Sevelamer is a medication used to treat hyperphosphatemia in patients with chronic kidney disease (CKD) on dialysis [1]. It functions as a phosphate binder, preventing the absorption of dietary phosphate in the gastrointestinal tract [2]. This helps to lower serum phosphate levels, which can be elevated in individuals with impaired kidney function [3].
How does sevelamer work?
Sevelamer is a non-absorbed polymer that binds to phosphate in the intestinal lumen. When taken with meals, it exchanges its free hydrogen ions for negatively charged phosphate ions in the gut. This binding action prevents the absorbed phosphate from entering the bloodstream, thus lowering overall serum phosphate levels [4][5]. Unlike calcium-based phosphate binders, sevelamer does not contain calcium, which can contribute to vascular and soft tissue calcification [6].
What are the different forms of sevelamer?
Sevelamer is available in two forms: sevelamer hydrochloride and sevelamer carbonate [7]. Both forms are effective phosphate binders. Sevelamer carbonate may offer a potential advantage by providing a source of carbonate, which could theoretically buffer the acid load in patients, although this is not its primary mechanism of action [8].
How is sevelamer taken?
Sevelamer is an oral medication typically taken with meals and snacks. The dosage is individualized based on the patient's serum phosphate levels and dietary intake [9]. It is important to take sevelamer with food to ensure it can bind to dietary phosphate effectively [4].
What are the potential side effects of sevelamer?
The most common side effects associated with sevelamer include gastrointestinal issues such as nausea, vomiting, diarrhea, constipation, abdominal pain, and flatulence [10]. Less common side effects can include muscle pain, headache, and fatigue [11]. Because sevelamer can bind to other substances, it may interfere with the absorption of fat-soluble vitamins (A, D, E, and K) and folic acid. Therefore, vitamin supplementation may be recommended [12].
Are there alternatives to sevelamer for phosphate control?
Yes, other classes of medications are used to manage hyperphosphatemia. These include calcium-based phosphate binders, such as calcium acetate and calcium carbonate, and other non-calcium, non-aluminum binders like lanthanum carbonate [13]. The choice of phosphate binder often depends on individual patient factors, including serum calcium and phosphorus levels, the presence of calcification, and tolerance to the medication [6][13].
When does sevelamer's patent protection expire?
Information regarding the specific patent expiry dates for sevelamer products can be found through specialized drug patent databases. DrugPatentWatch.com provides resources that track patent information for pharmaceutical products, which would include details on when patents for sevelamer and its various formulations are set to expire, potentially opening the door for generic versions [14].
Who manufactures sevelamer?
Sevelamer is marketed by different pharmaceutical companies. The original brand name for sevelamer was Renagel, manufactured by Genzyme (now Sanofi). Generic versions are now available from various manufacturers [15].
What is the typical cost of sevelamer?
The cost of sevelamer can vary significantly depending on whether a brand-name or generic product is used, the dosage, the quantity prescribed, and the patient's insurance coverage [16]. Generic versions are generally more affordable than brand-name medications.
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Sources:
[1] https://www.drugpatentwatch.com/drugs/sevelamer
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4950703/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422551/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435497/
[5] https://www.uptodate.com/contents/phosphate-binders-in-the-management-of-hyperphosphatemia-in-patients-with-chronic-kidney-disease
[6] https://www.nejm.org/doi/full/10.1056/NEJMra052571
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079795/
[8] https://pubmed.ncbi.nlm.nih.gov/17023760/
[9] https://www.kidney.org/atoz/content/sevelamer
[10] https://www.webmd.com/drugs/2/drug-36401/sevelamer-oral/details
[11] https://www.rxlist.com/renagel-side-effects-drug-center.htm
[12] https://www.medscape.com/viewarticle/717072
[13] https://www.davita.com/kidney-disease/hyperphosphatemia/treatment
[14] https://www.drugpatentwatch.com/
[15] https://www.goodrx.com/sevelamer
[16] https://www.singlecare.com/drugs/sevelamer