Sevabonat®
Sevelamer carbonate
800 mg Tablet
Sevelamer is a phosphate binder indicated for the control of serum phosphorus in patients with chronic kidney disease on dialysis.
Mechanism of Action:
Sevelamer contains sevelamer carbonate, a non-absorbed phosphate binding crosslinked polymer, free of metal and calcium. It contains multiple amines separated by one carbon from the polymer backbone. These amines exist in a protonated form in the intestine and interact with phosphate molecules through ionic and hydrogen bonding. By binding phosphate in the gastrointestinal tract and decreasing absorption, sevelamer carbonate lowers the phosphate concentration in the serum (serum phosphorus).
Method of Administration:
Starting dose of Sevelamer is 0.8 or 1.6 grams administered orally three times per day with meals
Titrate by 0.8 g per meal in two-week intervals as needed to obtain phosphorus target (3.5 to 5.5 mg/dL)
Switch gram-for-gram among sevelamer formulations. Further titration ¬may be necessary to achieve desired phosphorus levels.
Notes
Contraindications:
Bowel obstruction
Interactions:
When clinically significant drug interactions are expected, consider separation of the timing of administration and/or monitor clinical responses or blood levels of the concomitant medication.
Sevelamer did not alter the pharmacokinetics of digoxin, enalapril, iron, metoprolol and warfarin.
Sevelamer has demonstrated interaction with ciprofloxacin and mycophenolate mofetil, and therefore these drugs should be dosed separately from Sevelamer
Pregnancy and Lactation:
Pregnancy Category C
The effects of sevelamer carbonate on breast-feeding in humans is unknown
Warning and Precaution:
Serious cases of dysphagia, bowel obstruction, and perforation have been associated with sevelamer use, some requiring hospitalization andsurgery.
Adverse Reactions:
Nausea, vomiting, diarrhea, dyspepsia, abdominal pain, flatulence.
Storage:
Store below 30 and protect from light and moisture.