Abstract
Aim: The present study aimed to explore the outpatient prescribing pattern of sevelamer in Al Seih.
 Methodology: This was a retrospective study that included reviewing the electronic prescriptions that contained sevelamer among outpatients in the city of Al Saih.
 Results: During 2017 and 2018, 47 patients received sevelamer from the outpatient pharmacy in a public hospital in Alkharj. More than 23 % of the prescriptions were prescribed in January and about 21.28% of the prescriptions were prescribed in May. All of the prescriptions that contained sevelamer were prescribed for the duration of 1 month (100.00%), all of the sevelamer prescriptions were written by residents (100.00%) and all of the prescriptions were prescribed by nephrology department (100.00%). More than half of the patients who received sevelamer were females (60.00%). The age of about 90% of the patients who received sevelamer was more than 39 years.
 Conclusion: The present study showed that the prescribing of sevelamer was uncommon in Al Seih. Further studies are required to investigate the pattern and the frequency of sevelamer in the outpatients setting and in other settings.
Highlights
Patients with end-stage renal disease retain phosphorus and can develop hyperphosphatemia.Management of hyperphosphatemia includes the decrease in dietary phosphate intake, inhibition of the intestinal absorption of phosphate with phosphate binders, and the removal of phosphate with dialysis [1].Sevelamer is a phosphate binder, so it binds phosphorus that the patient gets from foods in his diet and prevents it from being absorbed into his blood stream [2]
Sevelamer should be used within the context of a multiple therapeutic approach, which could include vitamin D and calcium supplement to control the development of renal bone disease [4]
Perry and Plosker reported that in the EU, sevelamer carbonate is approved in adult CKD patients who require dialysis and in those who do not require dialysis with serum phosphate levels ≥ 1.78 mmol/L, while in the USA sevelamer carbonate is approved only for adult CKD patients who require dialysis [5]
Summary
Sevelamer is a phosphate binder, so it binds phosphorus that the patient gets from foods in his diet and prevents it from being absorbed into his blood stream [2]. It is indicated mainly for the control of serum phosphorus in patients with chronic kidney disease on dialysis [3]. It could be used to control of hyperphosphataemia in adult patients with chronic kidney disease not on dialysis with serum phosphorus ≥ 1.78 mmol/l [4]. Perry and Plosker reported that sevelamer carbonate may be useful for the management of patients at risk of metabolic acidosis and for individuals requiring treatment with a phosphate binding agent that does not contain aluminium or calcium [5,6]
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