sevelamer + sodium bicarbonate + sodium chloride

This is a combination formulation containing sevelamer (typically as sevelamer carbonate), sodium bicarbonate, and sodium chloride. Sevelamer is a non-absorbed, calcium- and metal-free phosphate-binding polymer used to control hyperphosphatemia in patients with chronic kidney disease (CKD), especially those on dialysis. It acts by binding dietary phosphate in the gastrointestinal tract, thereby reducing its absorption and lowering serum phosphorus levels[4][6][8]. Sodium bicarbonate serves as an alkalinizing agent to help correct or prevent metabolic acidosis—a common complication in CKD—by increasing serum bicarbonate levels[7][8]. Sodium chloride may be included for tablet stability or to adjust electrolyte balance[7]. This specific combination aims to provide effective phosphate binding while minimizing the risk of metabolic acidosis that can occur with some other formulations of sevelamer.