セベラマー
Sevelamer
Sevelamer hydrochloride
別名: Renagel · Renvela · GT16-026A · Sevelamer carbonate
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hyperphosphatemia | 400 mg PO with meals | PO | with meals | — | 🌎 NA |
| Chronic kidney disease (hyperphosphataemia) | 30-40 mg/kg | PO | q8h | Titrated to the desired serum phosphate concentration | 🌍 EU |
- Hyperphosphatemia: For medium to large sized dog
- Chronic kidney disease (hyperphosphataemia): Should be given with meals and at least 1 hour before or 3 hours after other medications.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hyperphosphatemia | 200 mg 2-3 times daily | PO | q8-12h | — | 🌎 NA |
| Chronic kidney disease (hyperphosphataemia) | 30-40 mg/kg | PO | q8h | Titrated to the desired serum phosphate concentration | 🌍 EU |
- Hyperphosphatemia: Anecdotally appears to be safe and effective.
- Chronic kidney disease (hyperphosphataemia): Should be given with meals and at least 1 hour before or 3 hours after other medications.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
セベラマー（Sevelamer）は、カルシウムやアルミニウムを含まないリン吸着剤であり、主に慢性腎臓病（CKD）に伴う高リン血症の管理に使用されます。
- 臨床的利点：従来のリン吸着剤（水酸化アルミニウムや炭酸カルシウムなど）とは異なり、アルミニウム中毒や医原性高カルシウム血症のリスクがありません。
- アルミニウム塩に耐えられない場合や、カルシウムベースの吸着剤が転移性組織石灰化を悪化させる可能性のある進行したCKD患者に特に有用です。
- 注意：従来のアルミニウムやカルシウムベースの製品と比較して、一般的に高価です。
作用機序
Sevelamer is a cross-linked polymeric amine that acts locally in the gastrointestinal tract.
- Mechanism: The polymer contains multiple amine groups that become partially protonated in the acidic environment of the stomach and intestine. These protonated amines interact with dietary phosphate ions via ionic and hydrogen bonding → preventing phosphate absorption across the gut wall → increasing fecal excretion of phosphate → ultimately lowering serum phosphorus levels.
- Secondary Effects: It also binds bile acids in the gut, which can lead to a reduction in serum low-density lipoproteins (LDL) and total cholesterol.
安全性・警告
禁忌
- Hypophosphatemia
- Bowel obstruction
- Known hypersensitivity to sevelamer
- Gastrointestinal obstruction
有害事象
- Gastrointestinal upset (nausea, vomiting, diarrhea, or constipation)
- Decreased absorption of fat-soluble vitamins (A, D, E, K) and folic acid
- Pills are hygroscopic and will expand (potential risk of esophageal obstruction if not swallowed quickly)
注意事項
Pregnancy & Nursing: Safety during pregnancy is not established (FDA Category C). Because of the potential for binding vitamins, additional vitamins (both fat and water-soluble) may be necessary for pregnant or nursing animals.
- Vitamin K Deficiency: Because sevelamer can bind fat-soluble vitamins, it may impact Vitamin K absorption, potentially affecting coagulation.
- Administration Timing: Must be given with meals to be effective at binding dietary phosphorus.
医薬品相互作用
Sevelamer may reduce oral absorption; give at least 1 hour before or 3 hours after sevelamer.
Sevelamer may reduce oral absorption; give at least 1 hour before or 3 hours after sevelamer.
Concurrent administration may decrease absorption by 50%; administer at least 1 hour before or 3 hours after sevelamer.
May reduce absorption; consider dosing other oral drugs separately.
Sevelamer may reduce vitamin absorption from food; consider administering vitamin supplements separately.
May bind to and decrease the absorption of concurrently administered oral drugs. Should be given at least 1 hour before or 3 hours after other medications.
May inhibit vitamin absorption; consider monitoring prothrombin time.
監視
- Serum phosphorus
- Serum calcium
- Serum bicarbonate
- Serum chloride
- Baseline coagulation screening test (before and after therapy implementation, due to potential Vitamin K malabsorption)
- Serum phosphate levels (at 4-6 week intervals to adjust dosage)
- Prothrombin time (due to potential vitamin K malabsorption)
- Bowel movements (monitor for constipation)
薬物動態
半減期
吸収
Administered orally, but is not absorbed systemically.
分布
Remains entirely within the gastrointestinal tract.
代謝
Not metabolized systemically.
消失
Excreted unchanged in the feces.
過剰投与
Because sevelamer is not absorbed systemically, the potential for acute toxicity from an overdose appears to be negligible. Overdose would likely result in gastrointestinal distress (constipation or diarrhea) and potential hypophosphatemia.
製品
製剤
- Oral tablets
- Powder for oral suspension
- Oral: 800 mg tablets
ヒト用医薬品
- sevelamer HCl Oral Tablets: 400 mg & 800 mg (Renagel, Renvela)
- sevelamer Powder for Oral Suspension: 0.8 grams/packet & 2.4 grams/packet (Renvela)
- Renagel 800 mg tablets
規制ステータス
Human authorized product used off-label in veterinary medicine under the cascade.
POM (Prescription Only Medicine). Human authorized product used off-label.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Sevelamer capsules/tablets should be stored at room temperature and protected from moisture.
飼主向け情報
重要なタイミング：この薬は適切に効果を発揮するために、必ず食事と一緒に与える必要があります。ペットの体内に吸収される前に、食事中のリンをスポンジのように吸収します。
- 他の薬との間隔：セベラマーは他の薬の吸収を妨げる可能性があります。他の薬は、セベラマーを与える少なくとも1時間前、または3時間後に与えてください。
- ビタミン：この薬は食事からのビタミン吸収を減少させる可能性があるため、獣医師がビタミンサプリメントを推奨する場合があります。
- 副作用：嘔吐、下痢、便秘などの胃腸の不調の兆候に注意してください。これらの症状が現れた場合は、獣医師に連絡してください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。