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Sevelamer Drug Binding Perioperative — ESENeph MCQ

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EasyChronic Kidney DiseaseSevelamer Drug Binding PerioperativeESENeph

A 48-year-old woman with CKD G3a develops symptomatic cholelithiasis requiring cholecystectomy. She is on Sevelamer. Her surgeon asks whether Sevelamer affects anaesthetic drugs. What perioperative consideration exists?

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Correct answer: D — Reduced absorption of concurrently administered oral medicines

Sevelamer is a non-absorbed phosphate binder that can also bind other drugs in the GI tract (sequestration effect). Medications that may be affected include Levothyroxine, Ciprofloxacin, Mycophenolate, and some anticonvulsants. The clinical significance varies, but as a precaution, other oral medications should be taken at least 1 hour before or 3 hours after Sevelamer. On the day of surgery while fasting, Sevelamer (and other phosphate binders) should be withheld as they are taken with meals. This drug interaction property applies to all phosphate binders to varying degrees.

Reference: https://guidelines.ukkidney.org