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Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.

Cover of Drugs and Lactation Database (LactMed®)

Drugs and Lactation Database (LactMed®) [Internet].

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Last Revision: June 21, 2021.

Estimated reading time: 1 minute

CASRN: 52757-95-6

image 135230745 in the ncbi pubchem database

Drug Levels and Effects

Summary of Use during Lactation

Because sevelamer is not orally absorbed, sevelamer does not reach the breastmilk or adversely affect the breastfed infant after maternal administration. A suspension of sevelamer has been added directly to breastmilk to lower the phosphorus concentration of milk. This could be a useful maneuver for breastmilk use in infants with renal impairment; however, clinical use has not been reported. In addition to lowering average phosphorus content by 65% to over 80%, the calcium content of breastmilk was reduced by almost as much and the casein content also decreased somewhat. With sevelamer hydrochloride, the chloride content increased by 60% and the pH changed from 6.8 to 7.8, although pH appears to rebound over time.[1,2] Addition of large amounts of sevelamer to artificial formula also lowers the copper, magnesium, manganese, potassium, sulfur and zinc concentrations by about 20%.[3] Similar reductions might occur with breastmilk.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.


Ferrara E, Lemire J, Reznik VM, et al. Dietary phosphorus reduction by pretreatment of human breast milk with sevelamer. Pediatr Nephrol. 2004;19:775–9. [PubMed: 15103549]
Raaijmakers R, Houkes LM, Schroder CH, et al. Pre-treatment of dairy and breast milk with sevelamer hydrochloride and sevelamer carbonate to reduce phosphate. Perit Dial Int. 2013;33:565–72. [PMC free article: PMC3797676] [PubMed: 23636435]
Taylor JM, Oladitan L, Carlson S, et al. Renal formulas pretreated with medications alters the nutrient profile. Pediatr Nephrol. 2015;30:1815–23. [PMC free article: PMC4572699] [PubMed: 25930981]

Substance Identification

Substance Name


CAS Registry Number


Drug Class

Breast Feeding


Chelating Agents

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Copyright Notice

Attribution Statement: LactMed is a registered trademark of the U.S. Department of Health and Human Services.

Bookshelf ID: NBK500659PMID: 29999718


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