Lanthanum Carbonate: Phosphate Binder for CKD & Hyperphosphatemia

Lanthanum Carbonate: Key Points and Overview

Lanthanum carbonate is a phosphate binder used to lower elevated phosphate levels in individuals with chronic kidney disease (CKD) or end-stage renal disease (ESRD). It works by binding to phosphate in the digestive tract, preventing its absorption into the bloodstream. This helps reduce the risk of complications such as bone disease and cardiovascular issues. Always consult your healthcare provider before starting or adjusting your dose of lanthanum carbonate.

Lanthanum Carbonate: Brand and Generic Names

US Brand Name: Fosrenol

Generic Name: Lanthanum carbonate

The generic name refers to the chemical composition of the medication, while the brand name is assigned by the manufacturer. In this article, the generic name (lanthanum carbonate) will be used in parentheses where applicable.

Pharmacologic Category: Phosphate Binder

Lanthanum carbonate belongs to a class of medications known as phosphate binders, which are used to manage phosphate levels in patients with kidney disease.

Lanthanum Carbonate Dosage for Various Conditions

Lanthanum carbonate is prescribed for several conditions related to kidney disease. The dosage may vary depending on the specific condition being treated. Always consult your doctor or one of our telemedicine providers before adjusting your dose.

Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD)

The typical starting dose of lanthanum carbonate ranges from 1,500 mg to 3,000 mg per day, divided into smaller doses taken with meals. Your doctor may adjust the dose based on your phosphate levels.

Hyperphosphatemia Treatment (High Phosphate Levels)

The initial dose is usually 1,500 mg per day, divided into doses taken with meals. The dose may be increased every 2-3 weeks based on blood phosphate levels.

Renal Osteodystrophy and Bone Disease

The dose typically ranges from 1,500 mg to 3,000 mg per day, taken with meals. Your doctor will monitor your bone health and adjust the dose accordingly.

Secondary Hyperparathyroidism

The dose is usually between 1,500 mg and 3,000 mg per day, taken with meals. Your doctor will monitor your parathyroid hormone (PTH) levels and adjust the dose as needed.

Mineral and Bone Disorder in CKD

The dose is typically 1,500 mg to 3,000 mg per day, taken with meals. Regular blood tests will help guide dose adjustments.

Osteoporosis in CKD Patients

While lanthanum carbonate is not a primary treatment for osteoporosis, it may be used in patients with CKD to help manage phosphate levels, which can impact bone health. The dose is typically 1,500 mg to 3,000 mg per day, taken with meals.

Kidney Failure and Dialysis-Related Complications

The dose is typically 1,500 mg to 3,000 mg per day, taken with meals. Your doctor will adjust the dose based on your phosphate levels and overall health.

Lanthanum Carbonate Dosage Forms and Strengths

Lanthanum carbonate is available in the following forms and strengths:

1. Chewable Tablets: 500 mg, 750 mg, 1,000 mg
2. Oral Powder: 750 mg, 1,000 mg

How to Take Lanthanum Carbonate: Administration Instructions

Lanthanum carbonate should be taken with or immediately after meals to help bind phosphate from the food you eat. Chew the tablets thoroughly before swallowing; do not swallow them whole. If you are using the oral powder, mix it with a small amount of food or liquid and consume immediately. Do not mix the powder with water. Always follow your doctor’s instructions carefully.

Lanthanum Carbonate Side Effects and Adverse Reactions

Like all medications, lanthanum carbonate can cause side effects. Some are more common, while others are rare but serious. If you experience any side effects, contact your healthcare provider or one of our telemedicine providers right away.

Common Side Effects of Lanthanum Carbonate

1. Nausea: Feeling nauseous, especially when starting the medication.
2. Diarrhea: Loose stools may occur, particularly in the first few weeks.
3. Constipation: Some patients may experience difficulty with bowel movements.
4. Abdominal pain: Mild to moderate stomach discomfort is common.

Less Common Side Effects

1. Vomiting: Some patients may experience vomiting, especially if the tablets are not chewed thoroughly.
2. Headache: Mild headaches may occur but are generally not severe.

Serious Side Effects (Rare)

1. Allergic reactions: Rash, itching, swelling, or difficulty breathing may indicate an allergic reaction. Seek immediate medical attention.
2. Severe abdominal pain: This could indicate a more serious condition, such as a bowel blockage. Contact your doctor immediately.

Contraindications for Lanthanum Carbonate

A contraindication is a specific situation or condition where a medication should not be used because it may be harmful to the patient. If you have any of the following conditions, you should not take lanthanum carbonate, or you should discuss it thoroughly with your healthcare provider before starting the medication.

Bowel Obstruction

Lanthanum carbonate is contraindicated in patients with bowel obstruction because it can worsen the blockage, leading to severe complications.

Fecal Impaction

If you have fecal impaction, lanthanum carbonate may increase the risk of gastrointestinal issues, including worsening of the impaction.

Severe Constipation

Lanthanum carbonate can cause or exacerbate constipation, which may lead to more serious complications in patients already experiencing severe constipation.

Hypersensitivity to Lanthanum Carbonate

If you are allergic to lanthanum carbonate or any of its components, taking the medication could lead to allergic reactions, including rash, itching, or more severe symptoms like difficulty breathing.

Lanthanum Carbonate Drug Interactions

Lanthanum carbonate can interact with other medications, potentially affecting how well they work or increasing the risk of side effects. It’s important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements. Some known drug interactions include:

Levothyroxine (Synthroid)

Lanthanum carbonate can reduce the absorption of levothyroxine, a medication used to treat thyroid conditions. It’s recommended to take levothyroxine at least 2 hours before or after lanthanum carbonate.

Antibiotics (Quinolones)

Antibiotics like ciprofloxacin (Cipro) and levofloxacin (Levaquin) may have reduced absorption when taken with lanthanum carbonate. These antibiotics should be taken at least 1 hour before or 4 hours after lanthanum carbonate.

Calcium Supplements

Lanthanum carbonate may interfere with calcium absorption, so it’s important to space out the dosing of calcium supplements and lanthanum carbonate.

Antacids

Antacids containing aluminum, magnesium, or calcium can affect how well lanthanum carbonate works. It is recommended to avoid taking antacids within 2 hours of lanthanum carbonate.

Lanthanum Carbonate in Pregnancy

Is it safe to take lanthanum carbonate when pregnant?

There is limited information regarding the safety of lanthanum carbonate during pregnancy. While animal studies have not shown harm to the developing fetus, there are no well-controlled studies in pregnant women. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of lanthanum carbonate with your healthcare provider. They can help determine whether the medication is necessary for managing your condition during pregnancy.

Lanthanum Carbonate while Breastfeeding

Is it safe to take lanthanum carbonate while breastfeeding?

It is currently unknown whether lanthanum carbonate passes into breast milk. Given the lack of available data, caution is recommended if you are breastfeeding while taking this medication. Be sure to consult your healthcare provider to carefully weigh the benefits of lanthanum carbonate against any potential risks to your baby.

Estimated Cost of Lanthanum Carbonate

The estimated cost of a 30-day supply of lanthanum carbonate (500 mg tablets) without insurance typically ranges from $300 to $400, depending on the pharmacy. However, using a GoodRx coupon can reduce the price to approximately $200 to $250. Prices may vary, so it’s a good idea to check with your local pharmacy or use a discount service like GoodRx for the most accurate pricing.

Possible Alternatives to Lanthanum Carbonate

If lanthanum carbonate is not the right option for you, other treatments and lifestyle changes may help manage your condition. Always consult your healthcare provider before making any adjustments to your treatment plan. If you need to speak with a healthcare professional, our telemedicine services are available to assist you.

Chronic Kidney Disease (CKD)

In addition to phosphate binders like lanthanum carbonate, dietary modifications—such as reducing phosphate intake from processed foods and sodas—can help manage CKD. Other phosphate binders, such as sevelamer (Renvela) or calcium acetate (PhosLo), may also be considered as alternatives.

End-Stage Renal Disease (ESRD)

For patients with ESRD, dialysis is the primary treatment. Phosphate binders, including sevelamer or calcium-based binders, may also be used to help control phosphate levels.

Hyperphosphatemia

Managing high phosphate levels often involves reducing dietary phosphate intake and using alternative phosphate binders, such as sevelamer or calcium acetate.

Renal Osteodystrophy

Treatment for renal osteodystrophy typically includes managing phosphate levels, along with calcium and vitamin D supplementation. In some cases, medications like calcitriol or paricalcitol may be prescribed to help regulate bone health.

Secondary Hyperparathyroidism

To manage secondary hyperparathyroidism, medications such as cinacalcet (Sensipar) or vitamin D analogs may be used, in addition to phosphate binders.

Bone Disease

Treatment for bone disease depends on the specific condition but may include calcium and vitamin D supplementation, bisphosphonates, or other medications designed to strengthen bones.

Mineral and Bone Disorder

Managing mineral and bone disorders involves controlling phosphate, calcium, and vitamin D levels. Phosphate binders, along with dietary adjustments, can play a key role in managing this condition.

Osteoporosis

Osteoporosis treatment may involve medications such as bisphosphonates, hormone therapy, or denosumab (Prolia). Weight-bearing exercises and calcium/vitamin D supplementation are also important components of managing this condition.

Kidney Failure

For kidney failure, dialysis and kidney transplantation are the primary treatment options. Phosphate binders and dietary changes may also be necessary to manage complications related to kidney failure.

Dialysis-Related Complications

Managing phosphate levels, calcium, and other electrolytes is crucial for reducing dialysis-related complications. Phosphate binders, along with proper dialysis management, can help minimize these issues.

Recent Updates on Lanthanum Carbonate Research

Recent studies have focused on the long-term safety and effectiveness of lanthanum carbonate in managing hyperphosphatemia in patients with chronic kidney disease and end-stage renal disease. Research indicates that lanthanum carbonate effectively lowers phosphate levels without significantly increasing the risk of vascular calcification, a concern with some other phosphate binders. Ongoing studies are also exploring the potential benefits of lanthanum carbonate in reducing bone disease and improving overall mineral balance in patients with kidney failure.

As research continues to evolve, staying informed about new findings is important. If you have concerns about your current treatment or would like to discuss the latest research, our telemedicine providers are available to assist you.

James Kingsley

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