Simer-400 Tablet 10's is used to control high phosphate levels in the body (hyperphosphataemia) in adult patients on dialysis (a blood clearance technique), patients undergoing hemodialysis (using a blood filtration machine), and patients with chronic kidney disease. It is also used for the treatment of bone disease.

Simer-400 Tablet 10's contains sevelamer that works by binding phosphate in the gastrointestinal tract and decreasing absorption. It effectively reduces excess phosphate levels in the blood, prevents the unsafe build-up of phosphate in your body, helps keep your bones strong, and decreases the risk of heart disease and strokes.

Take Simer-400 Tablet 10's exactly as directed by your doctor. The most common side effects of Simer-400 Tablet 10's are vomiting, upper abdominal pain, nausea, diarrhoea, stomach ache, indigestion, and flatulence. However, if the side effects persist, contact your doctor.

The use of Simer-400 Tablet 10's is restricted in persons with a known history of allergic to any of the ingredients present in this medicine, have low levels of phosphate in their blood, and have a bowel obstruction. Simer-400 Tablet 10's contains lactose (milk sugar). If you have an intolerance to some sugars, contact your doctor before taking Simer-400 Tablet 10's. Tell your doctor if you are facing swallowing problems, motility (movement) in your stomach and bowel, being sick frequently, active inflammation of the bowel,  have undergone major surgery on your stomach or bowel, or have serious inflammatory bowel disease. If you are pregnant or breastfeeding, please consult your doctor before taking Simer-400 Tablet 10's.

Simer-400 Tablet 10's belongs to a group of medications called phosphate binder, which works by binding phosphate in the gastrointestinal tract and decreasing its absorption. This lowers the phosphate concentration in the body. It effectively reduces excess phosphate levels in the blood, prevents the unsafe buildup of phosphate in your body, helps keep your bones strong, and decreases the risk of heart disease and strokes. Simer-400 Tablet 10's controls hyperphosphataemia (high blood phosphate levels) in adult patients on dialysis (a blood clearance technique), patients undergoing hemodialysis (using a blood filtration machine) or peritoneal dialysis (where the fluid is pumped into the abdomen and an internal body membrane filters the blood), and patients with chronic kidney disease.

• Headache

• Diarrhoea

• Stomach upset

• Constipation

You should avoid taking Simer-400 Tablet 10's if you are allergic to Simer-400 Tablet 10's. Speak to your doctor if you have swallowing disorders, digestive tract surgery, severe constipation, have undergone major surgery on your stomach or bowel, or have serious inflammatory bowel disease. It should be used with caution if you are pregnant or planning to become pregnant. Simer-400 Tablet 10's should not be recommended for breastfeeding mothers as it passes into breast milk. Avoid alcohol consumption while taking Simer-400 Tablet 10's as it might cause unpleasant side effects. The safety and effectiveness of children under six years of age have not been established, so a Simer-400 Tablet 10's should not be given to them. Simer-400 Tablet 10's contains lactose (milk sugar). If you have an intolerance to some sugars, contact your doctor before taking Simer-400 Tablet 10's. Regular monitoring of serum phosphate levels, vitamin D, A, E, K, and folic acid is advised while taking Simer-400 Tablet 10's.

Drug-Drug Interactions: Simer-400 Tablet 10's interacts with antibiotics (ciprofloxacin), immunosuppressive agents (mycophenolate), thyroid medications  (levothyroxine), and medication used to treat bladder cancer (erdafitinib).

Drug-Food Interactions: Avoid taking high-phosphate additives and alcohol as this makes it harder for your body to absorb Simer-400 Tablet 10's and increases side effects. Using Simer-400 Tablet 10's together with multivitamins with minerals may decrease the effects of multivitamins with minerals. So, Multivitamins with minerals should be administered at least 4 hours before Simer-400 Tablet 10's.

Drug-Disease Interactions: The use of Simer-400 Tablet 10's is restricted in people with hypophosphatemia (low phosphate level in blood), bowel obstruction and perforation, and severe liver disease.

• CIPROFLOXACIN
• MYCOPHENOLATE SODIUM
• LEVOTHYROXINE SODIUM
• ERDAFITINIB

• Take fresh fruits, vegetables, rice, milk, un-enriched corn and rice cereals, and soda without phosphate additives in your regular diet.

• Avoid or limit high phosphorus addictive foods (processed meats, instant puddings, sauces, spreadable cheeses, and beverage products).

•  Avoid intake of alcoholic beverages with Simer-400 Tablet 10's as it can make you dehydrated and may increase the side effects. 

• Make sure you drink plenty of fluids. This will help you clear out the extra phosphate and will help you overcome some.

• Simer-400 Tablet 10's is preferably taken with meals as it can bind to dietary phosphate and prevent its absorption into the bloodstream. Drink it with a full glass of water.

• Do not stop taking the Simer-400 Tablet 10's dose until your doctor says so.

• Do not use Simer-400 Tablet 10's if you have a history of bowel obstruction.

• Regular monitoring of serum phosphate levels, vitamin D, A, E, K, and folic acid is recommended while taking Simer-400 Tablet 10's.

Hyperphosphatemia: Hyperphosphatemia is defined as an increased phosphate level in the blood. This condition is often a complication of chronic kidney disease. Phosphate is an important electrolyte. It strengthens your bones and teeth and produces energy.  When phosphate levels increase in the blood due to kidney impairment (the kidney does not remove extra phosphate out of the body), this can cause muscle problems and increase the risk of weak bones, heart attacks, and strokes. It is more common in people with chronic kidney disease and people on dialysis. Symptoms may include itchy skin, red eyes, bone pain, and fractures.