Renvela

Indications

Sevelamer Carbonate is used to control high blood phosphate levels (hyperphosphataemia) in adults with chronic kidney disease, mainly those on dialysis. High phosphate can weaken bones and cause calcium to build up in blood vessels and the heart.

How It Works

Sevelamer is a phosphate binder. It is a polymer that is not absorbed into the body. In the gut, it binds phosphate from food, so the phosphate passes out in the stool instead of being absorbed into the blood. It contains no calcium or aluminium. It may also lower LDL cholesterol slightly.

Dosage and Administration

Take as prescribed. The usual starting dose for adults is 800 mg to 1,600 mg three times a day with meals, depending on the blood phosphate level; the doctor then adjusts the dose every 2 to 4 weeks according to blood tests. Take it with meals, not on an empty stomach. Swallow tablets whole; do not crush, chew or break them. Powder forms should be mixed with water as directed on the pack. Follow your prescribed low-phosphate diet.

Interactions

Sevelamer can reduce the absorption of some medicines taken at the same time, including Ciprofloxacin, Mycophenolate Mofetil, Levothyroxine, Ciclosporin and Tacrolimus. Medicines where a small change in level matters, such as anti-epileptics or anti-arrhythmics, should be taken at least 1 hour before or 3 hours after Sevelamer. Your doctor may check levels of some of these medicines.

Contraindications

• Allergy to Sevelamer or any ingredient
• Low blood phosphate
• Bowel obstruction

Side Effects

Common side effects are nausea, vomiting, diarrhoea, constipation, indigestion, wind and tummy pain. Rarely, severe constipation, bowel blockage, bowel perforation or inflammation of the gut lining can occur. Long-term use may lower levels of some vitamins (A, D, E, K and folic acid).

Get urgent medical help if you have severe tummy pain, severe constipation, swelling of the abdomen, vomiting that does not stop, blood in the stool or black stools, or signs of a severe allergic reaction.

Pregnancy and Lactation

Information in pregnancy and breastfeeding is limited. It is not absorbed into the body but may reduce absorption of vitamins. Use only if the doctor decides it is needed, with attention to vitamin and folic acid intake.

Precautions and Warnings

Use with care if you have swallowing problems, severe bowel motility problems, inflammatory bowel disease or recent major bowel surgery. Blood phosphate, calcium, bicarbonate and vitamin levels are checked regularly. Tell your doctor if you develop severe constipation.

Overdose

Sevelamer is not absorbed, so overdose is unlikely to cause body-wide poisoning, but it may cause constipation and bowel problems. Seek medical advice if a large amount is taken.

Therapeutic Class

Phosphate binder (non-calcium)

Storage

Store below 30°C in a dry place, away from light and moisture, with the bottle tightly closed. Keep out of the reach of children.