Sevelamer
- Atc Codes:V03AE02
- CAS Codes:182683-00-7#52757-95-6
- PHARMGKB ID:182683-00-7#52757-95-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Renagel; Belgium: Renagel; Bulgaria: Renagel, Renvela; Cyprus: Renagel; Czech Republic: Renagel; Renvela; Denmark: Renagel, Renvela; Estonia: Renagel, Renvela; Finland: Renagel, Renvela; France: Renagel; Germany: Renagel, Renvela; Greece: Renagel, Renvela; Hungary: Renagel; Ireland: Renagel, Renvela; Italy: Renagel; Latvia: Renagel, Renvela; Lithuania: Renagel, Renvela; Luxembourg: Renagel; Malta: Renagel, Renvela; Netherlands: Renagel, Renvela; Poland: Renagel; Portugal: Renagel, Renvela; Romania: Renagel, Renvela; Slovakia: Renagel, Renvela; Slovenia: Renagel, Renvela; Spain:Renagel; Sweden: Renagel, Renvela; UK: Renagel.
North America
Canada: Renagel; USA: Renagel, Renvela.
Asia
Japan: Phosblock, Renagel.
Drug combinations
Chemistry
Sevelamer Hydrochloride: (C~3~H~7~N)~m~(C~3~H~5~ClO)~n~ xHCl. (1) 2-Propen-1-amine polymer with (chloromethyl)oxirane, hydrochloride; (2) Allylamine polymer with 1-chloro-2,3-epoxypropane, hydrochloride. CAS-182683-00-7; CAS-52757-95-6 (sevelamer)(1997).
Pharmacologic Category
Ion-removing Agents; Phosphate-removing Agents. Phosphate Binder. Antidotes. (ATC-Code: V03AE02).
Mechanism of action
Sevelamer (polymeric compound) binds phosphate within intestinal lumen, limiting absorption and decreasing serum phosphate concentrations without altering calcium, aluminum, or bicarbonate concentrations. Increased serum bicarbonate levels observed with use of sevelamer carbonate, compared to sevelamer hydrochloride. Reduced phosphate absorption decreases serum and urinary phosphorus concentrations and increases fecal excretion of phosphorus. Binds bile acids in intestine, forming nonabsorbable complex. Decreases serum total and LDL-C concentrations. Does not appear to alter serum HDL-C or triglyceride concentrations. Does not contain aluminum or other metals (does not produce aluminum toxicity).
Therapeutic use
Reduction or control of serum phosphorous in chronic kidney disease on hemodialysis.
Pregnancy and lactiation implications
Animal studies show reduced or irregular ossification of fetal bones. As sevelamer may cause reduction in absorption of some vitamins, it should be used with caution in pregnant women. Excretion in breast milk unknown (use caution).
Unlabeled use
Contraindications
Hypophosphatemia. Bowel obstruction. Known hypersensitivity to sevelamer hydrochloride or any ingredient in the formulation.
Warnings and precautions
Use with caution in GI disorders including dysphagia, swallowing disorders, severe GI motility disorders (including constipation), or major GI surgery. Sevelamer may bind to some drugs in GI tract and decrease their absorption. May cause reductions in vitamin D, E, K, and folic acid absorption. Should not be taken apart or chewed; broken or crushed tablets will rapidly expand in water/saliva and may be a choking hazard.