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Indications and Dosage
Oral
Hyperphosphataemia in patients with chronic renal failure Adult: As chewable tab/oral powd: Initially, 0.75-2.25 g daily in 3 divided doses. Maintenance dose: 1.5-3 g daily in divided doses. Max: 3.75 g daily. Dose is adjusted every 2-3 wk according to serum phosphate level.
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Administration
Should be taken with food. Take w/ or immediately after meals. Chew thoroughly before swallowing. Do not swallow whole.
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Contraindications
Bowel obstruction, ileus, faecal impaction, hyperphosphataemia.
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Special Precautions
Patient w/ altered GI anatomy (e.g. diverticular disease, peritonitis, history of GI surgery, GI cancer, GI ulceration), hypomotility disorders (e.g. constipation, diabetic gastroparesis), active peptic ulcer, Crohn's disease, ulcerative colitis. Hepatic impairment. Pregnancy and lactation.
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Adverse Reactions
Significant: GI obstruction, ileus, subileus, GI perforation, faecal impaction.
Nervous: Headache, dizziness, vertigo, asthenia, fatigue, malaise. GI: Nausea, vomiting, diarrhoea, abdominal pain, taste alteration, gastroenteritis, constipation, dyspepsia, flatulence, dry mouth, eructation, IBS, anorexia. Endocrine: Hyperglycaemia, hyperparathyroidism. Haematologic: Eosinophilia. Musculoskeletal: Bone deposition, arthralgia, myalgia, osteoporosis. Dermatologic: Alopecia, sweating. Others: Hypocalcaemia, hyperphosphataemia, hypophosphataemia, hypercalcaemia. |
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Patient Counseling Information
This drug may cause dizziness and vertigo, if affected, do not drive or operate machinery.
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Monitoring Parameters
Monitor serum Ca, phosphorus levels.
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Overdosage
Symptoms: Headache, nausea and vomiting. Management: Supportive treatment.
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Drug Interactions
May reduce bioavailability of quinolones, tetracycline and levothyroxine chloroquine, ketoconazole. May decrease serum concentration of ACE inhibitor, ampicillin, halofantrine.
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Lab Interference
May produce a radio-opaque appearance on abdominal radiography.
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Action
Description:
Mechanism of Action: Lanthanum carbonate is a phosphate binder which inhibits the absorption of dietary phosphate from the intestines. It disintegrates in the GI tract to lanthanum ions (La3+) that binds phosphate to make insoluble and unabsorbable lanthanum phosphate complexes, causing a decrease in serum phosphate and Ca levels. Pharmacokinetics: Absorption: Poorly absorbed from the GI tract. Distribution: Plasma protein binding: >99%. Excretion: Mainly via faeces (74%) and urine (<2%). Elimination half-life: 53 hr (plasma); 2-3.6 yr (bone). |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Lanthanum Carbonate, CID=168924, https://pubchem.ncbi.nlm.nih.gov/compound/Lanthanum-Carbonate (accessed on Jan. 22, 2020) |
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Storage
Store at 25°C. Protect from moisture.
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MIMS Class
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ATC Classification
V03AE03 - lanthanum carbonate ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.
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References
Anon. Lanthanum. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 20/07/2017. Buckingham R (ed). Lanthanum Carbonate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 20/07/2017. Fosrenol Tab Chewable/Powder (Shire US Manufacturing Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 20/07/2017. Joint Formulary Committee. Lanthanum. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 20/07/2017. McEvoy GK, Snow EK, Miller J et al (eds). Lanthanum Carbonate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 20/07/2017.
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