Renagel

Renagel is a prescription-only medicine used to treat hyperphosphatemia (high blood level of phosphate) in chronic kidney disease patients undergoing dialysis. It is available as:

• Tablet
• Powder for Suspension
• Capsule

Before using Renagel, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will do you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Safety and efficacy of sevelamer in children have not been well documented. Therefore, consult your doctor before using in children.

Geriatric: Sevelamer is generally safe for use in elderly, and may require lower doses initially.

Pregnancy: It falls under pregnancy category C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this medication is safe for use in pregnancy.

Breastfeeding: Sevelamer is shown to have no significant risk to the infant when used by a nursing mother.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions.

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

• Ciprofloxacin
• Levothyroxine
• Mycophenolate Mofetil
• Mycophenolic Acid

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe.

Inform your doctor about the following conditions, if any:

• Bowel obstructions: Do not use sevelamer
• Trouble with swallowing
• Major gastrointestinal surgery
• Severe conditions of stomach or colon such as constipation: Use cautiously

To use Renagel properly, you must follow all instructions given by your doctor and do not take more, less, more frequently or for a longer duration than recommended.

Using this medicine with food helps to lower the incidence of side effects. Make sure you follow any special dietary instructions suggested by your doctor.

How to prepare oral suspension from the supplied powder:

• Remove the content from the packet into a cup and add water (2 tablespoons for the 0.8-gram dose or 4 tablespoons for the 2.4-gram dose). 
• Stir vigorously, and drink the mixture immediately or within 30 minutes.
• Stir the mixture before each use.

Do not take any other medicines at least 1 hour before or 3 hours after taking sevelamer.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose.

The doses of a medicine can differ according to the conditions for which it is being prescribed, your age and your overall health status.

Remember your doses can differ. Consult your doctor if you have anything to ask.

The doses of tablets or suspension to treat hyperphosphatemia are:

For patients who are not being treated with a phosphate binder

Tablets:

• Adults: Starting with 800 to 1600 milligrams (mg) thrice daily with food, your doses may be adjusted as needed.
• Children: Use and dose must be determined by your doctor.

Powder for suspension:

• Adults: Starting with 0.8 to 1.6 grams (g) of powder for suspension thrice daily with food, your doses may be adjusted as needed.
• Children: Use and dose must be determined by your doctor.

For patients replacing calcium acetate with sevelamer, the doses are calculated by your doctor and adjusted as needed.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.

Storage:

• Store in a closed container at room temperature.
• Keep away from heat, moisture, and direct light.
• Do not freeze.
• Keep away from children.
• Discard any unused or expired medicines.

In using Renagel, you must be careful and take some precautions as advised by your doctor. Your progress should be regularly monitored to determine if you are responding to the treatment.

You may need to get your blood tested to look for any undesirable effects.

• Talk to your doctor if your condition does not improve or worsen.
• Do not skip any dose and take your medicine at almost the same time every day.
• Follow any dietary instructions or special diet programs suggested by your doctor.

As with many medications, there are several potential side effects associated with Renagel.

Consult your doctor immediately if you have any of the following side effects:

Incidence not known:

• Black, tar-like stools
• Blood in stools
• Breathing difficulties
• Burning in the chest
• Dyspepsia
• Nausea and severe vomiting
• Severe abdominal pain
• Severe constipation
• Severe and continuing vomiting with the vomit resembling coffee grounds

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including: 

More common: 

• Burping
• Constipation or diarrhea
• Excess gas formation in the stomach or intestines
• Upset stomach

Incidence not known:

• Itchy skin rashes

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.