Other drug names:	A-Am  An-Az  B  C-Ch  Ci-Cz  D-Dh  Di-Dz  E  F  G  H  I-J  K-L  M-Mh  Mi-Mz  N-Nh  Ni-Nz  O  P-Pl  Pm-Pz  Q-R  S-Sn  So-Sz  T-To  Tp-Tz  U-V  W-Z  0-9

In the U.S.—

Renagel

• Antihyperphosphatemic

Sevelamer ( se-VEL-a-mer) is used to treat hyperphosphatemia (too much phosphate in the blood) in patients with kidney disease who are on dialysis.

This medicine is available only with your doctor's prescription, in the following dosage form:

Oral
• Capsules (U.S.)
• Tablets (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sevelamer, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to sevelamer. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in humans. Studies in animals have found that sevelamer may affect development of bones, possibly by reducing the amount of vitamin D absorbed into the body. It is not known if sevelamer affects the absorption of vitamins in pregnant women; however, sevelamer did not affect the levels of vitamins in the blood in humans who were taking multivitamins. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—Sevelamer has not been reported to cause problems in nursing babies.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of sevelamer in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of sevelamer in the elderly with use in other age groups, this medicine has been used in elderly patients and is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sevelamer, it is especially important that your health care professional know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of sevelamer. Make sure you tell your doctor if you have any other medical problems, especially:

• Bowel obstruction (blockage) or other disorders affecting the gastrointestinal tract or
• Difficulty in swallowing or
• Major surgery on the gastrointestinal tract—Use of sevelamer may cause problems in these conditions

• Hypophosphatemia—Use of sevelamer may make this condition worse

Take this medicine with meals.

Take this medicine only as directed by your doctor. Do not take more or less of it, and do not take it more often than your doctor ordered.

Swallow the capsule whole. Do not break or chew the capsule before swallowing.

Do not open up the capsules before taking them. The medicine inside may swell if it comes in contact with water.

Follow carefully any diet program your doctor may recommend.

Dosing—

The dose of sevelamer will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of sevelamer. If your dose is different, do not change it unless your doctor tells you to do so.

• For oral dosage form (capsules):
  • For high phosphorus levels in the blood:
    • Adults not taking a phosphate binder—The first dose is usually between 2 and 4 capsules three times a day, with each meal, depending on how high your blood phosphorus level is. After that, your doctor may change the dose, again depending on your blood phosphorus levels.
    • Adults switching from calcium acetate to sevelamer— The first dose of sevelamer is generally between 2 and 5 capsules three times a day, with each meal, depending on how many tablets of calcium acetate you are currently taking. After that the doctor may change the dose, depending on your blood phosphorus levels.
    • Children—Use and dose must be determined by your doctor.

• For oral dosage forms (tablets)
  • For high phosphorus levels in the blood:
    • Adults not taking a phosphate binder—The first dose is usually between 1 and 4 tablets three times a day, with each meal, depending on how high your blood phosphorus level is. After that, your doctor may change the dose, depending on your blood phosphorus levels.
    • Adults switching from calcium acetate to sevelamer— The first dose of sevelamer is generally between 1 and 5 tablets three times a day, with each meal, depending on how many tablets of calcium acetate you are currently taking. After that the doctor may change the dose, depending on your blood phosphorus levels.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. The following side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Less common
  • Bloating or gas;  constipation;  diarrhea;  heartburn;  nausea or vomiting 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 06/08/1999

Revised: 01/16/2001