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Renassist Insurance Verification Form and Assistance Application (PDF)

The only form you need to get started with Renassist. Simply submit the completed form to Renassist via fax or email. Need detailed instructions? Get them now.

Does your dialysis unit require authorization or consent forms?

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HCP patient authorization (PDF)

A patient information authorization form to be completed by the healthcare provider to confirm release, transfer, and use of patient information by Sanofi.

Patient consent form (PDF)

A patient information authorization form to be completed by the patient to confirm release, transfer, and use of personal information by Sanofi.

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Click here for Ferrlecit Important Safety Information and Full Prescribing Information

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Click here for Hectorol Important Safety Information and Full Prescribing Information

Indication
Renvela® (sevelamer carbonate) is indicated for the control of serum phosphorus in adults and children 6 years of age and older with chronic kidney disease (CKD) on dialysis.

Renagel® (sevelamer hydrochloride) is indicated for the control of serum phosphorus in patients with chronic kidney disease (CKD) on dialysis

Important Safety Information
  • Sevelamer is contraindicated in patients with bowel obstruction and in patients with known hypersensitivity to sevelamer carbonate or sevelamer hydrochloride or to any of the excipients.
  • Caution should be exercised in patients with dysphagia, swallowing disorders, and severe gastrointestinal (GI) motility disorders, including severe constipation or major GI tract surgery.
  • Common adverse events reported with sevelamer include vomiting, nausea, diarrhea, dyspepsia, abdominal pain, flatulence, and constipation. Other events reported include pruritus, rash, fecal impaction and, less commonly, ileus, bowel obstruction, and bowel perforation.
  • Uncommon cases of difficulty swallowing the Renagel or Renvela tablet have been reported. Caution should be exercised in these patients and consideration given to using Renvela suspension in patients with a history of difficulty swallowing.
  • Drug-drug interactions may occur with some medications and should be taken into consideration when instructing patients how to take sevelamer.
  • Serum bicarbonate and chloride levels should be monitored.
  • Follow patients for reduced vitamins D, E, and K (coagulation parameters) and folic acid levels.
  • Patients should be informed to take sevelamer with meals and to adhere to their prescribed diets.

Please click here for Full Prescribing Information for Renvela (PDF) or here for Full Prescribing Information for Renagel (PDF).

Indication
Renvela® (sevelamer carbonate) and Renagel® (sevelamer hydrochloride) are used to control phosphorus levels in patients with chronic kidney disease (CKD) on dialysis.

Important Safety Information
  • Do not use sevelamer if you have a history of bowel obstruction.
  • Talk to your doctor if you have had difficulty swallowing or swallowing disorders; or if you have had digestive tract surgery or other digestive disorders, including severe constipation.
  • The most common side effects with sevelamer include vomiting, nausea, diarrhea, upset stomach, abdominal pain, flatulence, and constipation.
  • Cases of itching, rash, fecal impaction and, less commonly, slow bowel activity, bowel obstruction, and bowel perforation have been reported.
  • Uncommon cases of difficulty swallowing the Renagel or Renvela tablet have been reported. Talk to your doctor if you have difficulty swallowing medicines in tablet form. Renvela powder for oral suspension may be considered by your doctor if you have a history of difficulty swallowing.
  • Your doctor should monitor bicarbonate and chloride blood levels.
  • Reduced vitamins D, E, and K (clotting factors) and folic acid blood levels may be followed by your doctor.
  • Talk to your doctor when taking sevelamer with other medications.
  • Promptly contact your doctor if you experience severe abdominal pain, new or worsening constipation, or other severe intestinal symptoms while on sevelamer.
  • Take sevelamer with meals and adhere to your prescribed diet.

Please click here for Full Prescribing Information for Renvela (PDF) or here for Full Prescribing Information for Renagel (PDF).

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