Introduction
Sevel 800 is used to treat increased phosphate level in the blood. It is used in patients who are on dialysis due to severe kidney disease. It inhibits the absorption of phosphate from the intestine and lower the phosphate levels in the blood.
Sevel 800 should be taken with food. Take it in the dose and duration as advised by your doctor. Take it regularly and at a fixed time each day to get maximum benefit of the medicine.
Using of Sevel 800 may cause side effects such as nausea, vomiting, abdominal pain, constipation and diarrhea. You may also develop low levels of calcium, folic acid and vitamins A, D, E and K in your blood. Take necessary supplements as advised by your doctor.
Uses of Sevel 800
- High phosphate levels in blood
Side effects of Sevel 800
Common
- Nausea
- Vomiting
- Upper abdominal pain
- Flatulence
- Constipation
- Diarrhea
How to use Sevel 800
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Sevel 800 is to be taken with food.
How Sevel 800 works
Sevel 800 inhibits the absorption of phosphate from the intestine and lower the phosphate levels in the blood.
What if you forget to take Sevel 800?
If you miss a dose of Sevel 800, skip it and continue with your normal schedule. Do not double the dose.
Indication
Hyperphosphataemia
Administration
Should be taken with food.
Adult Dose
End-Stage Renal Disease
Hemodialysis; hyperphosphatemia
Initial dose
Serum PO4 >9 mg/dL [2.91 mmol/L]: 1600 mg PO q8hr with meals
Serum PO4 7.5-9 mg/dL [2.42-2.91 mmol/L]: 1200-1600 mg PO q8hr with meals
Serum PO4 5.5-7.5 mg/dL [1.78-2.42 mmol/L]: 800 mg PO q8hr with meals
Maintenance dose
Serum PO4 >5.5 mg/dL [>1.78 mmol/L]: Increase dose by 400-800 mg per meal
Serum PO4 3.5-5.5 mg/dL [1.13-1.78 mmol/L]: Maintain current dose
Serum PO4 <3.5 mg/dL [1.13 mmol/L] decrease by 400-800 mg per meal
Dosing considerations
Titrate dose; increase by 400-800 mg per meal at 2-week intervals; no more than 4 g
Switching From Ca-Acetate
Substitute 800 mg for 667 mg of Ca-acetate
Substitute 1600 for1334 mg of Ca-acetate
Substitute 2400 mg for 2001 mg Ca-acetate
Child Dose
Safety and efficacy not established
Contraindication
Hypophosphatemia or bowel obstruction.
Mode of Action
Sevelamer, a polymeric compound, acts by binding to phosphate molecules in the gut, limiting its absorption and thus lowering serum phosphate levels w/o altering Ca, Al, or bicarbonate levels.
Precaution
Patients w/ dysphagia, swallowing disorders, severe GI motility disorders, active inflammatory bowel disease or major GI tract surgery. Pregnancy and lactation. Monitoring Parameters Monitor serum levels of phosphate, Ca, Cl and bicarbonate. Vitamin supplementation due to reduction in vit D, E, K and folic acid absorption. Monitor for signs and symptoms of peritonitis in patients undergoing peritoneal dialysis.
Lactation: Not absorbed systemically; not excreted in breast milk
Side Effect
>10%
Vomiting (22%),Nausea (20%),Diarrhea (19%),Dyspepsia (16%),Nasopharyngitis (14%),Limb pain (13%),Pruritus (13%),Arthralgia (12%),Bronchitis (11%),Dyspnea (10%),Hypertension (10%)
1-10%
Abdominal pain (9%),Constipation (8%),Flatulence (8%),Peritonitis (during peritoneal dialysis: 8%),Hypercalcemia (5-7%)
Frequency Not Defined
Back pain,Cough,Headache,Pyrexia,Upper respiratory infection,Pruritus,Rash,Intestinal perforation,Fecal impaction,Intestinal obstruction.
Interaction
May decrease absorption of ciprofloxacin, ciclosporin, mycophenolate, tacrolimus and levothyroxine. Sevelamer should be given 3 hr before or 1 hr after taking other drugs to minimise potential pharmacokinetic interaction.