| LANTHANUM CARBONATE
Classifications: electrolyte and water balance agent; phosphate binder; Therapeutic: phosphate binder
Prototype: Sevelamer hydrochloride
Pregnancy Category: C
250 mg, 500 mg, 750 mg, 1g chewable tablets
Lanthanum is used for the management of hyperphosphatemia in end-stage renal disease; it is a calcium/aluminum-free phosphate
binding agent. Has a higher affinity for binding to phosphate than calcium or aluminum. Low systemic absorption minimizes
the risk of aluminum intoxication and hypercalcemia. Lanthanum decreases phosphate absorption from the diet. Dietary phosphate
bound to lanthanum carbonate is excreted in the feces.
Lowers serum phosphate.
Reduce serum phosphate levels in patients with end-stage renal disease.
Prior hypersensitivity to lanthanum carbonate; pregnancy (category C); children <18 y.
Bowel obstruction, Crohn's disease, acute peptic ulcer, ulcerative colitis; lactation.
Route & Dosage
Adult: PO 250500 mg t.i.d. with or immediately after meals; may titrate up every 23 wk in increments of 750 mg/d to achieve
acceptable serum phosphate levels (max: 3750 mg/d)
- Give with or immediately after a meal.
- Tablets must be chewed completely before swallowing. Whole tablets should not be swallowed.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS:
Hypotension. GI: Nausea, vomiting, diarrhea,
abdominal pain, constipation
. Respiratory: Bronchitis
, rhinitis. Other:
Dialysis graft occlusion.
Minimal from GI tract. Metabolism:
Not metabolized. Elimination:
In feces. Half-Life:
Assessment & Drug Effects
- Monitor for dialysis graft occlusion, as lanthanum therapy may increase occlusion risk.
- Lab tests: serum phosphate levels during dosage titration and regularly throughout treatment; periodic serum calcium, bicarbonate,
Patient & Family Education
- Chew chewable tablets completely, then swallow.
- Report promptly any of the following: headache, drowsiness, dizziness, fainting, confusion, irritability, nausea, vomiting,
or loss of appetite.