Renagel: Advanced Phosphate Control for Chronic Kidney Disease
| Product dosage: 800mg | |||
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| 60 | $4.04 | $265.33 $242.21 (9%) | 🛒 Add to cart |
| 120 | $3.84
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Synonyms | |||
Renagel (sevelamer hydrochloride) is a non-calcium, non-metal phosphate binder specifically formulated for the management of hyperphosphatemia in patients undergoing dialysis for chronic kidney disease. By effectively reducing serum phosphate levels, it addresses a critical complication of renal failure, helping to mitigate the risk of cardiovascular calcification and bone disease. Its unique polymer-based mechanism offers a targeted approach to phosphate management without adding calcium or aluminum load to the body, making it a cornerstone therapy in nephrology care for suitable patient profiles.
Features
- Active ingredient: Sevelamer hydrochloride
- Form: Film-coated tablets in 400 mg and 800 mg strengths
- Mechanism: Non-absorbed polymeric phosphate binder
- Excipients: Includes colloidal silicon dioxide and stearic acid; gluten-free
- Prescription status: Rx-only medication
- Packaging: Available in bottles of 180 tablets
Benefits
- Effectively lowers serum phosphate levels in dialysis patients
- Reduces the risk of vascular and soft tissue calcification
- Avoids calcium accumulation, decreasing potential for hypercalcemia
- Does not contain aluminum, eliminating associated toxicity risks
- May help lower LDL cholesterol through additional binding mechanisms
- Supports overall bone mineral metabolism management in CKD
Common use
Renagel is indicated for the control of serum phosphorus in patients with chronic kidney disease on hemodialysis. It is typically prescribed as part of a comprehensive treatment approach that includes dietary phosphate restriction and dialysis. The medication is used long-term to maintain phosphate levels within target ranges (typically 3.5-5.5 mg/dL), helping prevent the serious consequences of persistent hyperphosphatemia, including secondary hyperparathyroidism, renal osteodystrophy, and cardiovascular complications.
Dosage and direction
The recommended starting dose for Renagel is 800-1600 mg taken orally three times daily with meals. Dosage should be individualized based on serum phosphorus levels and the phosphate content of meals, with regular monitoring every 2-4 weeks during dose titration.
Administration guidelines:
- Tablets should be swallowed whole with water; do not crush or chew
- Take with meals and snacks that contain phosphorus
- The total daily dose may be divided among all meals or adjusted based on phosphate content
- Typical maintenance doses range from 2400-4800 mg daily in divided doses
- Dose adjustments should be made in increments of 400-800 mg per meal based on serum phosphorus levels and tolerability
Precautions
- Use with caution in patients with dysphagia, swallowing disorders, or severe gastrointestinal motility disorders
- Monitor for signs of bowel obstruction, particularly in patients with previous abdominal surgery
- Regular monitoring of serum calcium, bicarbonate, and chloride levels recommended
- May cause reductions in vitamins D, E, K, and folic acid; consider supplementation if deficiency suspected
- Not recommended for use in children under 18 years due to limited safety data
- Use during pregnancy only if clearly needed; insufficient human data available
- Exercise caution in patients with fat malabsorption or conditions affecting vitamin absorption
Contraindications
- Hypersensitivity to sevelamer hydrochloride or any component of the formulation
- Bowel obstruction of any type
- Patients with hypophosphatemia
- Fecal impaction or severe constipation not adequately managed
- Anatomical disorders of the gastrointestinal tract that might predispose to obstruction
Possible side effect
Common (≥1% and <10%):
- Nausea, vomiting, diarrhea, dyspepsia
- Abdominal pain, flatulence, constipation
- Headache, hypertension
Uncommon (<1%):
- Intestinal obstruction, fecal impaction
- Peritonitis in peritoneal dialysis patients
- Pruritus, rash
- Acidosis, hypocalcemia
- Foreign body sensation, swallowing difficulties
Rare:
- Serious bowel obstruction requiring surgical intervention
- Severe metabolic acidosis
- Tablet lodging in throat or esophageal pouch
Drug interaction
- May decrease absorption of concurrently administered oral medications:
- Antiarrhythmics (quinidine, procainamide)
- Antiepileptics (phenytoin, valproic acid)
- Thyroid hormones (levothyroxine)
- Certain antibiotics (ciprofloxacin, tetracyclines)
- Immunosuppressants (mycophenolate, tacrolimus)
- Administer other oral medications at least 1 hour before or 3 hours after Renagel
- May potentiate effects of other acid-lowering therapies
- Caution with drugs that affect gastrointestinal motility
Missed dose
If a dose is missed, take it as soon as remembered with food. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent timing with meals for optimal phosphate binding efficacy.
Overdose
No specific antidote exists for Renagel overdose. Since the drug is not systemically absorbed, symptoms would primarily relate to gastrointestinal effects. Management should be supportive and symptomatic. Severe cases might include intestinal obstruction, which would require appropriate medical intervention. Hemodialysis is not effective for removing sevelamer due to its lack of systemic absorption.
Storage
- Store at room temperature (20-25°C or 68-77°F)
- Keep in original container with lid tightly closed
- Protect from moisture and excessive heat
- Keep out of reach of children and pets
- Do not use if tablets show signs of deterioration or discoloration
- Discard any unused medication after expiration date
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Renagel is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Dosage and treatment decisions must be individualized based on patient-specific factors and professional medical judgment. Always consult with a nephrologist or healthcare provider for personalized medical advice and before making any changes to your treatment regimen.
Reviews
Clinical evidence summary: Multiple randomized controlled trials have demonstrated Renagel’s efficacy in maintaining serum phosphorus within target range in 60-70% of dialysis patients. Long-term studies show significant reduction in coronary and aortic calcification progression compared to calcium-based binders. Patient tolerance is generally good, with gastrointestinal effects being the most commonly reported concern in real-world use.
Expert consensus: Nephrology guidelines recognize sevelamer as a first-line option for phosphate control, particularly in patients with vascular calcification or hypercalcemia. Its non-calcium, non-aluminum composition makes it suitable for long-term management, though cost considerations may influence prescribing decisions in some healthcare systems.
Patient-reported outcomes: Many patients report satisfactory phosphate control with Renagel, though some note the pill burden and gastrointestinal side effects as challenges. Adherence support and careful dose titration are often necessary for optimal outcomes.