Patients should adhere to recommended diets in order to control phosphate and fluid intake.
Tablets must be chewed completely and not swallowed whole. To aid with chewing the tablets may be crushed.
Adults, including elderly (>65 years): For patients taking FOSRENOL for the first time, the starting dose may be determined individually based on serum phosphate concentration as indicated as follows: (See Table 3.)
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FOSRENOL should be taken with or immediately after food, with the daily dose divided between meals, i.e. three times daily. Serum phosphate levels should be monitored and the dose of FOSRENOL titrated every 2-3 weeks until an acceptable serum phosphate level is reached, with regular monitoring thereafter.
Control of serum phosphate level has been demonstrated at doses from 750 mg with most patients achieving acceptable serum phosphate levels at 1500 - 3000 mg lanthanum per day.
Hepatic impairment: The effect of hepatic impairment on FOSRENOL pharmacokinetics has not been formally assessed. Due to its mechanism of action and the lack of liver metabolism, doses in hepatic impairment should not be modified, but patients should be monitored carefully (see Precautions and Pharmacology: Pharmacokinetics under Actions).
Children and Adolescents: The safety and efficacy of FOSRENOL has not been established in patients below the age of 18 years.