Sevelamer

Sevelamer
Systematic (IUPAC) name
poly(allylamine-
co-N,N'-diallyl-1,3-diamino-2-hydroxypropane)
Clinical data
Trade names Renagel
AHFS/Drugs.com monograph
MedlinePlus a601248
Pregnancy cat. B3 (Australia), C (US)
Legal status Schedule 4 (Australia), Rx only (US)
Routes oral
Pharmacokinetic data
Bioavailability nil
Metabolism nil
Half-life n/a
Excretion faecal 100%
Identifiers
CAS number 52757-95-6 Y
ATC code V03AE02
PubChem CID 3085017
DrugBank APRD01226
ChemSpider 2341997 N
UNII 941N5DUU5C N
KEGG D08512 Y
ChEMBL CHEMBL1201798 N
Chemical data
Formula [(C3H7N)a+b.(C9H17N2O)c]m
where a+b:c = 9:1
Mol. mass variable
 N(what is this?)  (verify)

Sevelamer (rINN) ( /sɛˈvɛləmər/ or /sɛˈvɛləmɪər/) is a phosphate binding drug used to prevent hyperphosphatemia in patients with chronic renal failure. When taken with meals, it binds to dietary phosphate and prevents its absorption. It is marketed by Genzyme under the trade names Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate).

Contents

Chemistry and pharmacology

Sevelamer is a copolymer of 2-(chloromethyl)oxirane (epichlorohydrin) and prop-2-en-1-amine. The marketed form sevelamer hydrochloride is a partial hydrochloride salt being present as approximately 40% amine hydrochloride and 60% sevelamer base. The amine groups of sevelamer become partially protonated in the intestine and interact with phosphorus molecules through ionic and hydrogen bonding.

Clinical use

Indications

Sevelamer is indicated for the management of hyperphosphataemia in adult patients with stage 4 and 5 chronic renal failure on hemodialysis.

Contraindications

Sevelamer therapy is contraindicated in hypophosphataemia or bowel obstruction.

Adverse effects

Common adverse drug reactions (ADRs) associated with the use of sevelamer include: hypotension, hypertension, nausea and vomiting, dyspepsia, diarrhea, flatulence, and/or constipation.

Other effects

Sevelamer can significantly reduce serum uric acid.[1] This reduction has no known detrimental effect and several beneficial effects, including reducing hyperuricemia, uric acid nephrolithiasis, and gout.

External links

References

  1. ^ Garg JP, Chasan-Taber S, Blair A, et al. (January 2005). "Effects of sevelamer and calcium-based phosphate binders on uric acid concentrations in patients undergoing hemodialysis: a randomized clinical trial". Arthritis and rheumatism 52 (1): 290–5. doi:10.1002/art.20781. PMID 15641045.