Sevelamer
Mechanism :
Sevelamer binds phosphate within the intestinal lumen, limiting absorption and decreasing serum phosphate concentrations.
Indication :
- Control of serum phosphorous
Contraindications :
Hypersensitivity to sevelamer or any component of the formulation; bowel obstruction: hypophosphatemia, active mucosal injury.
Dosing :
Safety and efficacy not established in children <6 years.
Body surface area (BSA) ≥0.75 to <1.2 m²:
800 mg per meal; titrate as needed by 400 mg per dose at 2 week intervals.
BSA ≥1.2 m²:
1,600 mg per meal; titrate as needed by 800 mg per dose at 2 week intervals.
Adverse Effect :
Metabolic acidosis, vomiting, nausea, diarrhea, dyspepsia, abdominal pain, constipation, flatulence, peritonitis.
Interaction :
Cyclosporine, Tacrolimus: Sevelamer may decrease the serum concentration of Cyclosporine.
Levothyroxine: Sevelamer may decrease the serum concentration of Levothyroxine.
Mycophenolate: Sevelamer may decrease the serum concentration of Mycophenolate.
Quinolones: Sevelamer may decrease the absorption of Quinolones.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Unlikely to be dialysed. Dose as in normal renal function |
| HDF/High flux | Unlikely to be dialysed. Dose as in normal renal function |
| CAV/VVHD | Unlikely to be dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.