<p>Patients not taking a Phosphate Binder: The recommended starting dose of Sevelamer is 800 to 1600 mg, which can be administered as two to four 400 mg Sevelamer tablets, with meals based on serum phosphorus level. Renophos 400 Recommendation for the patients with hyperphosphatemia is given below-<br />
<br />
Starting dose of Renophos for dialysis patients not taking any phosphate binder:</p>

<ul>
	<li><strong>Serum Phosphorus &gt;5.5 and &lt;7.5 mg/dL</strong>: 800 mg (2 tablets) three times daily with meals</li>
	<li><strong>Serum Phosphorus &ge;7.5 and &lt;9.0 mg/dL</strong>: 1200 mg (3 tablets) three times daily with meals</li>
	<li><strong>Serum Phosphorus &ge;9.0 mg/dL</strong>: 1600 mg (4 tablets) three times daily with meals</li>
</ul>

<p>Starting dose for dialysis patients switching from calcium acetate to Sevelamer:</p>

<ul>
	<li>Calcium Acetate 667 mg (1 tablet): Sevelamer 800 mg (2 tablets)</li>
	<li>Calcium Acetate 1334 mg (2 tablets): Sevelamer 1200 mg (3 tablets)</li>
	<li>Calcium Acetate 2001 mg (3 tablets): Sevelamer 2000 mg (5 tablets)</li>
</ul>

<p>Dose titration guideline:</p>

<ul>
	<li><strong>Serum Phosphorus &gt;5.5 mg/dL</strong>: Increase 400 mg (1 tablet) per meal at 2 week intervals</li>
	<li><strong>Serum Phosphorus 3.5-5.5 mg/dL</strong>: Maintain current dose</li>
	<li><strong>Serum Phosphorus &lt;3.5 mg/dL</strong>: Decrease 400 mg (1 tablet) per meal</li>
</ul>

<p><strong>Dose titration for all patients taking Sevelamer</strong>: Dosage should be adjusted based on the serum phosphorus concentration with a goal of lowering serum phosphorus to 5.5 mg/dl or less. The dose may be increased or decreased by one tablet per meal at two week intervals as necessary.</p>