l无全身性吸收，所以安全性高，可以有效控制血磷值并且不会导致高血钙症等副作用。磷能解锭的使用禁忌，主要是对低血磷、大肠阻塞、以及对该药成份会过敏的患者。
长期洗肾的病友，还需考虑软组织钙化，尤其是动脉钙化问题，这可能与心脏血管疾病有密切关联。Braun等人在二年的长期临床试验中，研究了114位洗肾病友，发现Renagel与其它含钙制剂的降磷效果相当。但使用含钙制剂的病人，有明显较多的高钙血症与PTH的过度抑制现象。其中高钙血症 (Ca ＞2.8 mmol/L) 在含钙制剂组与Renagel治疗组的出现比例，分别是19%与0%。另一方面，使用含钙制剂的病人，其心血管钙化程度有明显的增加 (median +34% in coronary artery)， 而服用Renagel的肾友则未观察到这个问题。
目前Renagel已在美、日、加、与欧洲等共计40多国上市并广泛的使用。在我国，Renagel已在林口及台北长庚完成国内人体临床试验，并发表于2003年台湾肾脏医学会年会。试验结果看来，肾友在10周的试验期服用此药可以有效降低血磷值，而且高血钙症的副作用明显低于服用钙剂患者。卫生署已核发该药品上市许可证。预期Renagel将在今年2005年8月在台湾正式上市。
RENAGEL TAB 400MG 360
Generic Name: SEVELAMER HCL
Class: R
Manufacture: GENZYME CORPORATION
Strength: 400MG
Size: 360
Unit: TAB
RENAGEL TAB 800MG 180
Generic Name: SEVELAMER HCL
Class: R
Manufacture: GENZYME CORPORATION
Strength: 800MG
Size: 180
Unit: TAB
RENAGEL TABLETS Rx
Generic Name and Formulations:
Sevelamer HCl 400mg, 800mg.
Company:
Genzyme Corporation
e-Prescribe this drug via Surescripts
Therapeutic Use:
Hyperphosphatemia
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Indications for RENAGEL TABLETS:
Reduction of serum phosphorus in end stage renal disease in patients on hemodialysis.
Adult Dose for RENAGEL TABLETS:
Swallow whole with meals. Patients not taking a phosphate binder: serum phosphorus >5.5 to <7.5mg/dL: 800mg 3 times daily; 7.5–9mg/dL: 1.2–1.6g 3 times daily; ≥9mg/dL: 1.6g 3 times daily. Titrate by 1 tab per meal at 2-week intervals to keep serum phosphorus ≤5.5mg/dL. Switching from calcium acetate to sevelamer: see literature.
Children's Dose for RENAGEL TABLETS:
Not recommended.
Pharmacological Class:
Phosphate binder.
Contraindications:
Hypophosphatemia. Bowel obstruction.
Warnings/Precautions:
Dysphagia. Swallowing disorders. Severe GI motility disorders. Major GI tract surgery. Monitor serum calcium, bicarbonate, chloride. Pregnancy (Cat.C).
Interactions:
Separate narrow therapeutic index drugs by 1 hr before or 3 hrs after sevelamer, or monitor.
Adverse Reactions:
GI upset, headache, constipation.
How Supplied:
Tabs 400mg—360; 800mg—180
