Lanthanum Carbonate

Indications

Lanthanum Carbonate is used for: Hyperphosphataemia in patients with chronic renal failure

Adult Dose

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.

Child Dose

Renal Dose

Administration

Should be taken with food. Take w/ or immediately after meals.

Contra Indications

Bowel obstruction, ileus, faecal impaction, hyperphosphataemia.

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. Patient Counselling This drug may cause dizziness and vertigo, if affected, do not drive or operate machinery. Monitoring Parameters Monitor serum Ca, phosphorus levels.

Pregnancy-Lactation

Pregnancy Available data from case reports in pregnant women are insufficient to identify a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; use a non-lanthanum containing phosphate binder in a pregnant woman Animal data In animal reproduction studies, oral administration to pregnant rats and rabbits during organogenesis at doses 3 and 2.5 times, respectively, the maximum recommended human dose (MRHD), resulted in no adverse developmental effects In rabbits, lanthanum carbonate doses 5 times the MRHD was associated with maternal toxicity and resulted in increased post-implantation loss, reduced fetal weights, and delayed fetal ossification Deposition of lanthanum into developing bone, including growth plate, was observed in juvenile animals in long-term animal studies with lanthanum carbonate Lactation There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production; deposition of lanthanum into developing bone, including growth plate, was observed in juvenile animals in long-term animal studies with lanthanum carbonate; use a non-lanthanum containing phosphate binder in a lactating woman

Interactions

May reduce bioavailability of quinolones, tetracycline and levothyroxine chloroquine, ketoconazole. May decrease serum concentration of ACE inhibitor, ampicillin, halofantrine.

Side Effects

Side effects of Lanthanum Carbonate : 1-10% Abdominal pain Constipation Dialysis graft complication/occlusion Diarrhea Headache Hypertension Nausea Vomiting <1% Bronchitis Hypercalcemia Rhinitis

Mode 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 (La 3+) that binds phosphate to make insoluble and unabsorbable lanthanum phosphate complexes, causing a decrease in serum phosphate and Ca levels.