sevelamer hydrochloride
Sevelamer hydrochloride, commonly known by its brand name Renagel, helps treat high phosphate levels in the blood (hyperphosphatemia) in adults with chronic kidney disease (CKD) who are receiving dialysis. This medication is a phosphate binder. It attaches to phosphate in food so it's not absorbed into your blood. Sevelamer hydrochloride (Renagel) comes as tablets that are taken by mouth three times per day with meals. Common side effects include nausea, vomiting, and diarrhea. This medication is available as a generic.
What is Sevelamer hydrochloride (Renagel)?
What is Sevelamer hydrochloride (Renagel) used for?
- High phosphate levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) who are receiving dialysis
How Sevelamer hydrochloride (Renagel) works
Sevelamer hydrochloride (Renagel) is a phosphate binder. It attaches to a nutrient called phosphate in your stomach. The medication prevents phosphate that's in the food you eat from getting absorbed into the body. This lowers the phosphate levels in your blood, which helps prevent additional problems with your kidneys and bones.
Drug facts
More on Sevelamer hydrochloride (Renagel) essentials
Side effects of Sevelamer hydrochloride (Renagel)
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%)
- Gas (8%)
- Constipation (8%)
Less Common Side Effects
- Itching
- Rash
Sevelamer hydrochloride (Renagel) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Digestive tract problems: severe stomach pain, bowel blockage, bleeding ulcers, blood in your stool
The following Sevelamer hydrochloride (Renagel) 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 hydrochloride (Renagel)
Pros
- Works well to lower phosphate levels
- Taken by mouth
- No effect on your calcium levels because it doesn't contain calcium
Cons
- Not a good choice for people who have trouble swallowing because you can't crush the tablet and there isn't a liquid available
- Need to take three times per day with food
- Can lower the levels of certain vitamins and minerals in the body
Pharmacist tips for Sevelamer hydrochloride (Renagel)
- Take sevelamer hydrochloride (Renagel) with each meal of the day. Ask your prescriber if you need to take the medication when you have snacks too.
- Make sure to swallow the sevelamer hydrochloride (Renagel) tablet whole. Contact your prescriber if you're having trouble swallowing the tablets so they can switch you to another medication that might be easier for you to take.
- Talk with your healthcare team about following a meal plan that helps you avoid foods that are high in phosphorous. This will help keep your phosphate levels low and your kidneys as healthy as possible.
- It's common to have side effects like nausea, vomiting, diarrhea, and indigestion with sevelamer hydrochloride (Renagel). You can try treatment options like over-the-counter bismuth subsalicylate (Pepto-Bismol) to help if your healthcare professional says it's safe for you to. Talk with your care team if these side effects are too bothersome and if they don't get better with over-the-counter treatments.
- Mark your calendar with your appointments to see your prescriber and to get any blood tests done during your treatment with sevelamer hydrochloride (Renagel). These blood tests measure your electrolyte levels, including your phosphate levels. This helps your prescriber keep track of your kidney health, see how well the medication is working, and make sure it's safe for you to take.
- Tell your care team about all of the medications you're taking or planning to take with sevelamer hydrochloride (Renagel). They can help make sure your medications are safe to take together. Your care team can let you know if you need to separate when you take your medications to make sure they don't interfere with each other.
- Sevelamer hydrochloride (Renagel) is typically safe to take while pregnant and breastfeeding. But the medication can lower how much certain nutrients get absorbed into the body. Let your obstetrician-gynecologist (OB-GYN) know that you're prescribed sevelamer hydrochloride (Renagel). They might recommend taking a supplement to keep your levels of these vitamins high, even if you're already taking a prenatal vitamin.
Common questions about Sevelamer hydrochloride (Renagel)
No, don't crush or cut sevelamer hydrochloride (Renagel) tablets. If you do, the medication inside can expand when it gets wet. This can raise the risk for choking. Also, it's hard to evenly split tablets that don't have a score line. This can lead you to take the wrong dose. Make sure to swallow the sevelamer hydrochloride (Renagel) tablets whole. Ask your prescriber if you're having trouble swallowing the tablets. They can see whether switching you to the powder form of sevelamer carbonate (Renvela) is right for you.
Sevelamer hydrochloride (Renagel) is only FDA approved to treat high phosphate levels in people on dialysis. Studies show that sevelamer carbonate (Renvela), a medication similar to sevelamer hydrochloride (Renagel), might work well to lower phosphate levels in people not on dialysis. Speak with your kidney specialist (nephrologist) if you have chronic kidney disease (CKD) and high phosphate levels. They'll discuss your options with you.
No, sevelamer hydrochloride (Renagel) doesn't contain calcium. It makes sevelamer hydrochloride (Renagel) a good choice for people who have high calcium levels (hypercalcemia). Sevelamer hydrochloride (Renagel) is a calcium-free alternative to another phosphate binder called calcium acetate (PhosLo).
There isn't a specific time of day that's best to take sevelamer hydrochloride (Renagel). You can take the medication at any time of the day, but you should take it whenever you have meals (e.g., breakfast, lunch, dinner). This helps sevelamer hydrochloride (Renagel) work to attach to phosphate from food so your body doesn't absorb it and raise your phosphate levels. Ask your prescriber or pharmacist if you have more questions about when to take sevelamer hydrochloride (Renagel) each day.
Yes, you need to take sevelamer hydrochloride (Renagel) three times per day with food. The purpose of taking the medication with food is for it to attach to phosphate from food. If you don't take sevelamer hydrochloride (Renagel) with food, your body will absorb the phosphate from food and raise your phosphate levels. Talk to your prescriber if you have specific questions about taking sevelamer hydrochloride (Renagel) with food.
Yes, it's possible for sevelamer hydrochloride (Renagel) to cause constipation. Some tips you can try to help manage constipation include staying hydrated, choosing foods that are high in fiber, and trying over-the-counter medications to relieve this side effect. Talk to your primary care provider or prescriber if you need more relief or if your constipation becomes severe. Constipation can be a sign of a more serious stomach problem from sevelamer hydrochloride (Renagel), such as a stomach or intestinal blockage.
No, weight gain isn't a typical side effect of sevelamer hydrochloride (Renagel). Talk to your primary care provider if you notice unexplained weight gain while you're taking this medication. They can help identify the cause.
Sevelamer carbonate (Renvela) and sevelamer hydrochloride (Renagel) are phosphate binders. They work just as well as each other to lower phosphate levels in people with CKD on dialysis. But these two medications contain a different salt form of sevelamer. Renvela is sevelamer carbonate, while Renagel is sevelamer hydrochloride. Sevelamer carbonate (Renvela) is also approved for children as young as 6 years old, whereas sevelamer hydrochloride (Renagel) is only for adults. In addition, sevelamer carbonate (Renvela) is an option for people who have trouble swallowing since there's a powder form of it that can be mixed with food. And sevelamer carbonate (Renvela) doesn't cause acid buildup in the blood like sevelamer hydrochloride (Renagel) potentially can. So sevelamer carbonate (Renvela) might be a safer choice for people at risk for metabolic acidosis. Speak with your prescriber or pharmacist about comparing between the two medications.
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Risks and warnings for Sevelamer hydrochloride (Renagel)
Sevelamer hydrochloride (Renagel) 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.
Problems with the digestive tract, such as blockage or damage
- Risk factors: History of swallowing problems | History of changes to the anatomy of your digestive tract | History of digestive tract problems, including severe constipation | Taking medications that can also cause blockage in the digestive tract
Some people who take sevelamer hydrochloride (Renagel) have had digestive tract problems. These problems can include stomach or intestinal blockage, bleeding ulcers, and inflammation. Some people might also have trouble swallowing.
Ask your prescriber if sevelamer hydrochloride (Renagel) is right for you if you have constipation or other digestive tract problems. Let your care team 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 this medication. These can be signs of serious digestive tract problems.
Low levels of vitamin D, E, and K and folic acid
Based on animal studies, sevelamer hydrochloride (Renagel) might lower how well your body can absorb certain vitamins (D, E, and K) and folic acid. Your prescriber might recommend that you take supplements to keep your vitamin levels healthy.
Sevelamer hydrochloride (Renagel) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 800mg | 90 tablets | $67.65 | $0.75 |
| 400mg | 90 tablets | $95.69 | $1.06 |
Typical dosage for Sevelamer hydrochloride (Renagel)
The typical starting dose is 800 mg to 1,600 mg by mouth three times per day with meals. Your prescriber will decide what your starting dose is based on whether you were previously taking a different phosphate binder and what your phosphate levels are.
As you continue treatment, your prescriber might adjust your dose depending on your phosphate levels and any bothersome side effects you have.
How much does Sevelamer hydrochloride (Renagel) cost?
Sevelamer hydrochloride (Renagel) 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 hydrochloride (Renagel) will not be safe for you to take.
- Blockage in the digestive tract
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