Lanthanum
Indications
Lanthanum carbonate is used to lower high blood phosphate levels (hyperphosphataemia) in people with chronic kidney disease, especially those on dialysis. High phosphate can weaken bones and cause calcium to deposit in blood vessels and the heart.
How It Works
Lanthanum is a phosphate binder. In the stomach and gut it binds to phosphate from food and forms a compound that cannot be absorbed. This compound passes out in the stool, so less phosphate enters the blood. Very little lanthanum itself is absorbed.
Dosage and Administration
Take as prescribed by your kidney specialist. The dose is adjusted every few weeks according to blood phosphate results. The tablets must be chewed completely (or crushed) before swallowing, never swallowed whole, and taken with or immediately after meals, with the daily dose divided between meals. If a meal is skipped, skip that dose.
Interactions
Lanthanum can reduce the absorption of some medicines. Take Ciprofloxacin and other quinolone antibiotics, Levothyroxine, Tetracyclines and Doxycycline at least 2 hours before or 4 hours after lanthanum, or as directed by the doctor or pharmacist. Antacids containing aluminium, calcium or magnesium should be spaced apart as well.
Contraindications
Do not take if you have low blood phosphate, a bowel blockage, or allergy to lanthanum carbonate or any ingredient.
Side Effects
Common effects include nausea, vomiting, diarrhoea, constipation, stomach pain, wind and headache. Low blood calcium can occur.
Get urgent medical help for severe stomach pain, severe constipation, a swollen belly, vomiting that will not stop, or black or bloody stools, which may mean a blockage or tear in the bowel, especially if tablets were not chewed properly. Also seek help for signs of an allergic reaction.
Pregnancy and Lactation
There is limited information in pregnancy and breastfeeding, so lanthanum is not recommended unless the doctor judges it necessary.
Precautions and Warnings
Chew tablets fully. Use with care in people with a history of bowel surgery, bowel obstruction, slow bowel movement, stomach ulcers or Crohn's disease. Blood phosphate and calcium are checked regularly. Lanthanum may show up on abdominal X-rays and look like a contrast agent. Follow the low-phosphate diet advised by your dialysis team.
Overdose
Overdose may cause nausea, headache and stomach upset. Seek medical advice; treatment is supportive.
Therapeutic Class
Phosphate binder (lanthanum salt).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Lanthanum