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.
High blood phosphate levels in people ages 6 years and older with chronic kidney disease (CKD) on dialysis
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.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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
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)
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.
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.
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).
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.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
800mg | 90 tablets | $33.72 | $0.37 |
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).
Digestive tract blockage
Allergy to sevelamer carbonate (Renvela) or sevelamer hydrochloride (Renagel)
High blood phosphate levels in people ages 6 years and older with chronic kidney disease (CKD) on dialysis
High phosphate levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) who are receiving dialysis
High blood phosphate levels in people with end-stage chronic kidney disease (CKD)
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Diet and Health: Implications for Reducing Chronic Disease Risk. (1989). 11 Fat-soluble vitamins. National Research Council (US) Committee on Diet and Health.
Genzyme Corporation. (2023). RENVELA- sevelamer carbonate powder, for suspension; sevelamer carbonate tablet, film coated [package insert]. DailyMed.
Goyal, R., et al. (2022). Hyperphosphatemia. StatPearls.
Gupta, D., et al. (2018). Salts of therapeutic agents: Chemical, physiochemical, and biological considerations. Molecules: A Journal of Synthetic Chemistry and Natural Product Chemistry.
Lewis, J., L., III. (2022). Overview of phosphate's role in the body. Merck Manual.
National Kidney Foundation. (n.d.). Dialysis.
Renvela. (n.d.). Renvela for oral suspension powder video.
Spilios, M., et al. (2021). Safety and feasibility of crushing sevelamer tablets for enteral feeding tube administration. Journal of Clinical Pharmacy and Therapeutics.
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