Key takeaways
Sevelamer hydrochloride (Renagel) and paricalcitol (Zemplar) are both used to manage complications in people with chronic kidney disease (CKD), but they work differently and treat different issues. Sevelamer hydrochloride is a phosphate binder that helps lower phosphorus levels in your blood by binding to the phosphate in your food. In contrast, paricalcitol is a form of vitamin D. It binds to vitamin D receptors, which lowers parathyroid hormone (PTH) levels to help prevent your body from making too much PTH. Sevelamer hydrochloride must be taken with meals, while paricalcitol can be taken with or without food and has more flexible dosing options, either once per day or three times a week. Both medications are available in a lower-cost generic form. Paricalcitol requires regular blood work to monitor calcium, phosphorus, and PTH levels, while sevelamer hydrochloride monitoring primarily focuses on phosphorus levels. Both medications have their own set of side effects and risks. Sevelamer hydrochloride can cause digestive issues like diarrhea and nausea, while paricalcitol can lead to high calcium levels.
