Renagel Dosage

Generic name: SEVELAMER HYDROCHLORIDE 400mg
Dosage form: tablet
Drug class: Phosphate binders

Medically reviewed by Drugs.com. Last updated on Apr 12, 2023.

Patients Not Taking a Phosphate Binder. The recommended starting dose of Renagel is 800 to 1600 mg, which can be administered as one or two 800 mg Renagel tablets with meals based on serum phosphorus level. Table 1 provides recommended starting doses of Renagel for patients not taking a phosphate binder.

Table 1: Starting Dose for Dialysis Patients Not Taking a Phosphate Binder
Serum Phosphorus	Renagel 800 mg
>5.5 and <7.5 mg/dL	1 tablet three times daily with meals
≥7.5 and <9.0 mg/dL	2 tablets three times daily with meals
≥9.0 mg/dL	2 tablets three times daily with meals

Patients Switching from Calcium Acetate. In a study in 84 CKD patients on hemodialysis, a similar reduction in serum phosphorus was seen with equivalent doses (approximately mg for mg) of Renagel and calcium acetate. Table 2 gives recommended starting doses of Renagel based on a patient's current calcium acetate dose.

Table 2: Starting Dose for Dialysis Patients Switching from Calcium Acetate to Renagel
Calcium Acetate 667 mg (Tablets per meal)	Renagel 800 mg (Tablets per meal)
1 tablet	1 tablet
2 tablets	2 tablets
3 tablets	3 tablets

Dose Titration for All Patients Taking Renagel. Adjust dosage based on the serum phosphorus concentration with a goal of lowering serum phosphorus to 5.5 mg/dL or less. Increase or decrease by one tablet per meal at two-week intervals as necessary. Table 3 gives a dose titration guideline. The average dose in a Phase 3 trial designed to lower serum phosphorus to 5.0 mg/dL or less was approximately three Renagel 800 mg tablets per meal. The maximum average daily Renagel dose studied was 13 g.