For the control of serum P in patient w/ CKD on dialysis; hyperphosphatemia in adults receiving hemodialysis or peritoneal dialysis. For adult CKD patients not on dialysis w/ serum P >1.78 mmol/L (5.5 mg/dL).
Adult & elderly >65 yr not taking a phosphate binder w/ serum P >5.5 & <7.5 mg/dL 1 tab tid, ≥7.5 & <9 mg/dL, ≥9 mg/dL 2 tab tid. Patient switching from Ca acetate Give sevelamer in equiv doses on a mg for mg wt basis compared to the previous Ca based binder (ie, 1 tab sevelamer carbonate 800 mg = 1 tab Ca acetate 667 mg).
Patients w/ dysphagia, swallowing disorders, severe GI motility disorders including severe constipation or major GIT surgery. Reevaluate treatment in patients who develop severe constipation or other severe GI symptoms. Patients w/ contributing co-morbid conditions affecting the ability to swallow including disorders of oroesophageal abnormalities may have difficulty swallowing the tab. Patient w/ CKD may develop low vit A, D, E & K levels. Test serum P every 2-3 wk until a stable P level is reached, & on a regular basis thereafter. Pregnancy. Childn <18 yr.
Decrease bioavailability of ciprofloxacin. Reduced conc of cyclosporine, mycophenolate mofetil & tacrolimus in transplant patients. Very rare cases of increased TSH levels w/ levothyroxine. Very rare cases of increased phosphate levels w/ PPIs.
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