VetSheet

司維拉姆

Sevelamer

Sevelamer hydrochloride

磷結合劑PO狗貓

別名: Renagel · Renvela · GT16-026A · Sevelamer carbonate

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

30-40 mg/kgPO· q8h· Titrated to the desired serum phosphate concentration
— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Hyperphosphatemia400 mg PO with mealsPOwith meals—🌎 NA
Chronic kidney disease (hyperphosphataemia)30-40 mg/kgPOq8hTitrated 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.

貓

適應症劑量途徑頻次療程地區
Hyperphosphatemia200 mg 2-3 times dailyPOq8-12h—🌎 NA
Chronic kidney disease (hyperphosphataemia)30-40 mg/kgPOq8hTitrated 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.

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

司維拉姆（Sevelamer）是一種不含鈣和鋁的​磷結合劑​，主要用於治療與​慢性腎臟病 (CKD)​ 相關的高血磷症。

  • ​臨床優勢​：與傳統的磷結合劑（如氫氧化鋁或碳酸鈣）不同，司維拉姆不會引起鋁中毒或醫源性高血鈣症的風險。
  • 對於無法耐受鋁鹽或使用鈣結合劑可能加重轉移性組織鈣化的晚期 CKD 患畜特別有用。
  • ​注意​：與傳統的鋁或鈣製劑相比，其價格通常較為昂貴。

作用機制

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.

安全性與警告

禁忌症

  • Hypophosphatemia
  • Bowel obstruction
  • Known hypersensitivity to sevelamer
  • Gastrointestinal obstruction

不良反應

  • 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.

藥物相互作用

Anticonvulsants (oral)

Sevelamer may reduce oral absorption; give at least 1 hour before or 3 hours after sevelamer.

Antiarrhythmics (oral)

Sevelamer may reduce oral absorption; give at least 1 hour before or 3 hours after sevelamer.

Ciprofloxacin (and other oral fluoroquinolones)

Concurrent administration may decrease absorption by 50%; administer at least 1 hour before or 3 hours after sevelamer.

Oral Medications (Narrow Therapeutic Index)

May reduce absorption; consider dosing other oral drugs separately.

Vitamins

Sevelamer may reduce vitamin absorption from food; consider administering vitamin supplements separately.

Other oral medicationsModerate

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.

Fat-soluble vitamins (e.g., Vitamin K)Moderate

May inhibit vitamin absorption; consider monitoring prothrombin time.

監測

  • 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)

藥物動力學

半衰期

貓N/A狗N/A

吸收

Administered orally, but is not absorbed systemically.

分佈

Remains entirely within the gastrointestinal tract.

代謝

Not metabolized systemically.

排除

Excreted unchanged in the feces.

過量

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.

可用產品

劑型

  • Oral tablets
  • Powder for oral suspension
  • Oral: 800 mg tablets

人用標示

  • 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

各地核准狀態

European Union✓ 已核准處方藥EMA

Human authorized product used off-label in veterinary medicine under the cascade.

United Kingdom✓ 已核准處方藥VMD

POM (Prescription Only Medicine). Human authorized product used off-label.

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Sevelamer capsules/tablets should be stored at room temperature and protected from moisture.

飼主須知

​關鍵用藥時間​：此藥物​必須隨餐服用​才能發揮作用。它就像海綿一樣，會在食物中的磷進入寵物體內之前將其吸收。

  • ​與其他藥物分開​：司維拉姆會阻礙其他藥物的吸收。請在給予司維拉姆前至少 ​1 小時​或後 ​3 小時​再給予其他藥物。
  • ​維生素補充​：您的獸醫可能會建議補充維生素，因為此藥物會減少食物中維生素的吸收。
  • ​副作用​：請留意腸胃不適的跡象，如嘔吐、腹瀉或便秘。如果出現這些情況，請聯繫您的獸醫。

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