Lanthanum carbonate


Concise Prescribing Info
Indications/Uses
Hyperphosphataemia in patients with chronic renal failure.
Dosage/Direction for Use
Adult : PO As chewable tab/oral powd: Initial: 0.75-2.25 g/day in 3 divided doses. Maintenance dose: 1.5-3 g/day in divided doses. Max: 3.75 g/day. Dose is adjusted every 2-3 wk according to serum phosphate level.
Dosage Details
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.
Administration
Should be taken with food. Take w/ or immediately after meals. Chew thoroughly before swallowing. Do not swallow whole.
Contraindications
Bowel obstruction, ileus, faecal impaction, hyperphosphataemia.
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.
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.
Patient Counseling Information
This drug may cause dizziness and vertigo, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor serum Ca, phosphorus levels.
Overdosage
Symptoms: Headache, nausea and vomiting. Management: Supportive treatment.
Drug Interactions
May reduce bioavailability of quinolones, tetracycline and levothyroxine chloroquine, ketoconazole. May decrease serum concentration of ACE inhibitor, ampicillin, halofantrine.
Lab Interference
May produce a radio-opaque appearance on abdominal radiography.
Action
Description: 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).
Chemical Structure

Chemical Structure Image
Lanthanum carbonate

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)

Storage
Store at 25°C. Protect from moisture.
ATC Classification
V03AE03 - lanthanum carbonate ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.
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.

Disclaimer: This information is independently developed by MIMS based on Lanthanum carbonate from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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