Sevelamer: uses, dosing, side effects & brands
Sevelamer is a phosphate binder sold in the U.S. under 3 brand and generic names, for hyperphosphatemia. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Phosphate Binder
- Treats (across its forms)
- Hyperphosphatemia
- Available as
- Tablet · Capsule · Powder
- Sold as
- 3 products — Renagel, Sevelamer Carbonate and Renvela
- Prescription?
- Prescription only
- Generic available?
- Yes
- What the pharmacy pays
- $7–$32 for a 30-count supply, depending on the brand — not your price
How Sevelamer Carbonate is dosed
From the FDA label for Sevelamer Carbonate (application ANDA209374). Other sevelamer products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Starting dose of sevelamer carbonate for oral suspension is 0.8 or 1.6 grams administered orally three times per day with meals based on serum phosphorus levels for adult patients and based on body surface area (BSA) category for pediatric patients. ( 2.1 ) Titrate by 0.8 g per meal in two-week intervals for adult patients as needed to obtain serum phosphorus target. ( 2.1 ) Titrate based on BSA category for pediatric patients in two-week intervals for 6 weeks and then every 4 weeks as needed to obtain serum phosphorus target. ( 2.1 ) 2.1 General Dosing Information Starting Dose fo r Adult Patients Not Taking a Phosphate Binder. The recommended starting dose of sevelamer carbonate for oral suspension is 0.8 to 1.6 g taken orally with meals based on serum phosphorus level. Table 1 provides recommended starting doses of sevelamer carbonate for oral suspension for adult patients not taking a phosphate binder. Table 1: Starting Dose for Adult Dialysis Patients Not Taking a Phosphate Binder Serum Phosphorus Sevelamer Carbonate for Oral Suspension > 5.5 and < 7.5 mg/dL 0.8 g three times daily with meals ≥ 7.5 mg/dL 1.6 g three times daily with meals Dose Titration for Adult Patients Taking Sevelamer Carbonate for Oral Suspension. Titrate the sevelamer carbonate for oral suspension dose by 0.8 g three times per day with meals at two‑week intervals as necessary to achieve target serum…
Everything below is the FDA label for Sevelamer Carbonate (powder, tablet). Sevelamer is also sold as capsule, and those are different medicines to take — follow the label for the one you were prescribed.
Sevelamer Carbonate side effects
Most of the safety experience is with sevelamer carbonate tablets and sevelamer hydrochloride. In long-term studies with sevelamer hydrochloride, which contains the same active moiety as sevelamer carbonate, the most common adverse events included: vomiting (22%), nausea (20%), diarrhea (19%), dyspepsia (16%), abdominal pain (9%), flatulence (8%), and constipation (8%). ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Bionpharma Inc. at 1-888-235-BION or 1-888-235-2466 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. There are limited clinical trial data on the safety of sevelamer carbonate. However, because it contains the same active ingredient as the hydrochloride salt, the adverse event profiles of the two salts are expected to be similar. In a cross-over study in hemodialysis patients with treatment durations of eight weeks each and no washout, and another cross-over study in hemodialysis patients with treatment durations of four weeks each and no washout between treatment periods, the adverse reactions on sevelamer carbonate powder were similar to those reported for…
Who shouldn’t take Sevelamer Carbonate
Sevelamer carbonate is contraindicated in patients with bowel obstruction. Sevelamer carbonate is contraindicated in patients with known hypersensitivity to sevelamer carbonate, sevelamer hydrochloride, or to any of the excipients. Bowel obstruction. ( 4 ) Known hypersensitivity to sevelamer carbonate, sevelamer hydrochloride, or to any of the excipients. ( 4 )
Sevelamer Carbonate drug interactions
There are no empirical data on avoiding drug interactions between sevelamer carbonate and most concomitant oral drugs. For oral medication where a reduction in the bioavailability of that medication would have a clinically significant effect on its safety or efficacy (e.g., cyclosporine, tacrolimus, levothyroxine), consider separation of the timing of the administration of the two drugs [see Clinical Pharmacology ( 12.3 )] . The duration of separation depends upon the absorption characteristics of the medication concomitantly administered, such as the time to reach peak systemic levels and whether the drug is an immediate-release or an extended-release product. Where possible consider monitoring clinical responses and/or blood levels of concomitant drugs that have a narrow therapeutic range. Table 5: Sevelamer Drug Interactions Oral drugs for which sevelamer did not alter the pharmacokinetics when administered concomitantly Digoxin Enalapril Iron Metoprolol Warfarin Oral drugs that have demonstrated interaction with sevelamer and are to be dosed separately from sevelamer carbonate Ciprofloxacin Mycophenolate mofetil Dosing Recommendations Take at least 2 hours before or 6 hours after sevelamer Take at least 2 hours before sevelamer For oral medication where a reduction in the bioavailability of that medication would have a clinically significant effect on its safety or efficacy, consider separation of the timing of administration and/or monitor clinical responses or blood levels of the concomitant medication. ( 7 ) Sevelamer did not alter the pharmacokinetics of digoxin, enalapril, iron, metoprolol and warfarin. ( 7 ) Sevelamer has demonstrated interaction with ciprofloxacin, mycophenolate mofetil, and therefore, these drugs should be dosed separately from sevelamer carbonate. ( 7 )
Every sevelamer product we track (3)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 70/100 | Prescription | Tablet | Generic | $32 | View → | |
| 2 | 70/100 | Prescription | Suspension | Generic | $7 | View → | |
| 3 | Not yet rated | Prescription | Suspension | Generic | $7 | View → |
What sevelamer pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
Sevelamer recalls
From the FDA Enforcement database. A recall covers specific lots — not the drug as a whole.
How long sevelamer keeps
No sevelamer label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does sevelamer expire? The in-use limits and storage rules from its labelsSevelamer and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for sevelamer: levels in milk, effects in breastfed infants, and the drugs it would consider insteadBecause sevelamer is not orally absorbed, sevelamer does not reach the breastmilk or adversely affect the breastfed infant after maternal administration. A suspension of sevelamer has been added directly to breastmilk to lower the phosphorus concentration of milk. This could be a useful maneuver for breastmilk use in infants with renal impairment; however, clinical use has not been reported. In addition to lowering average phosphorus content by 65% to over 80%, the calcium content of breastmilk was reduced by almost as much and the casein content also decreased somewhat. With sevelamer hydrochloride, the chloride content increased by 60% and the pH changed from 6.8 to 7.8, although pH appears to rebound over time. Addition of large amounts of sevelamer to artificial formula also lowers the copper, magnesium, manganese, potassium, sulfur and zinc concentrations by about 20%. Similar reductions might occur with breastmilk.
National Institute of Child Health and Human Development, record revised June 21, 2021. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about sevelamer
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 672 reports naming sevelamer, and the FDA flagged 92% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- hospitalisation45 reports
- arteriovenous fistula site complication33 reports
- diarrhoea33 reports
- nausea29 reports
- pneumonia26 reports
- pyrexia26 reports
- crystal deposit intestine25 reports
- dyspnoea22 reports
Read these as a signal, not a rate. A report does not mean sevelamer caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved July 26, 2026.
Related calculators
Frequently asked questions
What is Sevelamer Carbonate?
The active ingredient in sevelamer carbonate for oral suspension is sevelamer carbonate, a polymeric amine that binds phosphate and is meant for oral administration. It was developed as a pharmaceutical alternative to sevelamer hydrochloride. Sevelamer carbonate is an anion exchange resin, with the same polymeric structure as sevelamer hydrochloride, in which carbonate replaces chloride as the counterion. While the counterions differ for the two salts, the polymer itself, the active moiety involved in phosphate-binding, is the same.
What kind of drug is sevelamer?
The FDA classifies sevelamer as a phosphate binder. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take sevelamer with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run sevelamer against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is sevelamer sold under?
We track 3 sevelamer-containing products in the U.S.: Renagel, Sevelamer Carbonate and Renvela. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does sevelamer come in?
Across the brands we track, sevelamer is currently marketed as tablet, capsule and powder, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic sevelamer?
Yes. Our catalog lists 1 generic sevelamer product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Has sevelamer been recalled?
The FDA's Enforcement database lists 1 recall record whose product description mentions sevelamer. The most recent: Sevelamer Carbonate for Oral Suspension 0.8g packets (Jun 26, 2024). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Sevelamer: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/sevelamer
- MLA
- “Sevelamer: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/sevelamer.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for sevelamer on DailyMed (NIH) ↗.