Important Treatment Considerations
Renvela? (sevelamer carbonate) is indicated for the control of serum phosphorus in patients with chronic kidney disease (CKD) on dialysis
* Renvela is contraindicated in patients with bowel obstruction
* Caution should be exercised in patients with dysphagia, swallowing disorders, severe gastrointestinal (GI) motility disorders including severe constipation, or major GI tract surgery
* Uncommon cases of bowel obstruction and perforation have been reported
* Serum bicarbonate and chloride levels should be monitored
* Vitamins D, E, K (coagulation parameters), and folic acid levels should be monitored
* The most frequently occurring adverse reactions in a short-term study with sevelamer carbonate tablets were nausea and vomiting
* In a short-term study of sevelamer carbonate powder dosed three times daily, adverse events were similar to those reported for sevelamer carbonate tablets
* In long-term studies with sevelamer hydrochloride, which contains the same active moiety as sevelamer carbonate, the most common adverse events included: vomiting, nausea, diarrhea, dyspepsia, abdominal pain, flatulence, and constipation
* Cases of fecal impaction and, less commonly, ileus, bowel obstruction, and bowel perforation have been reported
* Drug-drug interactions may occur with some medications and should be taken into consideration when instructing patients how to take Renvela
* Patients should be informed to take Renvela with meals and to adhere to their prescribed diets
