Key takeaways
Sevelamer hydrochloride (Renagel) and ferric citrate (Auryxia) are both phosphate binders used to lower high blood phosphate levels in people with chronic kidney disease (CKD) on dialysis. However, they have some key differences. Sevelamer hydrochloride is only available in tablet form and must be taken with meals. It does not affect calcium levels in your body unlike other medications that lower high phosphate levels. On the other hand, ferric citrate is also taken with meals and must be swallowed whole, but it contains iron, making it an option for treating iron deficiency anemia. Due to the iron component of ferric citrate, your stools may look darker and may lead to iron overload if not monitored properly. This is not a concern with sevelamer hydrochloride. Both medications require frequent blood tests to adjust dosing. Ferric citrate can interact with certain antibiotics, so you need to be careful about timing when taking these medications together.
