Sevelamer
About Sevelamer
Sevelamer is a medication prescribed to lower high phosphorus levels in the blood of adults with chronic kidney disease who are on dialysis. When kidney function declines, the body cannot remove excess phosphorus, which can lead to severe health complications. This medicine helps manage this buildup by targeting the phosphorus in your digestive tract.
To get the best results, you must take Sevelamer consistently with every meal or snack. Taking it with food is essential because it works directly on the phosphorus present in your meals. Along with taking this medicine, your doctor will likely recommend a low-phosphorus diet and other lifestyle adjustments to help control your levels.
Most people tolerate this medicine well, but it can cause common digestive side effects like nausea, vomiting, bloating, or mild constipation. If you experience severe stomach pain, persistent constipation, or difficulty swallowing, you should stop taking it and contact your doctor immediately.
Before starting this medication, tell your doctor if you have a history of bowel blockages, severe constipation, swallowing difficulties, or major stomach surgery. Do not take this if you have a known bowel obstruction or naturally low levels of phosphorus in your blood.
This medicine can interact with several other oral drugs by preventing your body from absorbing them properly. Talk to your doctor or pharmacist if you are taking antibiotics, thyroid hormones, or heart medications, as you may need to space them apart from Sevelamer. If you are pregnant, breastfeeding, or an older adult, consult your doctor for personalised advice before starting treatment.
Uses of Sevelamer
• Treatment of hyperphosphatemia in dialysis patients: Used to lower high blood phosphate levels in adults undergoing haemodialysis or peritoneal dialysis.
• Management of hyperphosphatemia in non-dialysis chronic kidney disease (CKD) patients: Prescribed for patients with chronic renal disease who do not require dialysis but have elevated serum phosphorus levels (≥1.78 mmol/L).
• Prevention of bone disorders: Used in combination with calcium and vitamin D supplements to lower the risk of bone disease caused by high phosphate levels.
• Supports phosphate balance: Sevelamer helps to maintain a healthy balance of minerals in the blood when the kidneys are unable to filter phosphate properly.
Medicinal Benefits
Sevelamer helps manage elevated phosphorus levels in people with chronic kidney disease, particularly those undergoing dialysis. By reducing the absorption of phosphorus from food, it helps maintain healthier mineral balance in the body and supports long-term bone and cardiovascular health. This medicine offers several key benefits:
- Supports Stronger and Healthier Bones: By helping keep phosphorus levels within the recommended range, Sevelamer reduces the risk of mineral imbalances that can weaken bones over time. This supports bone strength and may help reduce the likelihood of bone pain, fractures, and other complications associated with chronic kidney disease.
- Helps Maintain Healthy Blood Vessel Function: Excess phosphorus can contribute to the formation of calcium-phosphate deposits in blood vessels and soft tissues. By controlling phosphorus levels, Sevelamer helps reduce the risk of these deposits, supporting healthier blood vessel function and overall cardiovascular health.
- Promotes Long-Term Health in Dialysis Patients: Regular use of Sevelamer as prescribed helps manage one of the key complications of chronic kidney disease. By maintaining healthier phosphorus levels, it supports better overall health and may help reduce the risk of long-term complications related to mineral and bone disorders.
Directions for Use
To get the full benefit of Sevelamer and minimise side effects, follow these simple guidelines:
- Swallow the tablets whole with a glass of water during your meals or snacks.
- Do not chew, crush, or break the tablets, as they can expand rapidly in your throat and cause choking.
- If you are taking the oral suspension powder form, mix the exact prescribed amount with the recommended amount of water, stir thoroughly, and drink the entire mixture immediately. Do not leave the mixture sitting.
- Always follow your doctor's exact instructions regarding how and when to take this medicine.
- Your healthcare provider may need to adjust your dosage over time based on your routine blood test results.
Storage
Side Effects of Sevelamer
Common Side Effects (Usually mild):
- Nausea or vomiting
- Constipation
- Diarrhea
- Upset stomach, gas, or bloating
Serious Side Effects (Call a doctor right away):
- Severe or worsening constipation
- Intense stomach pain or cramping
- Difficulty swallowing or feeling like the tablet is stuck in your throat
- Signs of an allergic reaction, including skin rash, hives, swelling of the face, lips, or tongue, or difficulty breathing
Medicines Containing this Salt
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Drug Warnings
- Always take this medicine with food to ensure it can bind to the phosphorus in your meals effectively.
- Never split, crush, or chew the tablets, as they can swell and block your airway.
- Keep a close watch on your bowel movements. If you experience severe constipation or do not have a bowel movement for several days, contact your healthcare provider immediately.
- Separate your other oral medications carefully. Take other oral drugs at least 1 hour before or 3 hours after taking Sevelamer to prevent absorption issues.
- Inform any healthcare provider you visit that you are taking this medicine, especially if you are scheduled for any stomach or bowel surgeries.
Drug Interactions
Drug-Drug Interactions
- Ciprofloxacin: Taking Sevelamer can lower the amount of this antibiotic your body absorbs. Take ciprofloxacin at least 2 hours before or 6 hours after taking this medicine.
- Mycophenolate mofetil: This medicine may reduce the absorption of mycophenolate mofetil (an immunosuppressant), potentially lowering its effectiveness.
- Levothyroxine: This thyroid medicine may not be absorbed properly if taken with Sevelamer. Take your thyroid medication at least 4 hours before taking this medicine.
- Digoxin: Sevelamer may interfere with how your body absorbs digoxin, a medication used for heart conditions.
Drug-Food Interactions
- There are no known direct interactions with specific foods, but taking this medicine without food prevents it from working, as it must bind to phosphorus in your meals.
Drug-Disease Interactions
- Bowel obstruction: Do not take this medicine if you have a blocked bowel or severe slow motility, as it can worsen bowel complications.
- Low blood phosphorus (hypophosphatemia): If your phosphorus levels are already too low, taking this medicine can decrease them further to unsafe levels.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended to avoid alcohol consumption while taking Sevelamer to avoid unpleasant side effects.
Pregnancy
consult your doctorSevelamer is not absorbed by the body and is not expected to reach the baby. If you are pregnant or planning to become pregnant, tell your doctor. They will advise you whether you should take Sevelamer during this time.
Breast Feeding
consult your doctorSevelamer is not absorbed by the body and is not expected to pass into breast milk. If you are breastfeeding or plan to breastfeed, tell your doctor. They will advise you if you should take Sevelamer while breastfeeding.
Driving
safe if prescribedSevelamer has no or negligible influence on the ability to drive or operate any machinery.
Liver
consult your doctorPlease consult your doctor if you have a liver impairment or any concerns regarding this.
Kidney
consult your doctorPlease consult your doctor if you have kidney impairment or any concerns regarding this.
Children
cautionSevelamer is not recommended for children below 6 years as its safety and effectiveness are not known.
Habit Forming
Diet & Lifestyle Advise
- Follow a low-phosphorus diet as recommended by your healthcare team or dietitian. Avoid or limit high-phosphorus foods such as dairy products, nuts, seeds, dark colas, beer, and processed meats containing phosphate additives.
- Maintain a daily food and symptom journal to track your meals and monitor for any digestive changes like constipation.
- Attend all scheduled blood tests. Your doctor will need to regularly check your phosphorus, calcium, bicarbonate, and chloride levels to ensure the treatment is working safely.
- Stay hydrated by drinking the amount of fluids recommended by your doctor, which helps manage and prevent mild constipation.
Special Advise
- Regular monitoring of serum phosphate levels, vitamin D, A, E, K, and folic acid is recommended while taking Sevelamer.
Patients Concern
Disease/Condition Glossary
Hyperphosphatemia: Hyperphosphatemia is defined as an increased phosphate level in the blood. This condition is often a complication of chronic kidney disease. Phosphate is an important electrolyte. It strengthens your bones and teeth and produces energy. When phosphate levels increase in the blood due to kidney impairment (the kidneys do not remove extra phosphate out of the body), this can cause muscle problems and increase the risk of weak bones, heart attacks, and strokes. It is more common in people with chronic kidney disease and people on dialysis. Symptoms may include itchy skin, red eyes, bone pain, and fractures.
FAQs
Sevelamer is used to control high phosphate levels in the body (hyperphosphataemia)‚ in adult patients on dialysis (a blood clearance technique), patients undergoing hemodialysis (using a blood filtration machine), and patients with chronic kidney disease. It is also used for the treatment of bone disease.
Sevelamer works by holding onto phosphate from the food so that it can pass out of your body. Decreasing blood phosphate levels can help keep your bones strong, prevent unsafe buildup of minerals in your body, and possibly decrease the risk of heart disease and strokes that can result from high phosphate levels.
Yes, serum phosphate levels should be monitored regularly while you are taking Sevelamer. The use of Sevelamer may decrease the levels of vitamin D, A, E, K, and folic acid, and hence, the levels need to be monitored during the treatment.
No, do not stop taking Sevelamer on your own. If you stop taking Sevelamer, your phosphate levels may elevate again. Please consult your doctor.
The side effects of Sevelamer include diarrhoea, headache, stomach upset, and constipation. If these side effects persist or worsen, please consult your doctor.
Take Sevelamer for as long as it is prescribed by your doctor. The dose and duration will depend on the response to treatment. Follow your doctor's instructions and do not stop taking Sevelamer on your own.
No, Sevelamer does not contain a steroid. It contains Sevelamer, which belongs to the class of drugs called phosphate binders.
It is important to take Sevelamer as phosphate levels in the blood cannot be controlled in patients undergoing dialysis, especially after a meal. When the phosphate level exceeds the range in the blood, it may cause problems such as red eyes, itchy skin, high blood pressure, bone pain, and also increase the risk of fractures. Sevelamer lowers these increased serum phosphate levels by binding phosphate from food in the digestive tract.
Sevelamer should be avoided by patients who are allergic to it and who have low phosphate levels in blood. Additionally, patients having intestinal obstruction should also avoid taking Sevelamer.
Sevelamer can affect the absorption of certain medicines, including some antibiotics such as ciprofloxacin. In general, other oral medicines should be taken at least 1 hour before or 3 hours after Sevelamer unless your doctor advises otherwise. Always inform your doctor about all medicines you are taking.
If you miss a dose of Sevelamer, do not worry. Take it as soon as you remember. But, if it is time for your next dose, skip the missed dose and take your regular dose. Do not take a double dose to make up for the missed dose.
No. Sevelamer should always be taken with meals or snacks because it works by binding to phosphorus from food in the digestive tract. Taking it on an empty stomach makes it much less effective.
You must swallow the tablets whole because they can expand quickly if they are broken, crushed, or chewed. This can lead to choking or difficulty swallowing. If you have trouble swallowing tablets, talk to your doctor or pharmacist about other options.
Yes, constipation is a common side effect of Sevelamer, although not everyone experiences it. Drinking adequate fluids (within your prescribed fluid allowance), staying physically active, and following your doctor's dietary advice may help. Contact your doctor if constipation becomes severe, persistent, or is accompanied by severe stomach pain.
Generally, you should take your other oral medicines at least 1 hour before or 3 hours after taking Sevelamer. This prevents Sevelamer from binding to your other medications and reducing their effectiveness. Talk to your doctor or pharmacist for a personalized schedule.
There is limited information about the safety of this medicine during pregnancy. Because it is not absorbed into the bloodstream, it is unlikely to harm an unborn baby directly, but it can affect your absorption of vitamins. Talk to your doctor if you are pregnant or planning to become pregnant.
Yes, Sevelamer is meant to be used alongside a low-phosphorus diet, not as a replacement for it. Continuing to limit your intake of phosphorus-rich foods will help you achieve the best results. Talk to your doctor or dietitian for guidance on your diet.
If you develop severe, persistent stomach pain, cramping, bloating, or if you begin vomiting, contact your doctor immediately. These could be signs of a serious bowel complication that requires urgent medical attention.
You will not feel Sevelamer working directly, but your doctor will monitor its effectiveness through regular blood tests to check your phosphorus and calcium levels. Keep all your laboratory appointments so your healthcare team can track your progress.
