Medicase - Karvela 800 - 4 Tablets - 800mg - Sevelamer Hydrochloride/Carbonate

Karvela 800800mg

Type:4 Tablets

Generic Name:Sevelamer Hydrochloride/Carbonate

Manufacturer:Healthcare Pharmaceuticals Ltd.

Price:৳240.00

Indication

Hyperphosphataemia

Administration

Should be taken with food.

Adult Dose

End-Stage Renal Disease Hemodialysis; hyperphosphatemia Initial dose Serum PO4 >9 mg/dL [2.91 mmol/L]: 1600 mg PO q8hr with meals Serum PO4 7.5-9 mg/dL [2.42-2.91 mmol/L]: 1200-1600 mg PO q8hr with meals Serum PO4 5.5-7.5 mg/dL [1.78-2.42 mmol/L]: 800 mg PO q8hr with meals Maintenance dose Serum PO4 >5.5 mg/dL [>1.78 mmol/L]: Increase dose by 400-800 mg per meal Serum PO4 3.5-5.5 mg/dL [1.13-1.78 mmol/L]: Maintain current dose Serum PO4 <3.5 mg/dL [1.13 mmol/L] decrease by 400-800 mg per meal Dosing considerations Titrate dose; increase by 400-800 mg per meal at 2-week intervals; no more than 4 g Switching From Ca-Acetate Substitute 800 mg for 667 mg of Ca-acetate Substitute 1600 for1334 mg of Ca-acetate Substitute 2400 mg for 2001 mg Ca-acetate

Child Dose

Safety and efficacy not established

Contraindication

Hypophosphatemia or bowel obstruction.

Mode of Action

Sevelamer, a polymeric compound, acts by binding to phosphate molecules in the gut, limiting its absorption and thus lowering serum phosphate levels w/o altering Ca, Al, or bicarbonate levels.

Precaution

Patients w/ dysphagia, swallowing disorders, severe GI motility disorders, active inflammatory bowel disease or major GI tract surgery. Pregnancy and lactation. Monitoring Parameters Monitor serum levels of phosphate, Ca, Cl and bicarbonate. Vitamin supplementation due to reduction in vit D, E, K and folic acid absorption. Monitor for signs and symptoms of peritonitis in patients undergoing peritoneal dialysis. Lactation: Not absorbed systemically; not excreted in breast milk

Side Effect

>10% Vomiting (22%),Nausea (20%),Diarrhea (19%),Dyspepsia (16%),Nasopharyngitis (14%),Limb pain (13%),Pruritus (13%),Arthralgia (12%),Bronchitis (11%),Dyspnea (10%),Hypertension (10%) 1-10% Abdominal pain (9%),Constipation (8%),Flatulence (8%),Peritonitis (during peritoneal dialysis: 8%),Hypercalcemia (5-7%) Frequency Not Defined Back pain,Cough,Headache,Pyrexia,Upper respiratory infection,Pruritus,Rash,Intestinal perforation,Fecal impaction,Intestinal obstruction.

Interaction

May decrease absorption of ciprofloxacin, ciclosporin, mycophenolate, tacrolimus and levothyroxine. Sevelamer should be given 3 hr before or 1 hr after taking other drugs to minimise potential pharmacokinetic interaction.