Renvela (Sevelamer) - Oral

What Is Renvela?

Renvela (sevelamer) is a medication that is used to control high phosphorus levels (hyperphosphatemia) in people with chronic kidney disease (CKD) who are on dialysis. Dialysis is a medical treatment that manually filters your blood when the kidneys can’t do it independently.

Phosphorus is an important electrolyte that helps with energy levels, bone growth, and muscle contraction. But having too much phosphorus in your body can damage the heart, bones, and muscles. This is because your kidneys control the level of electrolytes in the body. When kidney function declines, they are unable to do this effectively. This leads to accumulation and high levels of some electrolytes like phosphorus.

Renvela belongs to a class called phosphate binders or phosphorus binders. Phosphate binders work by attaching to excess phosphorus in your blood and removing it from your body.

This medication comes in powder and tablet dosage forms. It is available under the brand name Renvela and as a generic product under the name sevelamer. A licensed healthcare provider will need to prescribe Renvela for you, as it is not available over-the-counter (OTC).

Drug Facts

Generic Name: Sevelamer

Brand Name: Renvela, Renagel

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Phosphate binder

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Sevelamer carbonate

Dosage Form: Tablet, powder

What Is Renvela Used For?

Renvela controls high phosphorus levels in people with chronic kidney disease (CKD).

Normal functioning kidneys work like the body's filters, removing waste through urine and returning substances that are needed to the body's circulation.

Kidneys are also responsible for maintaining your body’s fluid volume, which affects blood pressure, breathing, and brain function. Having the right balance of electrolytes is vital to this function. A person with CKD may not be able to maintain the appropriate amount of electrolyte levels (such as phosphorus), causing them to become dangerously high.

As Renvela moves through your digestive tract, it picks up phosphorus molecules and removes them from your blood, ultimately removing them from your body.

How to Take Renvela

You will most likely take Renvela with each meal. It comes either as a tablet or in packets of powder.

To prepare the powder, place it in a cup and add water. The amount of water you use should depend on the dose. You may have to stir the mixture if it doesn’t dissolve on its own, but note that the mixture will be cloudy as the powder does not fully dissolve:

  • For 0.4 grams (g) of powder, add one ounce or 30 milliliters (mL) or 2 tablespoons of water.
  • For 0.8 grams of powder, add 1 ounce or 30 milliliters or 2 tablespoons of water.
  • For 2.4 grams of powder, add 2 ounces or 60 milliliters or 4 tablespoons of water.

Wait until you’re ready to take the powder before mixing, as it needs to be taken within 30 minutes once mixed. Do not premix or batch doses.

You can also mix Renvela with another liquid besides water, such as juice or soft food like applesauce. Do not add it to hot foods or place the mixture in the microwave. Finish the entire beverage or snack to ensure you get the total Renvela dose.

Storage

Store Renvela powder and tablets at room temperature (68 F to 77 F). Keep them in the bottle or package they came in. Do not mix the powder with liquid until you’re ready to take your dose, as it must be taken within 30 minutes of mixing.

If you’re traveling by plane, keep Renvela in your carry-on luggage in case your checked luggage goes missing.

How Long Does Renvela Take to Work?

Sevelamer significantly reduced phosphorus levels in a clinical trial measuring phosphorus levels before and eight weeks after individuals started taking the drug. Sevelamer may work more or less quickly to lower levels depending on the individual. For Renvela to work, it’s important to take it exactly as prescribed.

What Are the Side Effects of Renvela?

Like other medications, Renvela may cause side effects. 

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects that you may experience while taking Renvela are gastrointestinal (GI). Note that “common” in this case means they were experienced by greater than or equal to 5% of people in clinical trials:

  • Vomiting
  • Nausea
  • Diarrhea
  • Dyspepsia (indigestion)
  • Abdominal pain
  • Flatulence (passing gas)
  • Constipation

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms include:

  • Gastrointestinal ulcer: This is an open sore or a break in the lining of part of the GI tract, such as the stomach or intestines.
  • Colonic necrosis and perforation: Colonic necrosis occurs when a part of your colon (large intestine) dies due to cell damage. This can lead to perforation, which is a hole forming in the intestinal wall. These rare side effects are most common in people with a pre-existing intestinal disease or kidney disease.
  • Fecal impaction: This happens when a stool hardens so much that you cannot pass it, leading it to get stuck in the intestines. Removing it may require medications or sometimes surgery.

Report Side Effects

Renvela may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Renvela Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For high phosphorus levels in the blood:
    • For oral dosage forms (suspension or tablets):
      • For patients not taking a phosphate binder:
        • Renagel®:
          • Adults—At first, 800 to 1600 milligrams (mg) (1 to 2 tablets) three times a day with meals, depending on your blood phosphorus level. Your doctor will adjust your dose as needed.
          • Children—Use and dose must be determined by your doctor.
        • Renvela®:
          • Adults—At first, 800 to 1600 mg (1 to 2 tablets) or 0.8 to 1.6 grams (g) of powder for suspension three times a day with meals depending on your blood phosphorus level. Your doctor will adjust your dose as needed.
          • Children 6 years of age and older—Dose is based on body surface area (BSA) and must be determined by your doctor:
            • 1.2 square meter (m2) or more of BSA—At first, 1.6 g of powder for suspension three times a day with meals depending on your blood phosphorus level. Your doctor will adjust your dose as needed.
            • 0.75 to less than 1.2 m2 of BSA—At first, 0.8 g of powder for suspension three times a day with meals depending on your blood phosphorus level. Your doctor will adjust your dose as needed.
          • Children younger than 6 years of age—Use and dose must be determined by your doctor.
      • For patients switching from Renagel® tablets to Renvela® powder for suspension or tablets:
        • Adults—Use the same dose in grams. Your doctor will adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
      • For patients switching from calcium acetate to sevelamer, your doctor will determine the best dose for you and adjust as needed.

Modifications

Pregnancy and Breastfeeding

No quality studies have evaluated the safety of sevelamer use while pregnant or breastfeeding. But since Renvela stays in the digestive tract and is not absorbed into your bloodstream, it is unlikely to cause harm to a developing fetus or newborn. Nevertheless, it should only be used in pregnancy or nursing if the benefits outweigh the potential risks.

One thing to note is that sevelamer may decrease specific fat-soluble vitamins and folic acid levels in pregnant people. Ask your healthcare provider about additional supplementation.

Children

Renvela has been studied and is considered safe and effective for children 6 years and older with chronic kidney disease. Similar to adults, most side effects were GI-related. No new or separate risks were identified in clinical trials, including children. However, Renvela has not been studied in children younger than 6.

Missed Dose

If you forget to take a dose of Renvela, skip the missed dose and wait for your next scheduled one. Do not double up doses to make up for missed ones.

Overdose: What Happens If I Take Too Much Renvela?

You don't need to be concerned about overdosing as long as you’re taking Renvela as prescribed.

In clinical studies, individuals with CKD took doses up to 14 grams (approximately double the average daily amount), with no overdoses reported. Sevelamer is not absorbed, so the risk of toxicity in your bloodstream is low.

What Happens If I Overdose on Renvela?

If you think you or someone else may have used too much or accidentally swallowed Renvela, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses, has a seizure, has trouble breathing, or can’t wake up after using too much or accidentally swallowing Renvela, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

If your symptoms do not improve or if they get worse, call your doctor.

This medicine may cause serious stomach or bowel problems, including blockage, bleeding, ulcers, colitis (severe diarrhea), necrosis, or perforation (tear or hole). Check with your doctor right away if you have bloating, bloody, black, or tarry stools, constipation, diarrhea, fever, heartburn, indigestion, nausea and vomiting, stomach pain, cramping, burning, or tenderness, or vomiting of material that looks like coffee grounds.

Many people with kidney problems need to be on a special diet. To keep your kidney disease from getting worse, it is very important that you follow your special diet and take your medicines regularly, even if you are feeling better.

What Are Reasons I Shouldn’t Take Renvela?

The following are circumstances in which Renvela should not be used or should at least be discussed with your healthcare provider before use:

  • Hypophosphatemia (low phosphorus levels)
  • Any kind of obstruction or impaction in the stomach or small intestines
  • Dysphagia (difficulty swallowing), other swallowing disorders, or severe gastrointestinal motility disorders (such as severe constipation)

What Other Medications Interact With Renvela?

Ensure your healthcare providers, including your pharmacist, know all prescription and OTC medicines you take, including vitamins and herbal products. You may need to adjust your dose timing with some medications around sevelamer, as it can affect how they are absorbed.

Take these medicines at least one hour before or three hours after Renvela:

  • Gengraf, Neoral Sandimmune (cyclosporine)
  • Levo-T, Synthroid, Tirosint (levothyroxine)
  • Astagraf, Prograf, Protopic (tacrolimus)

Take Cipro (ciprofloxacin) at least two hours before or six hours after taking Renvela.

Take CellCept (mycophenolate) at least two hours before taking Renvela.

What Medications Are Similar to Renvela?

Other drugs that work to lower phosphorus levels include:

  • Renagel (sevelamer hydrochloride) is similar to Renvela but comes as a different salt attached to the drug molecule. Renagel is available only as a tablet and may have a higher risk of acidosis (excess acid in the body's fluids).
  • Fosrenol (lanthanum carbonate) is another phosphate binder. It is available in more tablet strengths, which may result in fewer daily pills.
  • Velphoro (sucroferric oxyhydroxide) is similar to Fosrenol because it will usually only require three daily pills. They are chewable tablets, which may help some who have trouble swallowing.

These three drugs are all non-calcium-based. Other phosphate binders used to lower phosphorus levels are calcium-containing binders (like calcium carbonate) and aluminum-containing binders (like aluminum hydroxide), both of which are older and less expensive drug classes.

This is not a list of drugs recommended to take with Renvela. You should not take these drugs together.

Frequently Asked Questions

  • What is Renvela used for?

    Renvela is used to lower phosphorus levels in the blood. Phosphorus is an electrolyte; having too much of it in your blood can lead to heart, bone, and muscle damage. Renvela is usually taken with meals three times per day.

  • How does Renvela work?

    Renvela works by binding to phosphorus and removing it as it moves through the gastrointestinal tract. The drug is not absorbed into your bloodstream, so it does not build up in your body.

  • What are the side effects of Renvela?

    Since Renvela works in your digestive tract and does not get absorbed into the blood, the most common side effects are gastrointestinal. These include nausea and vomiting, diarrhea, indigestion, abdominal pain, gas, and constipation. More rare but potential side effects include ulcers, bowel perforation, and fecal impaction.

How Can I Stay Healthy While Taking Renvela?

Chronic kidney disease can significantly impact the quality of life, especially if the condition progresses and dialysis is necessary.

One of the many caveats of dealing with kidney disease is monitoring electrolytes. Managing levels of electrolytes like phosphorus in the body can be complicated. Phosphorus is vital in maintaining heart, muscle, and bone health. However, if too much accumulates (as it can in people with CKD), it has the potential to damage organs and bones.

In addition to taking phosphate binders, your healthcare provider may recommend a renal diet with a controlled amount of phosphorus. Some foods containing phosphorus offer other nutritional benefits and can be eaten in moderation. However, you should avoid foods like soft drinks and fast food that offer no nutritional benefit in addition to their high phosphorus content.

Fundamental health changes such as quitting smoking and increasing exercise frequency will improve your quality of life when dealing with CKD. Learning all you can about the disease, educating your family and friends, and joining support groups can also help you cope with the stresses of managing a chronic condition.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Renvela (sevelamer cabonate) prescribing information.

  2. National Kidney Foundation. Phosphorus and your diet.

  3. Oregon State University. Physiology of urine formation.

  4. Chen N, Wu X, Ding X, et al. Sevelamer carbonate lowers serum phosphorus effectively in haemodialysis patients: a randomized, double-blind, placebo-controlled, dose-titration study. Nephrol Dial Transplant. 2014;29(1):152-160. doi:10.1093/ndt/gft232

  5. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); Sevelamer.

  6. MedlinePlus. Sevelamer.

  7. Chan S, Au K, Francis RS, Mudge DW, Johnson DW, Pillans PI. Phosphate binders in patients with chronic kidney disease. Aust Prescr. 2017;40(1):10-14. doi:10.18773/austprescr.2017.002

  8. Howden EJ, Coombes JS, Strand H, Douglas B, Campbell KL, Isbel NM. Exercise training in CKD: efficacy, adherence, and safety. Am J Kidney Dis. 2015;65(4):583-591. doi:10.1053/j.ajkd.2014.09.017

By Sara Hoffman, PharmD
Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.