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Is Renvela the Same as Sevelamer?

Key Takeaways

  • Renvela is a brand name for sevelamer carbonate, so it is a type of sevelamer, but it is not identical to all sevelamer products.
  • Renagel is sevelamer hydrochloride, a different sevelamer formulation that may affect bicarbonate and metabolic acidosis risk differently.
  • Both Renvela and Renagel are phosphate binders used in chronic kidney disease (CKD), especially in dialysis patients, to lower serum phosphorus and manage hyperphosphatemia (high phosphorus levels).
  • Common side effects are mostly gastrointestinal, including constipation, gas, nausea, diarrhea, and stomach pain. Severe constipation or bowel obstruction can also occur in rare cases.
  • A healthcare provider can help choose between sevelamer carbonate vs sevelamer hydrochloride based on lab results, dosage forms, drug interactions, and tolerability.

What Is Renvela?

Renvela is a brand-name phosphate binder used to treat high phosphorus levels (hyperphosphatemia) in people with chronic kidney disease (CKD). It is commonly prescribed for dialysis patients, including hemodialysis patients, because the kidneys affected by CKD can’t remove phosphorus effectively.

Renvela contains sevelamer carbonate, an anion-exchange resin that binds phosphorus in the gastrointestinal tract, so less phosphorus from your diet is absorbed. Lowering phosphorus levels helps protect bones and blood vessels and is a key goal in CKD care.

Renvela comes in different dosage forms, including 800 mg tablets and a powder for oral suspension.

What Is Sevelamer?

Sevelamer is the generic name of a phosphate binder used to lower phosphate levels in CKD, especially in dialysis patients. Sevelamer works through phosphate binding in the gut rather than being absorbed into the bloodstream, which is one reason it’s widely used in kidney disease.

There are two main sevelamer formulations:

  • Sevelamer carbonate (Renvela)
  • Sevelamer hydrochloride (Renagel)

So, Renvela is a type of sevelamer, but the term “sevelamer” alone could refer to either carbonate or hydrochloride (HCl) formulation.

Renvela vs Renagel: What’s the Difference?

Renvela and Renagel are closely related, but the main difference is the chemical form.

Renvela (sevelamer carbonate)

  • Contains carbonate
  • Often preferred in many CKD patients due to acid-base considerations

Renagel (sevelamer hydrochloride)

  • Contains chloride (HCl)
  • Has been associated with a higher chance of metabolic acidosis in some patients

The reason is related to bicarbonate balance. In simple terms, hydrochloride forms can contribute to acid load, while carbonate forms may be less likely to worsen metabolic acidosis.

Because chronic kidney disease already increases the risk of acid-base imbalance, this difference matters for certain dialysis patients.

How Renvela Works as a Phosphate Binder

Renvela works by binding phosphate from food in the gut. It is considered a non-calcium phosphate binder, meaning it lowers phosphorus levels without adding calcium.

This can be important because excessive calcium intake may contribute to vascular calcification in CKD.

Mechanism of action (simplified):

  • Renvela acts as an anion-exchange resin
  • It binds dietary phosphate in the gastrointestinal tract
  • Bound phosphate is eliminated through the stool
  • Less phosphate enters the bloodstream
  • Serum phosphorus decreases over time

This process supports better control of phosphate levels in dialysis patients.

What Conditions Is Renvela Used For?

Renvela is primarily used for:

  • Hyperphosphatemia in chronic kidney disease
  • High phosphorus levels in dialysis patients

It may be used in hemodialysis patients and sometimes in CKD patients not on dialysis, depending on clinical judgment.

Side Effects of Renvela and Sevelamer

The most common side effects are gastrointestinal (GI) related and include:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Gas and bloating
  • Indigestion
  • Constipation

Serious side effects can include:

  • Bowel obstruction or intestinal blockage
  • Severe constipation
  • Ulcers or gastrointestinal injury in rare cases

If you have severe constipation, persistent vomiting, or intense abdominal pain, you should seek immediate medical attention.

Drug Interactions

Sevelamer products can interfere with the absorption of some medications. Drug interactions can be managed by spacing doses apart, but this should be done with guidance from your healthcare provider.

Examples of important interactions include:

  • Ciprofloxacin
  • Levothyroxine
  • Mycophenolate
  • Some vitamin D preparations and fat-soluble vitamins

Supplements, Vitamins, and CKD Considerations

Many CKD and dialysis patients take supplements such as vitamin D, folic acid, or specialized renal vitamins. Since phosphate binders can interfere with nutrient absorption, healthcare providers may monitor vitamin levels to be sure they are within normal range.

Renvela is considered non-calcium, so it does not provide calcium like calcium acetate or other calcium-based binders. In some patients, calcium-based binders may still be used, depending on lab goals and tolerability.

Dosage Forms and How They’re Taken

Renvela is available as:

  • Oral Tablets
  • Powder for Oral Suspension

It is usually taken with meals to bind phosphorus from food. The dose is adjusted based on serum phosphorus levels and ongoing lab monitoring.

Do not crush or chew tablets unless instructed, and prepare oral suspension as directed.

Clinical Trials and Evidence

Sevelamer products have been studied in clinical trials, including crossover designs comparing sevelamer hydrochloride and sevelamer carbonate. Two randomized, crossover studies found that the two sevelamer formulations were equally effective in their ability to lower serum phosphate levels.

Some studies suggest sevelamer may also lower LDL cholesterol, which can be an added benefit in some CKD patients, though the primary goal remains phosphorus control.

Bottom Line

Renvela is sevelamer carbonate, so it is a type of sevelamer. However, sevelamer can also refer to sevelamer hydrochloride (Renagel), which is a different formulation. Both are phosphate binders used to lower serum phosphorus in chronic kidney disease, especially in dialysis patients. Your healthcare provider can help determine which formulation fits your labs, side effect risk, and medication schedule best.

FAQs

Is Renvela the same thing as generic sevelamer?
Renvela is one specific type of sevelamer called sevelamer carbonate. Generic sevelamer may be carbonate or hydrochloride, depending on the product, so it’s important to confirm which formulation you are receiving.

Why do some people take Renvela instead of Renagel?
Renvela contains sevelamer carbonate, which may be less likely to worsen metabolic acidosis compared with sevelamer hydrochloride. This can matter in chronic kidney disease and dialysis patients, since acid-base balance is already a concern.

Does Renvela have the same side effects as other phosphate binders?
Like most phosphate binders, Renvela’s side effects are mainly gastrointestinal, especially diarrhea, nausea, vomiting, constipation, and stomach pain. Serious side effects like bowel obstruction are rare, but they can happen, so persistent abdominal pain should be evaluated.

Can Renvela interfere with other medications?
Yes, Renvela can reduce the absorption of certain drugs like ciprofloxacin or levothyroxine if taken too close together. Your healthcare provider can help you space doses to reduce drug interactions while keeping phosphorus levels controlled.

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