Perfosen Dosage/Direction for Use

Because of the rapid reaction with the hydrochloric acid in the stomach, the dosing of Perfosen powder or tablet is anticipated to be similar to that of the Sevelamer hydrochloride salt or tablet.
General Dosing Information: Perfosen should be given three times a day with meals.
Patients Not taking a Phosphate Binder: The Recommended starting dose of Perfosen is 0.8 to 1.6 g with meals based on serum phosphorus level. Table 1 provided recommended starting doses of Perfosen for patients not taking a phosphate binder. (See Table 1.)

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Switching from Sevelamer Hydrochloride Tablets: For patients switching from sevelamer hydrochloride tablets to sevelamer carbonate tablets or powder, use the same dose in grams. Further titration may be necessary to achieve desired phosphorus levels. The highest daily dose of sevelamer carbonate studied was 14 grams in CKD patients on dialysis.
Switching between Sevelamer Carbonate Tablets and Powder: Use the same dose in grams. Further titration may be necessary to achieve desired phosphorus levels.
Switching from calcium acetate: In a study 84 CKD patients on hemodialysis, a similar reduction in serum phosphorus was seen with equivalent dose (approximately mg for mg) of sevelamer hydrochloride and calcium acetate.
Table 2 gives recommended starting dose of Perfosen on a patient's current calcium acetate dose. (See Table 2.)

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Dose Titration for all Patients Taking Perfosen: Titrate the Perfosen dose by 0.8 g three times per day with meals at two-week intervals as necessary with the goal of controlling serum phosphorus within the target range. Or as prescribed by the physician.