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Serum phosphate levels should be closely monitored and the dose of sevelamer hydrochloride titrated by 0.8 g three times per day2.4 g/dayincrements with the goal of lowering serum phosphate to 1.76 mmol/L5.5 mg/dlor lessSerum phosphate should be tested every two to three weeks until a stable serum phosphate level is reached and on a regular basis thereafter.
Dose Titration for All Patients Taking RenagelDosage should be adjusted based on the serum phosphorus concentration with a goal of lowering serum phosphorus to 5.5 mg/dL or lessThe dose may be increased or decreased by one tablet per meal at two-week intervals as necessaryTable 3 gives a dose titration guidelineThe 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 mealThe maximum average daily Renagel dose studied was 13 grams.
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There is at present insufficient data to exclude the possibility of folate deficiency during long term Renagel treatment.
May decrease serum levels of fat soluble vitamins and folic acid in pregnant womenconsider supplementation.
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