Sevelamer Hydrochloride Dose Calculator
Serum Phosphate Level Calculator
Enter your serum phosphate level to determine the appropriate Sevelamer Hydrochloride dose.
Enter your serum phosphate level to see recommended dose range.
Recommended Dose Range
Enter phosphate level to see dose recommendation.
Key Takeaways
- Start adults at 800mg three times daily with meals; adjust by serum phosphate.
- Kidney‑failure patients on dialysis often need higher total daily doses.
- Never crush the tablet; chew or swallow whole with plenty of water.
- Monitor phosphorus, calcium, and bicarbonate at least monthly.
- Common side effects are GI‑related; severe constipation requires dose reduction.
When a doctor prescribes a phosphate binder, the goal is to keep blood phosphate in the 3.5‑5.5mg/dL range without raising calcium. Sevelamer Hydrochloride is a non‑calcium, non‑metal polymer that binds dietary phosphate in the gut and is eliminated unchanged. It is marketed under the brand name Renvela and comes in 800mg tablets. Below you’ll find the step‑by‑step dosing and administration rules you’ll need to follow, plus how to compare it with other binders.
What is Sevelamer Hydrochloride?
Sevelamer Hydrochloride belongs to the Phosphate Binder class. Unlike calcium‑based binders, it does not add extra calcium to the bloodstream, which helps prevent vascular calcification in patients with chronic kidney disease (CKD). The polymer’s negative charge attracts positively charged phosphate ions, forming an insoluble complex that is excreted in feces.
Why is it prescribed?
Patients with Chronic Kidney Disease (CKD) or end‑stage renal disease (ESRD) lose the ability to excrete phosphate. Elevated serum phosphate (hyperphosphatemia) contributes to bone disease and cardiovascular risk. Sevelamer Hydrochloride is indicated for adult patients with CKD on dialysis who need phosphate control.
Available Dosage Forms & Strengths
- 800mg tablet - chewable or swallow whole.
- Each tablet contains 800mg of sevelamer hydrochloride and 0.1mmol of hydrochloride.
General Dosage Guidelines
The starting dose is usually 800mg taken with each main meal (three times daily). Adjustments are made based on serial serum phosphate levels, aiming for the target range.
| Serum Phosphate (mg/dL) | Starting Dose | Typical Dose Range |
|---|---|---|
| 4.5‑5.5 | 800mg TID | 800‑2400mg/day |
| 5.6‑6.5 | 800mg TID | 1600‑3200mg/day |
| >6.5 | 800mg TID | 2400‑4800mg/day |
Adjusting Dose for Dialysis Patients
Patients on hemodialysis often require higher total daily doses because their phosphate intake can be higher and the dialysis session itself does not fully clear phosphate. A typical regimen may reach up to 4800mg/day, split into three doses (1600mg each) taken with meals.
How to Administer Properly
- Take the tablet with a full glass of water (≈240ml).
- Swallow whole or chew thoroughly; do not crush or split the tablet.
- Administer each dose during or immediately after a meal to maximize phosphate binding.
- Space doses at least 4‑6hours apart to avoid overlap.
If a patient has difficulty swallowing, the chewable formulation is acceptable, but the tablet must remain intact for the polymer to work.
Monitoring & Safety
Regular lab work is essential. Check serum phosphate, calcium, bicarbonate, and albumin at least once a month during dose titration. Watch for the following adverse events:
- Gastro‑intestinal discomfort (nausea, abdominal pain, constipation).
- Metabolic acidosis - more common in high‑dose regimens; consider bicarbonate supplementation.
- Hypophosphatemia - if phosphate falls below 3.5mg/dL, reduce the dose by 800mg.
Special populations:
- Pediatric patients - safety not established; use only if benefits outweigh risks.
- Pregnant or breastfeeding women - limited data; discuss risks with a prescriber.
Comparison with Other Phosphate Binders
| Feature | Sevelamer Hydrochloride | Calcium Acetate | Lanthanum Carbonate |
|---|---|---|---|
| Calcium Load | None | High - may cause hypercalcemia | Minimal |
| Effect on Lipids | ↓ LDL & ↑ HDL (beneficial) | No significant effect | No significant effect |
| Typical Daily Dose | 800‑4800mg | 660‑2400mg (as calcium acetate) | 750‑3000mg |
| Common Side‑effects | GI upset, constipation | Hypercalcemia, constipation | GI upset, nausea |
| Cost (US, 2025) | $$$ (higher) | $$ (moderate) | $$$ (similar to sevelamer) |
Choosing the right binder depends on calcium balance, lipid profile, cost, and patient tolerance. Sevelamer shines when calcium overload is a concern or when a modest lipid‑lowering effect is welcomed.
Quick Checklist Before Starting Therapy
- Confirm CKD stage and dialysis status.
- Baseline labs: serum phosphate, calcium, bicarbonate, albumin.
- Review concomitant meds - antacids may interfere.
- Educate patient on chewing/swallowing and timing with meals.
- Schedule follow‑up labs in 4‑6 weeks.
Frequently Asked Questions
Can I take Sevelamer Hydrochloride on an empty stomach?
No. The tablet must be taken with food so the polymer can bind dietary phosphate. Taking it on an empty stomach reduces its effectiveness.
What should I do if I miss a dose?
Take the missed dose with the next meal. Do not double‑dose to make up for the missed tablet.
Is Sevelamer safe for patients on calcium‑based binders?
It can be used together, but clinicians usually switch to sevelamer when calcium load becomes excessive. Monitor calcium closely.
How long does it take to see a drop in serum phosphate?
Typically 2‑4 weeks after reaching a stable dose, assuming dietary phosphate intake remains constant.
Can Sevelamer cause constipation?
Yes, especially at higher doses. Increase fluid intake, consider a stool softener, or reduce the dose if constipation becomes severe.
