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 Release 22.0, Sept. 2008
 
The Medical Algorithms Project
Chapter : ch45. Pharmacy Practice Section : Writing and Filling a Prescription
  Determining the Appropriate Dose of Sevelamer Hydrochloride to Control Serum Inorganic Phosphorus Levels in Patients with End Stage Renal Failure

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Overview :

Sevelamer hydrochloride (Renagel, Genzyme) is a phosphate binding agent that can reduce serum phosphate levels in patients with end-stage renal disease.

 

Formulations:

(1) 400 mg tablets

(2) 403 mg capsules

(3) 800 mg tablets

 

Initiating Therapy

 

Serum Phosphorus Level

Dose 400 mg tablets or capsules

Dose 800 mg tablets

>= 9.0 mg/dL

4 tablets or capsules 3 times daily with meals

2 tablets 3 times daily with meals

>= 7.5 and < 9.0 mg/dL

3 tablets or capsules 3 times daily with meals

2 tablets 3 times daily with meals

> 6.0 and < 7.5 mg/dL

2 tablets or capsules 3 times daily with meals

1 tablet 3 times daily with meals

 

 

Serum Phosphorus Level

Dosage Adjustment

< 3.5 mg/dL

decrease one 400 mg tablet or capsule per meal

3.5 to 6.0 mg/dL

maintain current dose

> 6.0 mg/dL

increase one 400 mg tablet or capsule per meal at 2 week intervals

 

  References:

Physicians' Desk Reference (PDR). 57 Edition, 2003. Medical Economics, Thomson Healthcare. page 1419-1421.

 

 
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