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There are several kinds of medicines used to control phosphate levels which contain sevelamer developed by GelTex Pharmaceuticals as active ingredient or other active components. Renagel is based on sevelamer; this drug is sevelamer hydrochloride, which binds phosphate in alimentary tube, thus, decreasing the level of phosphate in blood. The active component of Renagel is not absorbed in the gastrointestinal tract - it connects with the molecules of phosphate contained in food just in the stomach and helps them to pass out of the body. Thanks to this, the risk of toxicity is quite low.
One of the most prominent advantages of Renagel, if compared with medicines having another active ingredient, is to be free of calcium. This factor helps to reduce cases of hypercalcemia in those who take medicines aimed at phosphate binding.
Recommendations for Use
There arenít many indications for use for Renagel Ė it is prescribed to treat high serum phosphorus in patients with chronic kidney disease diagnose who are on dialysis. Also, it may be used for prevention of hypocalcemia.
Dosing of this medicine which is proper for one certain patient depends on different features, including treatment received before, changes in serum phosphorus concentration and experience of taking phosphate binding drugs. It must be defined by your doctor, as well as other medicines used in treatment together with Renagel. However, there are some common things about taking it:
ē Renagel must be taken with meals;
ē For those who take phosphate binder for the first time, the starting dose is from 800 to 1,600 mg;
ē If a patient has been receiving treatment with Calcium Acetate, dose of Renagel must be corresponding, itís 800 mg of Renagel instead of 1 tablet (667 mg) each meal;
ē After some period of treatment, the dose of Renagel may be changed to achieve 3.5 Ė 5.5 mg/dL serum phosphorus level, which must be controlled each 2-3 weeks;
ē The maximum dose of Renagel studied was 13 g.
Precautions and Contraindications
Renagel is a rather safe medicine, but some contraindications still exist. First of all, itís about hypersensitivity or allergy to any components of the drug. You should note that apart from sevelamer Renegal contains such inactive ingredients as colloidal silicon dioxide, diacetylated monoglyceride, hypromellose, stearic acid and also components included into tablet covering.
Another serious contraindication is bowl obstruction. Thus, there are only two cases when Renagel mustnít be prescribed. However, itís necessary to inform you doctor if you have any other health problems, like low blood phosphorus level, swallowing, stomach problems or surgeries.
Pregnant women may take Renagel if their doctors consider it to be necessary. Breastfeeding mothers are in nearly the same situation, as it hasnít been studied whether this drug passes into the milk. The same situation is with children under 18 Ė efficacy and safety for this group of patients havenít been studied.
Itís important to control the level of bicarbonate and chloride in blood to observe the efficacy of the treatment.
As for patients on dialysis, there havenít been performed any tests on this group. However, it was discovered that those medicines which action, efficacy and safety depend on bioavailability mustnít be taken together with Renagel. Itís allowed to take such medicines not less than one hour before Renagel, or three hours after it. Moreover, the period of timing depends on whether this drug is immediate or extended release.
Most side effects caused by Renagel are connected with the gastrointestinal tract. They include nausea, vomiting, dyspepsia, diarrhea, stomach ache, tympanism, constipation, etc. There may also appear itching skin, arthralgia and fatigue.
If side effects become severe, itís necessary to inform your doctor about them as soon as possible. There are some other side effects, which are quite rare, but may appear if Renagel is taken in spite of all the contraindications. In case you feel bad while taking Renagel itís a reason to visit your doctor.
Renagel is the medicine of high quality, which is effective in phosphate bonding and useful for patients with kidney diseases on dialysis. However, it must be prescribed and controlled by a doctor to avoid health problems.
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