Generic
Lanthanum Carbonate
1 brands available in the market
At a glance
Lanthanum Carbonate is a phosphate binder used to reduce serum phosphate in patients with end-stage renal disease (ESRD). It binds to dietary phosphate to form insoluble lanthanum phosphate complexes that are not absorbed from the gastrointestinal tract.
Description
Lanthanum Carbonate is a non-calcium dietary phosphate-binder that releases La3+ ions in the acid environment of the stomach. These ions bind to dietary phosphate to form insoluble lanthanum phosphate complexes, reducing phosphate absorption. In vitro studies have shown that Lanthanum binds phosphate in the physiologically relevant pH range of 3 to 7. The medicine must be administered with or immediately after meals to bind dietary phosphate.
Indications
- Reduction of serum phosphate in patients with end-stage renal disease (ESRD)
Therapeutic class
Drugs used in Chronic Kidney Dialysis
Pharmacological class
Non-calcium Phosphate Binder
Pharmacology
Lanthanum Carbonate releases La3+ ions in stomach acid, which bind to dietary phosphate to form insoluble lanthanum phosphate complexes, preventing phosphate absorption.
Mechanism of action
Binds to dietary phosphate to form insoluble compounds and prevents phosphate absorption.
Dosage
Adult Dose (Oral):
- Initial total daily dose: 1,500 mg in divided doses
- Titrate every 2-3 weeks based on serum phosphate levels
- Take with or immediately after meals
Chewable Tablets: Do not swallow whole; chew or crush completely
Administration
- Chew tablets completely; do not swallow whole
- Take with or immediately after meals
- Maintain 2-hour interval with antacids or other medications
Missed dose
Not generally applicable; consult doctor if needed.
Side effects
Common Side Effects:
- Nausea
- Vomiting
- Abdominal pain
- Constipation
- Dyspepsia
- Allergic skin reactions
- Tooth injury while chewing
Precautions & warnings
- Monitor for signs and symptoms of gastrointestinal obstruction (ileus, fecal impaction)
- Re-evaluate treatment if severe constipation or severe GI symptoms develop
- Advise patients to chew tablets completely (serious GI complications reported with unchewed tablets)
Contraindications
- Bowel obstruction (including ileus and fecal impaction)
Drug interactions
- Do not co-administer with antacids within 2 hours
- With quinolone antibiotics: ciprofloxacin bioavailability reduced by ~50%; take 1 hour before or 4 hours after
- With levothyroxine: bioavailability reduced by ~40%; take 2 hours before or after
Food interactions
No food interactions applicable.
Use in pregnancy
Use in Pregnancy: Insufficient data in pregnant women; use a non-Lanthanum containing phosphate binder in pregnant women.
Use in lactation
Use in Lactation: No data on presence in human milk; use a non-Lanthanum containing phosphate binder in lactating women.
Pediatric use
Safety and efficacy not established in pediatric patients; use in this population is not recommended.
Geriatric use
Safe in elderly; no overall differences observed in patients >65 years.
Renal / hepatic impairment
Indicated for patients with end-stage renal disease.
Overdose effects
Overdose symptoms: headache, nausea, vomiting (GI symptoms reported with daily doses up to 6,000 mg/day with food).
Storage conditions
Store below 30°C in a dry place, away from light; keep out of reach of children.
Chemical structure
Lanthanum Carbonate