Identification

Name
Sevelamer
Accession Number
DB00658  (APRD01226)
Type
Small Molecule
Groups
Approved
Description

Sevelamer is a phosphate binding drug used to prevent hyperphosphataemia in patients with chronic renal failure. When taken with meals, sevelamer binds to dietary phosphate and prevents its absorption. It is marketed by Genzyme under the trade name Renagel.

Structure
Thumb
Synonyms
  • Sevelamer
  • Sévélamer
  • Sevelamero
  • Sevelamerum
External IDs
GT 16026 A / GT 335-012
Product Ingredients
IngredientUNIICASInChI Key
Sevelamer carbonate9YCX42I8IU845273-93-0Not applicable
Sevelamer hydrochlorideGLS2PGI8QG152751-57-0Not applicable
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
RenagelTablet400 mgOralSanofi Genzyme, a Division of Sanofi Aventis Canada Inc2001-11-212005-08-08Canada
RenagelTablet800 mg/1OralAtlantic Biologicals Corps.2008-06-06Not applicableUs17856 002120180907 15195 1c335to
RenagelTablet800 mg/1OralDoh Central Pharmacy2009-07-01Not applicableUs53808 077720180913 8702 1t9hnek
RenagelTablet800 mgOralSanofi Aventis2001-11-21Not applicableCanada
RenagelTablet800 mg/1OralGenzyme Corporation2008-06-06Not applicableUs58468 002120180907 15195 1a6on42
RenagelTablet400 mg/1OralCardinal Health2008-06-06Not applicableUs
RenagelCapsule403 mgOralSanofi Genzyme, a Division of Sanofi Aventis Canada Inc2000-08-142004-07-23Canada
RenagelTablet800 mg/1OralPhysicians Total Care, Inc.2006-06-302011-06-30Us
RenagelTablet400 mg/1OralCarilion Materials Management2008-06-06Not applicableUs
RenagelTablet400 mg/1OralGenzyme Corporation2008-06-06Not applicableUs
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Accel-sevelamerTablet800 mgOralAccel Pharma Inc2017-11-08Not applicableCanada
Sevelamer carbonateTablet, film coated800 mg/1OralRemedy Repack2017-12-14Not applicableUs
Sevelamer CarbonateTablet, film coated800 mg/1OralAurobindo Pharma2017-07-17Not applicableUs
Sevelamer CarbonatePowder, for suspension2.4 g/1OralWinthrop U.S.2018-01-01Not applicableUs
Sevelamer CarbonateTablet, film coated800 mg/1OralRemedy Repack2017-10-09Not applicableUs
Sevelamer CarbonatePowder, for suspension2400 mg/1OralAurobindo Pharma2017-06-13Not applicableUs
Sevelamer CarbonateTablet, film coated800 mg/1OralWinthrop U.S.2018-02-01Not applicableUs
Sevelamer CarbonateTablet, film coated800 mg/1OralMarlex Pharmaceuticals Inc2018-05-01Not applicableUs
Sevelamer carbonateTablet, film coated800 mg/1OralInvaGen Pharmaceuticals Inc.2017-10-26Not applicableUs
Sevelamer CarbonateTablet, film coated800 mg/1OralAmneal Pharmaceuticals2017-11-28Not applicableUs
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
TasermitySevelamer hydrochloride (800 mg)Tablet, film coatedOralGenzyme Europe Bv2015-02-262018-03-27Eu
International/Other Brands
Phosblock (Kyowa Hakko Kirin)
Categories
UNII
941N5DUU5C
CAS number
52757-95-6
Weight
Average: 149.619
Monoisotopic: 149.060741718
Chemical Formula
C6H12ClNO
InChI Key
ZNSIZMQNQCNRBW-UHFFFAOYSA-N
InChI
InChI=1S/C3H5ClO.C3H7N/c4-1-3-2-5-3;1-2-3-4/h3H,1-2H2;2H,1,3-4H2
IUPAC Name
2-(chloromethyl)oxirane; prop-2-en-1-amine
SMILES
NCC=C.ClCC1CO1

Pharmacology

Indication

For the control of serum phosphorus in patients with Chronic Kidney Disease (CKD) on hemodialysis.

Associated Conditions
Pharmacodynamics

Patients with end-stage renal disease (ESRD) retain phosphorus and can develop hyperphosphatemia. High serum phosphorus can precipitate serum calcium resulting in ectopic calcification. When the product of serum calcium and phosphorus concentrations (Ca x P) exceeds 55 mg2/dL2, there is an increased risk that ectopic calcification will occur. Hyperphosphatemia plays a role in the development of secondary hyperparathyroidism in renal insufficiency. An increase in parathyroid hormone (PTH) levels is characteristic of patients with chronic renal failure. Increased levels of PTH can lead to osteitis fibrosa, a bone disease. A decrease in serum phosphorus may decrease serum PTH levels. Treatment of hyperphosphatemia includes reduction in dietary intake of phosphate, inhibition of intestinal phosphate absorption with phosphate binders, and removal of phosphate with dialysis. Sevelamer taken with meals has been shown to decrease serum phosphorus concentrations in patients with ESRD who are on hemodialysis. In vitro studies have shown that the capsule and tablet formulations bind phosphate to a similar extent. Sevelamer treatment also results in a lowering of low-density lipoprotein (LDL) and total serum cholesterol levels.

Mechanism of action

Sevelamer prevents hyperphosphatemia by binding to dietary phosphate in the gut, preventing its absorption and thus decreasing serum parathyroid hormone levels.

TargetActionsOrganism
APhosphate
binder
Human
Absorption

Not absorbed following oral administration, however no absorption studies have been performed in patients with renal disease.

Volume of distribution
Not Available
Protein binding
Not Available
Metabolism
Not Available
Route of elimination
Not Available
Half life
Not Available
Clearance
Not Available
Toxicity

Sevelamer has been given to normal healthy volunteers in doses of up to 14 grams per day for eight days with no adverse effects. Sevelamer has been given in average doses up to 13 grams per day to hemodialysis patients. There are no reported overdosages of sevelamer in patients. Since sevelamer is not absorbed, the risk of systemic toxicity is low.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
(R)-warfarinSevelamer can cause a decrease in the absorption of (R)-warfarin resulting in a reduced serum concentration and potentially a decrease in efficacy.
(S)-WarfarinSevelamer can cause a decrease in the absorption of (S)-Warfarin resulting in a reduced serum concentration and potentially a decrease in efficacy.
1alpha-Hydroxyvitamin D5The serum concentration of 1alpha-Hydroxyvitamin D5 can be decreased when it is combined with Sevelamer.
3,5-diiodothyropropionic acidSevelamer can cause a decrease in the absorption of 3,5-diiodothyropropionic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.
4-hydroxycoumarinSevelamer can cause a decrease in the absorption of 4-hydroxycoumarin resulting in a reduced serum concentration and potentially a decrease in efficacy.
AbaloparatideSevelamer can cause a decrease in the absorption of Abaloparatide resulting in a reduced serum concentration and potentially a decrease in efficacy.
AceclofenacSevelamer can cause a decrease in the absorption of Aceclofenac resulting in a reduced serum concentration and potentially a decrease in efficacy.
AcemetacinSevelamer can cause a decrease in the absorption of Acemetacin resulting in a reduced serum concentration and potentially a decrease in efficacy.
AcenocoumarolSevelamer can cause a decrease in the absorption of Acenocoumarol resulting in a reduced serum concentration and potentially a decrease in efficacy.
AcetyldigitoxinSevelamer can cause a decrease in the absorption of Acetyldigitoxin resulting in a reduced serum concentration and potentially a decrease in efficacy.
Food Interactions
Not Available

References

Synthesis Reference

Deepak Anant Hedge, Varsha Shashank Choudhary, Venkatasubramanian Radhakrjshnan Tarur, Dhananjay Govind Sathe, Harish Kashinath Mondkar, Samadhan Daulat Patil, Sasikumar Mohan Thoovara, Yogesh Sharad Bhide, "Process for the Preparation of Sevelamer Hydrochloride and Formulation Thereof." U.S. Patent US20090280178, issued November 12, 2009.

US20090280178
General References
Not Available
External Links
Human Metabolome Database
HMDB0014796
KEGG Drug
D01983
PubChem Compound
3085017
PubChem Substance
46505951
ChemSpider
2341997
ChEMBL
CHEMBL1201798
PharmGKB
PA164781197
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Sevelamer
ATC Codes
V03AE02 — Sevelamer
AHFS Codes
  • 40:18.19 — Phosphate-removing Agents
FDA label
Download (36.4 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
0CompletedScreeningChronic Kidney Disease (CKD)1
1CompletedNot AvailableHealthy Volunteers1
1CompletedBasic ScienceChronic Renal Failure (CRF)1
1CompletedTreatmentDiabetic Nephropathies1
1CompletedTreatmentHealthy Volunteers2
1CompletedTreatmentHyperphosphataemia1
1RecruitingTreatmentHyperphosphataemia1
2CompletedPreventionCardiovascular Disease (CVD) / Chronic Renal Failure (CRF)1
2CompletedTreatmentChronic Kidney Disease (CKD)4
2CompletedTreatmentChronic Kidney Disease (CKD) / Hyperphosphataemia2
2CompletedTreatmentChronic Renal Failure (CRF)2
2CompletedTreatmentDiabetic Nephropathies1
2CompletedTreatmentHyperparathyroidism, Secondary / Renal Osteodystrophy1
2CompletedTreatmentHyperphosphatemia Patients With Chronic Kidney Disease on 3x/Week Replacement Therapy1
2CompletedTreatmentInfection, Human Immunodeficiency Virus I1
2CompletedTreatmentRenal Failure1
2RecruitingTreatmentInsulin Sensitivity2
3CompletedPreventionHyperphosphataemia / Renal Failure1
3CompletedTreatmentChronic Kidney Disease (CKD) / Chronic Kidney Disease on Hemodialysis1
3CompletedTreatmentChronic Kidney Disease (CKD) / Dialysis therapy / Hyperphosphataemia1
3CompletedTreatmentChronic Kidney Disease (CKD) / Hyperparathyroidism1
3CompletedTreatmentChronic Kidney Disease (CKD) / Hyperphosphataemia2
3CompletedTreatmentChronic Kidney Disease (CKD) / Impaired Renal Function / Renal Dialysis1
3CompletedTreatmentChronic Kidney Disease (CKD) / Peritoneal dialysis therapy1
3CompletedTreatmentChronic Kidney Disease Requiring Chronic Dialysis2
3CompletedTreatmentChronic Kidney Disease, Stage 51
3CompletedTreatmentChronic Renal Failure (CRF)2
3CompletedTreatmentEnd-Stage Renal Disease (ESRD) / Kidney Diseases / Renal Insufficiency,Chronic1
3CompletedTreatmentHemodialysis-dependent patients / Hyperphosphataemia1
3Not Yet RecruitingTreatmentCKD Stage 3b / CKD Stage 41
3Not Yet RecruitingTreatmentHyperphosphataemia1
3RecruitingTreatmentChronic Kidney Disease Requiring Chronic Dialysis / Hyperphosphataemia1
3RecruitingTreatmentHyperphosphataemia2
3TerminatedTreatmentChronic Kidney Disease (CKD) / Hyperphosphataemia1
3TerminatedTreatmentChronic Renal Failure (CRF)1
3TerminatedTreatmentChronic Renal Failure (CRF) / Hemodialysis-dependent patients1
3Unknown StatusTreatmentChronic Kidney Disease Stages 3-51
4CompletedPreventionWe Investigated the Relationship Between Plasma FGF23 Levels and Endothelial Dysfunction in a Sizable Series of Incident Stage 3-4 CKD Patients1
4CompletedTreatmentArteriosclerosis / Calcinosis / Hyperparathyroidism, Secondary1
4CompletedTreatmentCardiovascular Events / Hemodialysis-dependent patients / Hyperphosphataemia1
4CompletedTreatmentChronic Kidney Disease (CKD)3
4TerminatedPreventionChronic Kidney Disease (CKD)1
Not AvailableActive Not RecruitingNot AvailableHyperphosphataemia / Hypophosphatemia, Familial / Hypovitaminosis D1
Not AvailableCompletedNot AvailableChronic Kidney Disease (CKD) / Hyperphosphataemia1
Not AvailableCompletedBasic ScienceType 2 Diabetes Mellitus1
Not AvailableCompletedPreventionChronic Kidney Disease (CKD)1
Not AvailableCompletedPreventionHyperparathyroidism, Secondary1
Not AvailableCompletedPreventionRenal Failure1
Not AvailableCompletedTreatmentCardiovascular Mortality1
Not AvailableCompletedTreatmentEnd Stage Renal Disease (ESRD) / Hemodialysis-dependent patients / Intimal Media Thickness1
Not AvailableCompletedTreatmentEndstage Renal Disease1
Not AvailableRecruitingTreatmentAtherosclerosis / Cardiovascular Disease (CVD) / Dialysis therapy / Hyperphosphataemia / Inflammatory Reaction1
Not AvailableWithdrawnTreatmentChronic Renal Failure (CRF) / End-Stage Renal Disease (ESRD) / Hyperphosphataemia / Insulin Resistance1
Not AvailableWithdrawnTreatmentHaemodialyzed Patients / Hyperphosphataemia1

Pharmacoeconomics

Manufacturers
  • Genzyme corp
  • Genzyme Corporation
Packagers
  • Atlantic Biologicals Corporation
  • Cardinal Health
  • Genzyme Inc.
  • Heartland Repack Services LLC
  • Murfreesboro Pharmaceutical Nursing Supply
  • Pharma Pac LLC
  • Physicians Total Care Inc.
  • Prepak Systems Inc.
  • Remedy Repack
  • Resource Optimization and Innovation LLC
  • Southwood Pharmaceuticals
  • Tya Pharmaceuticals
  • Vangard Labs Inc.
  • Warner Chilcott Co. Inc.
  • Watson Pharmaceuticals
Dosage forms
FormRouteStrength
CapsuleOral403 mg
TabletOral400 mg/1
TabletOral400 mg
TabletOral800 mg
TabletOral800 mg/1
Powder, for suspensionOral1.6 g
Powder, for suspensionOral2.4 g
Tablet, film coatedOral800 mg/1
Tablet, film coatedOral800 mg
Powder, for suspensionOral0.8 g/1
Powder, for suspensionOral2.4 g/1
Powder, for suspensionOral2400 mg/1
Powder, for suspensionOral800 mg/1
Prices
Unit descriptionCostUnit
Renagel 800 mg tablet2.41USD tablet
Renvela 800 mg tablet2.17USD tablet
Renagel 400 mg tablet1.66USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5496545No1993-08-112013-08-11Us
CA2310960No2003-05-272014-08-10Canada
CA2169356No2000-07-042014-08-10Canada
US7985418No2005-10-272025-10-27Us
US6733780No2000-10-182020-10-18Us
US9095509No2010-12-062030-12-06Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubilityInsolubleNot Available
logP0.559Not Available
Predicted Properties
PropertyValueSource
logP0.68ChemAxon
pKa (Strongest Basic)-4.2ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count1ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area12.53 Å2ChemAxon
Rotatable Bond Count2ChemAxon
Refractivity20.06 m3·mol-1ChemAxon
Polarizability8.38 Å3ChemAxon
Number of Rings1ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9908
Blood Brain Barrier+0.9723
Caco-2 permeable+0.5783
P-glycoprotein substrateNon-substrate0.7654
P-glycoprotein inhibitor INon-inhibitor0.921
P-glycoprotein inhibitor IINon-inhibitor0.9399
Renal organic cation transporterNon-inhibitor0.7531
CYP450 2C9 substrateNon-substrate0.8823
CYP450 2D6 substrateNon-substrate0.8029
CYP450 3A4 substrateNon-substrate0.7617
CYP450 1A2 substrateNon-inhibitor0.5084
CYP450 2C9 inhibitorNon-inhibitor0.7543
CYP450 2D6 inhibitorNon-inhibitor0.839
CYP450 2C19 inhibitorNon-inhibitor0.5583
CYP450 3A4 inhibitorNon-inhibitor0.8711
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.6708
Ames testAMES toxic0.9498
CarcinogenicityCarcinogens 0.5468
BiodegradationNot ready biodegradable0.889
Rat acute toxicity2.9282 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.7403
hERG inhibition (predictor II)Non-inhibitor0.8883
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as epoxides. These are compounds containing a cyclic ether with three ring atoms(one oxygen and two carbon atoms).
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Epoxides
Sub Class
Not Available
Direct Parent
Epoxides
Alternative Parents
Oxacyclic compounds / Dialkyl ethers / Organopnictogen compounds / Organochlorides / Monoalkylamines / Hydrocarbon derivatives / Alkyl chlorides
Substituents
Dialkyl ether / Oxirane / Ether / Oxacycle / Amine / Primary amine / Organooxygen compound / Organonitrogen compound / Organochloride / Organohalogen compound
Molecular Framework
Not Available
External Descriptors
Not Available

Targets

Kind
Small molecule
Organism
Human
Pharmacological action
Yes
Actions
Binder
References
  1. Cannata-Andia JB, Rodriguez-Garcia M, Roman-Garcia P, Tunon-le Poultel D, Lopez-Hernandez F, Rodriguez-Puyol D: New therapies: calcimimetics, phosphate binders and vitamin D receptor activators. Pediatr Nephrol. 2010 Apr;25(4):609-16. doi: 10.1007/s00467-010-1462-9. Epub 2010 Feb 12. [PubMed:20151157]
  2. Novak JE, Szczech LA: Phosphate binders in chronic kidney disease and end-stage renal disease: a patient-centered approach. Semin Dial. 2009 Jan-Feb;22(1):56-63. doi: 10.1111/j.1525-139X.2008.00514.x. Epub 2008 Oct 16. [PubMed:19000107]
  3. Salusky IB: A new era in phosphate binder therapy: what are the options? Kidney Int Suppl. 2006 Dec;(105):S10-5. [PubMed:17136110]
  4. Schucker JJ, Ward KE: Hyperphosphatemia and phosphate binders. Am J Health Syst Pharm. 2005 Nov 15;62(22):2355-61. [PubMed:16278327]

Drug created on June 13, 2005 07:24 / Updated on October 16, 2018 08:29