sevelamer carbonate
Sevelamer carbonate (Renvela) is a medication that's used to lower blood phosphate levels in people ages 6 years and older with chronic kidney disease (CKD) on dialysis. It's common to have stomach side effects, like nausea, vomiting, diarrhea, and stomach pain, with this medication. Sevelamer carbonate (Renvela) is available as a tablet that's swallowed whole and as a powder that can be made into a liquid (suspension). Both formulations are available as lower-cost generics.
What is Sevelamer carbonate (Renvela)?
What is Sevelamer carbonate (Renvela) used for?
- High blood phosphate levels in people ages 6 years and older with chronic kidney disease (CKD) on dialysis
How Sevelamer carbonate (Renvela) works
Sevelamer carbonate (Renvela) is a phosphate binder. It attaches to the phosphate (a nutrient) in your stomach that comes from food. This prevents phosphate from getting absorbed into the body and instead allows phosphate to leave the body. This lowers your blood phosphate levels to help protect your kidneys and bones.
Drug facts
More on Sevelamer carbonate (Renvela) essentials
Side effects of Sevelamer carbonate (Renvela)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Vomiting (22%)
- Nausea (20%)
- Diarrhea (19%)
- Indigestion (16%)
- Stomach pain (9%)
- Feeling gassy (8%)
- Constipation (8%)
Sevelamer carbonate (Renvela) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Stomach or intestine problems: bowel blockage, bleeding ulcers, severe stomach pain, blood in your stool
The following Sevelamer carbonate (Renvela) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bowel blockage—stomach cramping, unable to have a bowel movement or pass gas, loss of appetite, vomiting
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Diarrhea
- Gas
- Nausea
- Stomach pain
- Upset stomach
- Vomiting
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Pros and cons of Sevelamer carbonate (Renvela)
Pros
- Works well to lower blood phosphate levels
- Available as a powder that can be made into a liquid for people who have trouble swallowing pills
- Available as a lower-cost generic
Cons
- Must take with meals for it to work
- Not the first choice for people with swallowing or constipation problems
- Might have interactions with some medications, such as ciprofloxacin (Cipro), that require specifically timed separation from sevelamer carbonate (Renvela)
Pharmacist tips for Sevelamer carbonate (Renvela)
- Take sevelamer carbonate (Renvela) with each meal of the day. Ask your provider if you need to take a dose with snacks too.
- Mark your calendar with your appointments to see your provider and to get any blood work done during treatment with sevelamer carbonate (Renvela). Your provider will keep track of your kidney health and measure your phosphate levels. This is how your provider can see how well the medication is working for you.
- Make sure to keep a healthy diet while taking sevelamer carbonate (Renvela). This includes avoiding foods that are high in phosphorous. Following this diet helps keep your phosphate levels low and your kidneys as healthy as possible. Speak to your provider or a nutritionist about the best diet plan for you.
- Stomach side effects (e.g., nausea, vomiting, diarrhea, indigestion) are common with sevelamer carbonate (Renvela). You can try treatment options like over-the-counter bismuth subsalicylate (Pepto-Bismol) to help if your provider says it's safe to do so. Contact your provider if these side effects are too bothersome and aren't getting better with over-the-counter treatments.
- Talk to your provider about other medications you're taking. Sevelamer carbonate (Renvela) interacts with certain medications (e.g., ciprofloxacin (Cipro)), and your medications might need to be taken at a separate time.
More tips for sevelamer carbonate (Renvela) powder for suspension
- Sevelamer carbonate (Renvela) powder for suspension is available as 0.8- and 2.4-gram packets. If your dose is 1.6 grams, you'll need to use two 0.8-gram packets.
- Instructions for preparing the oral suspension: Measure out some water into a cup (1 ounce for 800 mg doses and 2 ounces for 2,400 mg doses). Add the sevelamer carbonate (Renvela) powder to the cup of water. Stir the mixture well; the mixture will be cloudy, and the powder won't completely dissolve. Drink all of the mixture within 30 minutes.
- Instead of water, you can mix the sevelamer carbonate (Renvela) powder with a small amount of food or other drink. Take the mixture within 30 minutes. Don't mix with heated food or liquids or put the sevelamer carbonate (Renvela) powder in the microwave because the heat can damage the medication.
Common questions about Sevelamer carbonate (Renvela)
No, you have to take sevelamer carbonate (Renvela) with food. The medication works by attaching to the phosphate that's in the food you just ate so your body doesn't absorb it. This allows your body time to process the phosphate that's already in your body without absorbing more phosphate from food. As a result, sevelamer carbonate (Renvela) helps lower your blood phosphate levels. The medication won't work if you take it on an empty stomach because there's no phosphate from food to attach to.
The manufacturer doesn't specify if it's okay to crush sevelamer carbonate (Renvela) tablets. One study suggests that you might be able to crush the tablets if you're having trouble swallowing them. But, make sure to ask your provider first to see if that's the right option for you. They might prefer to switch you to the sevelamer carbonate (Renvela) powder that you can mix with food or a drink rather than have you crush the tablets.
Yes, diarrhea is a common side effect with sevelamer carbonate (Renvela). If you get diarrhea after starting sevelamer carbonate (Renvela), there are some over-the-counter treatment options that you can consider, such as loperamide (Imodium A-D) or bismuth subsalicylate (Pepto-Bismol). Ask your provider about the best options for you. Also, make sure to stay hydrated by drinking rehydration solutions like Pedialyte.
Renvela is sevelamer carbonate, while Renagel is sevelamer hydrochloride. These are different salt forms of the active ingredient sevelamer. Both medications work just as well as each other to lower blood phosphate levels in people with CKD on dialysis. But, there are some advantages of sevelamer carbonate (Renvela) over sevelamer hydrochloride (Renagel). While both medications are available as tablets, sevelamer carbonate (Renvela) is also available as a powder that can be mixed with food or drinks. This makes sevelamer carbonate (Renvela) a good option for people who have trouble swallowing pills. Additionally, sevelamer carbonate (Renvela) doesn't cause as much acid buildup in the body as sevelamer hydrochloride (Renagel). Finally, sevelamer carbonate (Renvela) can be used in children as young as 6 years old, whereas sevelamer hydrochloride (Renagel) is only for adults. Speak with your provider or pharmacist about other similarities and differences between the two medications.
No, you won't be able to find sevelamer carbonate (Renvela) over the counter. It's only available by prescription from your provider. In fact, all phosphate binders require a prescription from your provider.
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Risks and warnings for Sevelamer carbonate (Renvela)
Sevelamer carbonate (Renvela) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Blockage of your digestive tract
- Risk factors: Swallowing problems | Changes to the anatomy of your digestive tract | Digestive tract problems, including severe constipation
Some people taking sevelamer carbonate (Renvela) have experienced digestive tract problems. These problems can include stomach or intestinal blockage, bleeding ulcers, and inflammation. If you have constipation or other digestive tract problems, ask your provider if sevelamer carbonate (Renvela) is right for you. And if you have trouble swallowing, it might be safer to use the powder for suspension of instead of the tablets to prevent choking. Let your provider know right away if you have severe stomach pain, new or worsening constipation, blood in your stool, vomit that looks like coffee grounds, or other severe intestinal (gut) symptoms while you're taking sevelamer carbonate (Renvela).
Low levels of vitamin D, E, and K and folic acid
Based on animal studies, sevelamer carbonate (Renvela) might lower your absorption of certain vitamins (D, E, and K) and folic acid. Your provider might recommend that you take supplements to keep your vitamin levels healthy.
Sevelamer carbonate (Renvela) dosage
Typical dosage for Sevelamer carbonate (Renvela)
The typical dose ranges from 800 mg to 2,400 mg by mouth three times daily with meals.
Your provider will adjust your dose based on whether you were previously taking a phosphate binder, your blood phosphate levels, and body size (for children).
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Sevelamer carbonate (Renvela) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Sevelamer carbonate (Renvela) will not be safe for you to take.
- Digestive tract blockage
- Allergy to sevelamer carbonate (Renvela) or sevelamer hydrochloride (Renagel)
What are alternatives to Sevelamer carbonate (Renvela)?
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