Sevelamer Price in Bangladesh

Sevelamer is a phosphate binder: a tablet taken with meals that grabs phosphate from food inside the gut so it passes out in the stool instead of entering the blood. It is prescribed for people with kidney failure, most often those on dialysis, whose kidneys can no longer clear phosphate. Unlike calcium-based binders it contains no calcium or metal, which matters for people whose blood vessels are already stiffening.

Reduction Of Serum Phosphorus In Patients With Esrd sits under Other Genito-Urinary.

Why Phosphate Control Matters in Kidney Failure

Problem	What it causes	How it is managed
High blood phosphate	Itching, aching joints and calcium deposits in blood vessels	A binder with meals and a low-phosphate diet
Raised parathyroid hormone	Thin, painful bones that break easily	Phosphate control plus vitamin D treatment
Too much calcium from other binders	Faster hardening of the arteries	A calcium-free binder such as sevelamer
Acid build-up in the blood	Tiredness and muscle and bone loss	The carbonate form of sevelamer, or bicarbonate

What High Phosphate Does on Dialysis

Each dialysis session removes only part of the phosphate eaten between sessions, so levels creep up in almost everyone with kidney failure. High phosphate rarely causes symptoms at first, apart from stubborn itching, but over months it pulls calcium out of the bones and deposits it in the heart valves and arteries. That is a major reason heart disease is so common on dialysis. The fluids used for each session are on Haemodialysis Solutions.

Take Sevelamer With Meals, Not Between Them

Sevelamer only works when food is in the gut, because it binds the phosphate released from that meal. A tablet taken on an empty stomach does nothing useful. The renal team usually spreads the daily tablets across the main meals, with more for a large meal and fewer for a light snack. Swallow each tablet whole with the meal; do not crush, chew or break it, because the tablet swells on contact with fluid.

Foods Highest in Phosphate

• Milk, cheese, yoghurt and doi, which are rich in phosphate as well as protein.
• Cola and other dark soft drinks, made with phosphoric acid that is absorbed almost completely.
• Processed meat, instant noodles and packaged snacks, which often contain phosphate additives.
• Organ meat, nuts and large servings of dal, kept to the portions the dietitian suggests.

Constipation and Stomach Upset

Constipation, bloating, wind and nausea are the commonest side effects of sevelamer. The fluid limit set for dialysis makes constipation harder to avoid, so the renal team may suggest a softener or more fibre from permitted vegetables. Severe abdominal pain, a swollen belly, vomiting or no bowel movement for several days needs a doctor quickly, because sevelamer can rarely contribute to a blocked bowel in people with existing gut problems.

Spacing Other Medicines From Sevelamer

Because sevelamer binds substances in the gut, it can also trap other medicines and stop them being absorbed. Ciprofloxacin, levothyroxine, mycophenolate and ciclosporin are among those affected. The usual advice is to take such a medicine at least an hour before sevelamer or three hours after it, but the exact timing should come from the renal pharmacist. A weekly chart of what is taken with which meal keeps the spacing straight.

Phosphate, Calcium and Parathyroid Blood Tests

People on dialysis usually have phosphate and calcium checked monthly and parathyroid hormone every few months. The number of sevelamer tablets with each meal is adjusted from those results, so the count can change from one month to the next. A phosphate that stays high despite the tablets often means meals are being taken without them or that hidden phosphate additives are slipping in through processed food.

Carbonate and Hydrochloride Forms

Sevelamer is made in two salt forms. The carbonate form is now preferred for most patients, because the hydrochloride form can worsen the acid build-up already common in kidney failure. The registered names on this shelf list both salts together, so check the box or ask the pharmacist which form a particular brand contains, and stay with the form your nephrologist chose. A stomach that tolerates one form badly is a reason to ask about the other.

Vitamins and Folate on Sevelamer

Sevelamer can reduce absorption of the fat-soluble vitamins A, D, E and K, and of folic acid, from food. Dialysis itself also washes out water-soluble vitamins, so many renal units prescribe a dedicated renal vitamin. Ordinary multivitamins are not a substitute, because some contain minerals that kidney patients should avoid. People who also take warfarin may see the INR shift if vitamin K absorption changes, so extra INR checks are sensible.

Sevelamer Price in Bangladesh

The price of sevelamer moves with tablet strength and with the maker, the larger tablet costing more each, and several tablets are needed for each day of meals.

Sevelamer adds no calcium to the body, which is why nephrologists choose it over calcium acetate when blood calcium is already high or the arteries show calcium deposits. Vitamin D injections and other medicines given at the dialysis unit are on Kidney Dialysis.

Before You Order

• Take every dose with food, never on an empty stomach.
• Swallow the tablet whole; do not crush or chew it.
• Space thyroid tablets and antibiotics away from each dose.
• Cut back on cola, cheese and processed snacks.
• Confirm the salt form, carbonate or hydrochloride, on the box.

Manufacturers Stocked Here

Makers of sevelamer listed on Arogga:

• Synovia Pharma PLC. — Renvela
• The ACME Laboratories Ltd. — Sevel
• Incepta Pharmaceuticals Ltd. — Inophos
• Healthcare Pharmaceuticals Ltd. — Karvela
• Unimed Unihealth Pharmaceuticals Ltd. — Renosev

Popular Product Examples

Sevelamer tablets in both strengths:

• Renvela Tablet
• Sevel 800 Tablet
• Inophos 400 Tablet
• Karvela 800 Tablet

Frequently Asked Questions

Why must sevelamer be taken with food?

It binds phosphate from the meal it accompanies.

Can I crush sevelamer tablets?

No; they swell and must be swallowed whole.

Which drinks are high in phosphate?

Cola and dark soft drinks, and milk-based drinks.

Does sevelamer cause constipation?

Often; the renal team can suggest a softener.

How long should I wait between sevelamer and levothyroxine?

Usually several hours; confirm with your renal pharmacist.

Is sevelamer used before dialysis starts?

Sometimes, when phosphate rises in advanced kidney disease.