Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Renagel (Sevelamer-hydrochloride). If you are concerned about side effects, discuss the risks and benefits of Renagel (Sevelamer-hydrochloride) with your doctor.

The following side effects have been reported by at least 1% of people taking Renagel (Sevelamer-hydrochloride). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Constipation
• Diarrhea
• heartburn or indigestion
• itchiness
• nausea
• rash
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• difficulty swallowing
• signs of bowel obstruction (e.g., abdominal discomfort, cramps, gas pain, difficulty passing stools, nausea, vomiting)
• signs of inflammation in the digestive system (e.g., pain in the lower left abdomen, Fever, nausea, diarrhea, or constipation)
• signs of lower levels of calcium (e.g., muscle cramps, pain, dry skin)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of an allergic reaction (shortness of breath or difficulty breathing; Hives; swelling of the eyes, mouth, lips, or throat)
• signs of a blockage in the digestive system (e.g., abdominal cramping, gas pain, nausea, vomiting after meals, excessive burping)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Renagel (Sevelamer-hydrochloride).

Each oval, film-coated tablet imprinted with "RENAGEL 800" on the crown on one side contains 800 mg of sevelamer HCl. Nonmedicinal ingredients: colloidal silicon dioxide and stearic acid; coating: diacetylated monoglyceride and hypromellose; printing ink: hypromellose (hydroxypropyl methylcellulose), iron oxide black (E172), isopropyl alcohol, and propylene glycol.

Do not take sevelamer hydrochloride if you:

• are allergic to sevelamer hydrochloride or any ingredients of the medication
• have a bowel obstruction, Ulcerative Colitis, gastrointestinal bleeding, or other injury to the lining of the digestive tract
• have low levels of phosphorus in your blood

There may be an interaction between sevelamer hydrochloride and any of the following:

• Calcitriol
• Cyclosporine
• Levothyroxine
• medication for an irregular heartbeat (antiarrhythmics; e.g., Amiodarone, Propafenone)
• mycophenolate
• phosphate-containing medications or products
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• seizure medications (anticonvulsants; e.g., Carbamazepine, Phenytoin)
• Tacrolimus

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Renagel (Sevelamer-hydrochloride). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Renagel (Sevelamer-hydrochloride).

Gastrointestinal disorders: Sevelamer may cause a bowel obstruction to form. If you have gastrointestinal disorders (e.g., dysphagia [difficulty swallowing], severe disorders of movement in the gastrointestinal tract [i.e., the esophagus, stomach, and bowel]) or you have had major gastrointestinal surgery, discuss with your doctor how Renagel (Sevelamer-hydrochloride) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Renagel (Sevelamer-hydrochloride), and whether any special monitoring is needed.

Low calcium: People with kidney disease may develop a condition called hypocalcemia (low calcium levels in the blood). While you are taking Renagel (Sevelamer-hydrochloride), your doctor will regularly monitor your blood calcium levels. If you experience signs or symptoms of low blood calcium levels, such as muscle cramping or ache, dry skin or a feeling of pins and needles in your fingers, lips, tongue, or feet, contact your doctor as soon as possible.

Pregnancy: Renagel (Sevelamer-hydrochloride) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Renagel (Sevelamer-hydrochloride), contact your doctor immediately.

Breast-feeding: It is not known if sevelamer hydrochloride passes into breast milk. If you are a breast-feeding mother and are taking Renagel (Sevelamer-hydrochloride), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using Renagel (Sevelamer-hydrochloride) have not been established for children and adolescents less than 18 years of age.