Renagel vs Renvela: Which Is Better for High Phosphates?

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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The names (and active ingredients) of Renagel and Renvela are almost identical and can be extremely confusing. These medications both treat high phosphate levels, but they have varying insurance coverage, and can’t be substituted for one another without your prescriber’s approval.

What are the active ingredients in Renagel and Renvela?

The active ingredient in Renagel is sevelamer hydrochloride, while the active ingredient in Renvela is sevelamer carbonate.

What are sevelamer hydrochloride (Renagel) and sevelamer carbonate (Renvela) used for?

Sevelamer hydrochloride and sevelamer carbonate are used to treat hyperphosphatemia, also known as high phosphate levels. High phosphate levels may be caused by the consumption of phosphate-rich foods (like dairy products), or the result of kidney failure.

Your kidneys help filter waste products in your body, and kidney failure is due to the build-up of waste products not properly being excreted. Some types of kidney failure can be reversed, though others are irreversible.

It is especially important to take care of yourself if you have a disease such as diabetes or high blood pressure which can potentially lead to kidney failure if not appropriately controlled. Keeping up with your sugar readings and keeping your blood pressure numbers under control can help prevent the progression of chronic kidney disease to kidney failure.

What dosage forms are sevelamer hydrochloride and sevelamer carbonate available in?

Sevelamer hydrochloride (Renagel) is available as a tablet, in both 400 mg and 800 mg strengths.

Sevelamer carbonate (Renvela) is also available as an 800 mg tablet, and in 0.8 g or 2.4 g powder packets.

What is are the advantages and disadvantages of using sevelamer hydrochloride (Renagel)?

Sevelamer hydrochloride is a calcium-free, metal-free, nonabsorbed phosphate binder that has proven effective in controlling serum phosphorous levels in patients with chronic kidney disease.

However, some patients cannot tolerate it due to stomach side effects.

What are advantages and disadvantages of using sevelamer carbonate (Renvela)?
Sevelamer carbonate offers the same exact advantages as sevelamer hydrochloride, with the additional benefit of a carbonate acid buffer.

Sevelamer carbonate is also available in powder packets for oral suspension. The powder packets are sprinkled into a prescribed amount of water depending on the strength. The powder packets are a great advantage for those patients who have a hard time swallowing tablets or capsules.

Sevelamer carbonate might help reduce the risk of acidosis (too much acid in the bodily fluids), but also has the potential for stomach side effects.

The 800 mg tablet is also available as an authorized generic, which may be less expensive and/or more likely to be covered by your insurance.

Which medication will my insurance cover?

Unfortunately each prescription insurance plan differs so it’s hard to make a blanket statement about which medication is most likely to be covered by your individual plan.

More than likely only Renagel or Renvela will be covered by your insurance since the cost is similar and sevelamer hydrochloride and sevelamer carbonate are almost identical in efficacy. The main differences are a result of their side effect profiles.

Need financial support for Renagel or Renvela?

The same pharmaceutical company, Sanofi, makes both Renagel and Renvela and has several patient assistance programs. For more information check out their patient assistance website here.

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