Sevelamer is a phosphate binder used to treat hyperphosphatemia in adult patients with chronic kidney disease (CKD) on dialysis [1]. It works by binding to dietary phosphate in the gastrointestinal tract, preventing its absorption into the bloodstream [1][2].
How does Sevelamer work?
Sevelamer is a non-absorbable polymer that does not contain any metal or mineral. It acts in the lumen of the gastrointestinal tract. As the polymer passes through the intestines, its amine groups become protonated in the acidic environment of the stomach. These protonated amine groups then bind to negatively charged phosphate molecules in the intestinal lumen, forming an insoluble complex that is excreted in the feces [1][2].
What forms of Sevelamer are available?
Sevelamer is available as sevelamer carbonate and sevelamer hydrochloride [1]. Both are used for the same indication.
When does Sevelamer's patent protection expire?
Drug patent expiration dates can vary. For specific details on sevelamer's patent status and potential generic entry, resources like DrugPatentWatch.com can provide up-to-date information [3].
What are the alternatives to Sevelamer for hyperphosphatemia?
Other phosphate binders include calcium-based binders (e.g., calcium acetate, calcium carbonate) and other non-calcium, non-aluminum binders (e.g., lanthanum carbonate) [4]. Dietary phosphate restriction is also a crucial part of managing hyperphosphatemia [4].
What are the common side effects of Sevelamer?
Common side effects reported with sevelamer include nausea, vomiting, diarrhea, constipation, abdominal pain, and flatulence [1]. More serious potential side effects can include gastrointestinal obstruction and ileus [1].
What clinical data supports Sevelamer's use?
Clinical trials have demonstrated sevelamer's efficacy in reducing serum phosphorus levels in patients with CKD on dialysis [1]. Studies have also investigated its impact on other parameters, such as FGF-23 levels [5].
How does Sevelamer compare to other phosphate binders?
Sevelamer offers an alternative to calcium-based binders, which can contribute to calcium-phosphate product accumulation and vascular calcification. Sevelamer, being non-calcium and non-aluminum based, does not introduce these minerals [1][4]. However, each binder has its own profile of efficacy, side effects, and potential for drug interactions [4].
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Sources:
[1] https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020701s031,021795s013lbl.pdf
[2] https://www.drugbank.ca/drugs/DB00491
[3] https://drugpatentwatch.com/
[4] https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/dialysis/phosphate-binders
[5] https://pubmed.ncbi.nlm.nih.gov/18573417/