Answer
Jul 22, 2026 - 03:05 PM
Sevelamer is the general drug name. It is available in two salt forms:
- Sevelamer carbonate — commonly sold as Renvela or a generic.
- Sevelamer hydrochloride — commonly sold as Renagel or a generic.
Both are non-calcium phosphate binders that work in the intestines to reduce phosphorus absorption and should be taken with meals. They provide similar phosphorus control, and their gastrointestinal side effects—such as nausea, constipation, diarrhea and abdominal discomfort—are generally similar.
The main difference is their effect on the body’s acid–base balance. Sevelamer hydrochloride may lower blood bicarbonate and contribute to metabolic acidosis, whereas sevelamer carbonate is less likely to do so and may raise bicarbonate slightly. For this reason, carbonate is often preferred when low bicarbonate or metabolic acidosis is a concern.
Sevelamer carbonate is also available as tablets and powder for oral suspension, while hydrochloride is generally supplied as tablets. Adult patients may sometimes be switched gram-for-gram, but the change should be directed by their kidney specialist or pharmacist because the dose depends on phosphorus test results.
