Khrizvela Drug Interactions

When administering an oral medication where a reduction in the bioavailability of that medication would have a clinically significant effect on its safety or efficacy, the drug should be administered at least one hour before or three hours after Sevelamer Carbonate (Khrizvela), or the physician should consider monitoring blood levels of the drug.
In interaction studies in healthy volunteers. Sevelamer Carbonate (Khrizvela) had no effect on the bioavailability of a single-dose of digoxin, warfarin, enalapril, metoprolol or iron. However, the bioavailability of ciprofloxacin was decreased by approximately 50% when co-administered with Sevelamer Carbonate (Khrizvela) in a single dose study. Consequently. Sevelamer Carbonate (Khrizvela) should not be taken simultaneously with ciprofloxacin.
During postmarketing experience, reduced concentrations of cyclosporin, mycophenolate mofetil and tacrolimus have been reported in transplant patients when co-administered with Sevelamer hydrochloride without any clinical consequences (for example, graft rejection). The possibility of an interaction cannot be excluded and close monitoring of blood concentrations of cyclosporin, mycophenolate mofetil and tacrolimus should be considered during the use of any of these agents in combination with Sevelamer and after its withdrawal. During post-marketing experience, very rare cases of increased TSH levels have been reported in patients co-administered Sevelamer Carbonate (Khrizvela) and levothyroxine. Closer monitoring of TSH levels is therefore recommended in patients receiving both medications.
During postmarketing experience, very rare cases of increased phosphate levels have been reported in patients taking proton pump inhibitors coadministered with Sevelamer hydrochloride.
Food: In all clinical studies patients were instructed to take Sevelamer with meals.