses without your doctor’s permission. It is recommended to eat sevelamer with food.

The sevelamer powder must be dissolved in water before taking it. The 0.8 gram packet should be mixed with at least 1 ounce (2 tablespoons) of water. The 2.4 gram package should be mixed with at least 2 ounces (4 tablespoons) of water.

Stir the powder in water until it dissolves completely. Stir and drink this mixture right away. To get the full dose, add a little more water to the same glass, swirl gently, and drink immediately.

You may need to have frequent blood tests while taking this medicine.

Call your doctor if you have trouble swallowing the tablet or if it feels like it gets stuck in your esophagus after swallowing it.

Your doctor may also choose foods for a diet to accompany the use of medicine for your treatment.

Sevelamer dosage information

Usual adult dose for hyperphosphatemia of renal failure:

Starting dose for patients not on a phosphate binder: 800 mg to 1600 mg orally 3 times a day with meals

Based on the serum phosphorus level:

  • Phosphorus greater than 5.5 to less than 7.5 mg / dL: 800 mg 3 times a day with meals.
  • Phosphorus greater than or equal to 7.5 mg / dL: 1600 mg 3 times a day with meals.

Treat yourself in 800 mg increments 3 times a day at 2 week intervals with the goal of keeping your serum phosphorus within the target range.

  • Average prescribed dose: 7.2 g / day (2.4 g with each meal).
  • Maximum dose studied: 14 g per day (carbonate); 13 g per day (hydrochloride).

Changing the salt from hydrochloride to carbonate:

  • Use the same dose, however, a new titration may be necessary to reach the desired phosphorus levels.

Exchange for calcium acetate:

  • Substitute approximately mg for mg.

Treatment of hyperphosphatemia includes reducing dietary phosphate intake, inhibiting intestinal phosphate absorption with phosphate binders, and eliminating phosphate with dialysis.

Use:  to control serum phosphorus levels in patients with chronic kidney disease on dialysis.

What medications should you avoid while taking sevelamer?

There is the possibility that you will take other medications that should not be combined with sevelamer. Sevelamer can also affect how well other medications can work in the body.

  • Ciprofloxacin (Cipro): should be taken at least 2 hours before or 6 hours after taking sevelamer.
  • Mycophenolate mofetil (C ellCept): should be taken at least 2 hours before taking sevelamer.