Renagel: Advanced Phosphate Control for Chronic Kidney Disease
Renagel
| Product dosage: 800mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $4.40 | $132.00 (0%) | 🛒 Add to cart |
| 60 | $4.02 | $264.00 $241.00 (9%) | 🛒 Add to cart |
| 120 | $3.83
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Synonyms | |||
Renagel (sevelamer hydrochloride) is a non-calcium, non-aluminum phosphate binder specifically formulated for the reduction of serum phosphorus in patients with chronic kidney disease (CKD) on dialysis. As a polymeric compound, it operates through a unique ion-exchange mechanism in the gastrointestinal tract, binding dietary phosphate and preventing its absorption into the bloodstream. Its non-systemic action profile offers a targeted approach to managing hyperphosphatemia, a critical concern in renal failure patients associated with significant morbidity. This medication represents a cornerstone in nephrological care, supporting long-term mineral and bone disorder management.
Features
- Active ingredient: Sevelamer hydrochloride
- Pharmaceutical form: Film-coated tablets (400 mg and 800 mg strengths)
- Mechanism: Non-absorbed polymeric phosphate binder
- Ion-exchange capacity: High affinity for phosphate ions in the GI tract
- Excipients: Includes colloidal silicon dioxide and stearic acid; gluten-free formulation
- Packaging: High-density polyethylene (HDPE) bottles with child-resistant caps
Benefits
- Effectively lowers serum phosphate levels in end-stage renal disease patients
- Reduces risk of vascular calcification and cardiovascular complications
- Avoids calcium accumulation, decreasing potential for hypercalcemia
- Does not contribute to aluminum toxicity, offering a safer long-term profile
- 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 hyperphosphatemia in adult patients receiving hemodialysis or peritoneal dialysis. It is typically prescribed as part of a comprehensive treatment regimen that includes dietary phosphate restriction and dialysis. The medication is used chronically, with dosage adjustments based on regular monitoring of serum phosphorus levels. Clinical use extends to patients who cannot tolerate calcium-based binders or those with evidence of vascular calcification.
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 with the goal of maintaining phosphorus between 3.5-5.5 mg/dL. Tablets should be swallowed whole with water and taken with meals to maximize phosphate binding efficacy. Dose titration should occur in increments of 800 mg per meal at 2-week intervals based on serum phosphorus concentrations. Regular monitoring of serum calcium, bicarbonate, and chloride levels is recommended.
Precautions
Patients should be advised that Renagel may cause constipation or exacerbate pre-existing constipation. Those with dysphagia, swallowing disorders, or severe gastrointestinal motility disorders should use with caution. Vitamin D deficiency may develop with long-term use; periodic monitoring of 25-hydroxy vitamin D levels is recommended. The medication contains multiple amine groups and may affect acid-base balance; monitoring of serum bicarbonate and chloride is advised. Patients with hypophosphatemia should not receive Renagel.
Contraindications
Renagel is contraindicated in patients with hypophosphatemia or bowel obstruction. The medication is not recommended for patients with known hypersensitivity to sevelamer hydrochloride or any component of the formulation. It should not be used in patients not on dialysis or in pediatric patients, as safety and effectiveness have not been established in these populations.
Possible side effects
Common adverse reactions (>5% incidence) include: nausea, vomiting, diarrhea, dyspepsia, flatulence, and constipation. Serious but less frequent side effects may include intestinal obstruction, fecal impaction, bowel perforation (rare), and severe metabolic acidosis. Cases of pruritus, rash, and rare instances of difficulty swallowing or tablet sticking in the throat have been reported. Most gastrointestinal side effects tend to diminish with continued therapy.
Drug interaction
Renagel may bind to concurrently administered oral medications and reduce their bioavailability. Specifically, it may decrease absorption of: ciprofloxacin, mycophenolate mofetil, and thyroid hormones. Other medications that should be administered at least 1 hour before or 3 hours after Renagel include: levothyroxine, verapamil, and fat-soluble vitamins (A, D, E, K). Cyclosporine levels should be monitored closely when co-administered with Renagel.
Missed dose
If a dose is missed, patients should take it with their next meal. If it is nearly time for the next scheduled dose, the missed dose should be skipped. Patients should not double the dose to make up for a missed dose. Consistency with meal-time dosing is important for optimal phosphate binding efficacy.
Overdose
There is no specific antidote for Renagel overdose. Since the drug is not absorbed systemically, the primary risk is gastrointestinal obstruction. Management should be supportive and symptomatic. In cases of suspected intestinal obstruction, appropriate diagnostic imaging and surgical consultation should be obtained. Hemodialysis is not effective for removing sevelamer as it is not systemically absorbed.
Storage
Store at room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Keep container tightly closed and protect from moisture. Do not remove desiccant from bottle. Keep out of reach of children and pets. Do not use if the seal under the cap is broken or missing.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Treatment decisions should be made in consultation with a qualified healthcare provider. Individual patient responses may vary. Always follow the prescribed dosage and monitoring recommendations provided by your nephrologist.
Reviews
Clinical studies demonstrate that Renagel effectively reduces serum phosphorus levels by approximately 2.0-2.5 mg/dL from baseline in dialysis patients. Long-term extension studies show maintained efficacy over 3 years of treatment. The DCOR study (Dialysis Clinical Outcomes Revisited) involving over 2000 patients showed trends toward improved survival compared to calcium-based binders, though statistical significance was not reached. Patient satisfaction surveys indicate preference for Renagel over other binders due to reduced pill burden in some formulations and absence of calcium-related side effects.