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Renvela
Renvela, the brand name for sevelamer carbonate, is a phosphate binder used to control high levels of phosphate in the blood (hyperphosphatemia) in patients with chronic kidney disease (CKD) who are on dialysis. In patients with CKD, the kidneys are no longer able to effectively filter out phosphate, leading to dangerously high levels. Renvela helps bind phosphate in the digestive tract, preventing its absorption into the bloodstream and reducing phosphate levels.
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Frequently Asked Questions
How long does it take for Renvela to start working?
Renvela begins working immediately to bind phosphate in the food you eat. You may notice a reduction in phosphate levels within a few weeks of starting the medication, depending on your diet and dosage.
Can I take Renvela with other medications?
Renvela can interfere with the absorption of certain medications. To avoid interactions, take other medications at least 1 hour before or 3 hours after taking Renvela. Always check with your healthcare provider about possible interactions with your specific medications.
What should I do if I miss a dose of Renvela?
If you miss a dose, skip it and take the next dose with your next meal. Do not double the dose to make up for the missed one.
Can I take Renvela if I am not on dialysis?
Renvela is primarily used in patients with CKD who are on dialysis, but in some cases, it may be prescribed to CKD patients who are not on dialysis but have elevated phosphate levels. Always follow your healthcare provider’s instructions.
Can Renvela be taken long-term?
Yes, Renvela is typically used as a long-term treatment to manage phosphate levels in patients with CKD. Regular monitoring of phosphate levels, along with other labs, is important to ensure the medication is working effectively and to manage any side effects.
Comprehensive Drug Guide
How Does Renvela Work?
Renvela works by binding to phosphate in the gastrointestinal tract, which prevents its absorption into the bloodstream. The bound phosphate is then excreted in the stool, lowering overall phosphate levels in the blood. By controlling high phosphate levels, Renvela helps prevent complications associated with hyperphosphatemia, such as bone disease and calcium deposits in the blood vessels, heart, and other organs.
Common Dosages
- 800 mg tablets
- 0.8 g or 2.4 g powder packets for oral suspension
Typical Dosing
- For adults: The usual starting dose is 800 mg to 1600 mg with meals, depending on the patient's serum phosphate levels. Doses are typically adjusted based on phosphate levels over time.
- For children (6 years and older): The dose is based on the patient’s body surface area and phosphate levels, typically starting at 0.8 g to 2.4 g with meals.
Renvela should always be taken with food, as it binds to phosphate in the diet to prevent absorption.
Typical Dosing
FDA Approved Indications
- Control of serum phosphate levels in adults and children (6 years and older) with chronic kidney disease (CKD) on dialysis.
Who Shouldn't Take Renvela?
- Bowel obstruction or other severe gastrointestinal disorders, as phosphate binders can worsen these conditions.
- Hypophosphatemia (low phosphate levels), since further reducing phosphate levels can be dangerous.
- Known hypersensitivity to sevelamer carbonate or any components of the formulation.
Advice From The Pharmacist
- Take Renvela with meals to ensure it binds to the phosphate in your food. If you miss a meal, skip that dose and continue with your regular dosing schedule at your next meal.
- Do not crush or chew the tablets; they should be swallowed whole. If using the powder form, dissolve it in water before drinking.
- Stay hydrated to avoid constipation, which can be a side effect of phosphate binders.
- Monitor your phosphate levels regularly as directed by your healthcare provider to ensure that your phosphate is within the target range.
- If you are taking other medications, take them 1 hour before or 3 hours after Renvela, as it can affect the absorption of other medications.
Side Effects of Renvela
Common Side Effects
- Nausea
- Vomiting
- Diarrhea or constipation
- Stomach pain
- Indigestion or gas
Uncommon/Severe Side Effects
- Intestinal blockage or perforation: Symptoms include severe abdominal pain, bloating, or vomiting. This is more likely in patients with a history of gastrointestinal issues.
- Low levels of fat-soluble vitamins (A, D, E, and K): Long-term use of Renvela may reduce the absorption of these vitamins, so supplementation may be necessary.
Risks and Warnings of Renvela
- Gastrointestinal effects: Renvela can cause gastrointestinal issues such as constipation, bloating, and rarely, bowel obstruction. Patients with a history of severe gastrointestinal conditions should use this medication cautiously.
- Vitamin deficiencies: Renvela can reduce the absorption of fat-soluble vitamins and folic acid. Regular monitoring of vitamin levels may be needed, and supplementation may be required.
- Interactions with other medications: Renvela may affect the absorption of certain medications, including antibiotics, thyroid medications, and anticonvulsants. Always inform your healthcare provider of all medications you are taking.
Interactions with Renvela
Common Drug Interactions
- Antibiotics: Renvela may reduce the absorption of some antibiotics, such as ciprofloxacin. Take antibiotics at least 1 hour before or 3 hours after Renvela.
- Thyroid medications: Levothyroxine (used to treat hypothyroidism) may be less effective if taken with Renvela. Separate the doses by at least 3 hours.
- Fat-soluble vitamins: Renvela can reduce the absorption of vitamins A, D, E, and K. Vitamin supplementation may be necessary.
Alternatives to Renvela
- Phoslo (calcium acetate): Another phosphate binder used to lower phosphate levels in patients with CKD.
- Fosrenol (lanthanum carbonate): A phosphate binder that works similarly to Renvela by preventing the absorption of dietary phosphate.
- Velphoro (sucroferric oxyhydroxide): A phosphate binder that uses iron to bind phosphate in the digestive tract, reducing its absorption.
- Auryxia (ferric citrate): Another phosphate binder that uses iron to help reduce phosphate levels in patients with CKD.
