Sevelamer carbonate

Brand name: Renvela

Chemical:

- Polymeric phosphate binder

Functional:

- Antihyperphosphatemia agent

Mechanism of Action:

- Inhibits phosphate absorption in the intestine by binding dietary phosphate, thereby lowering
serum phosphorus level.
- Therapeutic effect: Inhibits phosphate absorption; decrease serum phosphate concentration.

Indication:

To control serum phosphate level in patients with chronic kidney disease on dialysis

Contraindication:

Bowel obstruction; hypersensitivity to sevelamer carbonate, sevelamer hydrochloride, or their

components

Caution:

Use cautiously on patients with:

- dysphagia
- severe GI tract motility disorders
- major GI tract surgery

Adverse effects:

CNS: fever

CV: thrombosis

EENT: nasopharyngitis

GI: abdominal pain, dysphagia, fecal impaction, ileus, intestinal obstruction or perforation

RESP: bronchitis, dyspnea, URTI

MS: arthralgia, back or limb pain

SKIN: pruritus, rash

Other: hypersensitivity reactions

S/E:
CNS: headache

CV: hypotension, hypertension

GI: diarrhea, dyspepsia, n/v, constipation

RESP: increased cough

Other: Infection

Nursing Considerations

Assess for any contraindications with the medication in the patient.

Obtain baseline chemistries (serum calcium, phosphate).

Monitor serum phosphorus level to determine drug’s effectiveness.

Monitor serum electrolyte levels (bicarbonate and chloride) to detect imbalances.

Give other drugs at least 1 hour before or 3 hours after taking sevelamer to prevent interaction.

Make known to patient the symptoms of thrombosis, and instruct the patient to report immediately if
symptoms arise.

Instruct patient or S/O to take medication with meals and swallow tablets whole. Remind not to chew,
crush, dissolve, or divide the tablet.

Instruct patient to promptly report persistent headache, n/v, diarrhea, and hypotension.