Each tablet contains Sevelamer carbonate 400/800 mg.
For control of serum phosphorous in patients with CKD on haemodialysis or peritoneal dialysis and patients with CKD not on dialysis with serum phosphate > 5.5 mg/dl.
Sevelamer carbonate is a non-absorbed phosphate binding cross-linked polymer, free of metal and calcium. It contains multiple amines separated by one carbon from the polymer backbone. These amines exist in a protonated form in the intestine and interact with phosphate molecules through ionic and hydrogen bonding. By binding phosphate in the gastrointestinal tract and decreasing absorption, sevelamer carbonate lowers the phosphate concentration in the serum (serum phosphorus).
Because of the rapid reaction with the hydrochloric acid in the stomach, the dosing of Forsemer tablet is anticipated to be similar to that of the sevelamer hydrochloride salt or tablet. Starting dose of Forsemer is 0.8 or 1.6 grams administered orally three times per day with meals.
Forsemer is contraindicated in patients with bowel obstruction.
Serious cases of dysphagia, bowel obstruction, and perforation have been associated with sevelamer use, some requiring hospitalization and surgery.
Pregnancy Category C: There are no adequate and well-controlled studies in pregnant women. The effects of sevelamer carbonate on labour and delivery in humans is unknown. The safety and efficacy has not been established in paediatric patients.
When clinically significant drug interactions are expected, consider separation of the timing of administration and/or monitor clinical responses or blood levels of the concomitant medication. Sevelamer did not alter the pharmacokinetics of digoxin, enalapril, iron, metoprolol and warfarin. Sevelamer has demonstrated interaction with ciprofloxacin and mycophenolate mofetil, and therefore these drugs should be dosed separately.
The most common adverse reactions include vomiting, nausea, diarrhoea, dyspepsia, abdominal pain, flatulence, constipation.
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