Brand and Other Names:Renagel, Renvela
- Classes: PO4 Scavengers
Dosing & Uses
Dosage Forms & Strengths
End-Stage Renal Disease
- Serum PO4 >9 mg/dL [2.91 mmol/L]: 1600 mg PO q8hr with meals
- Serum PO4 7.5-9 mg/dL [2.42-2.91 mmol/L]: 1200-1600 mg PO q8hr with meals
- Serum PO4 5.5-7.5 mg/dL [1.78-2.42 mmol/L]: 800 mg PO q8hr with meals
- Serum PO4 >5.5 mg/dL [>1.78 mmol/L]: Increase dose by 400-800 mg per meal
- Serum PO4 3.5-5.5 mg/dL [1.13-1.78 mmol/L]: Maintain current dose
- Serum PO4 <3.5 mg/dL [1.13 mmol/L] decrease by 400-800 mg per meal
- Titrate dose; increase by 400-800 mg per meal at 2-week intervals; no more than 4 g
Switching From Ca-Acetate
Substitute 800 mg Renagel or Renvela for 667 mg of Ca-acetate
Substitute 1600 Renvela or Renagel for 1334 mg of Ca-acetate
Substitute 2400 mg Renvela or Renagel for 2001 mg Ca-acetate
- Renagel = Renvela on a per gram basis
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Limb pain (13%)
Abdominal pain (9%)
Peritonitis (during peritoneal dialysis: 8%)
Frequency Not Defined
Upper respiratory infection
Caution in dysphagia, GI motility disorders, GI surgery
Bowel obstruction and perforation reported
Tablets should not be crushed, broken, or chewed (tablets rapidly expand and become a choking hazard)
Dysphagia and esophageal tablet retention reported, in some cases requiring hospitalization and intervention; consider sevelamer oral suspension in patients with history of swallowing disorders
May decrease GI absorption of antiarrhythmic, fat soluble vitamins, folic acid, and antiseizure medications; take medications 1 hour before or 3 hours after sevelamer dose
Monitor fat soluble vitamin and folic acid levels, especially in pregnancy
Safety/efficacy with dialysis not studied
Pregnancy & Lactation
Pregnancy category: C
Lactation: Not absorbed systemically; not excreted in breast milk
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Polymeric phosphate binder; decreases serum phosphate concentrations without changing calcium, aluminum, or bicarbonate concentrations
No intestinal absorption
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
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|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
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