Lanthanum Carbonate

Lanthanum Carbonate Brand Name– Fosrenol

What is Lanthanum Carbonate

Lanthanum carbonate is an oral, non-aluminum, non-calcium phosphate binding agent indicated for the management of hyperphosphatemia in patients with end-stage renal disease (ESRD).

In 2 large, randomized clinical trials conducted in patients with ESRD undergoing dialysis, lanthanum carbonate was shown to be as effective as calcium carbonate and other conventional phosphate binders in reducing and maintaining serum phosphorus concentrations to 5.6 mg/dL or less and 5.9 mg/dL or less over 6 months and 2 years, respectively.

Thus, lanthanum carbonate is an effective alternative to these therapies in ESRD patients with hyperphosphatemia.

Since it does not contain aluminum, lanthanum carbonate does not cause aluminum intoxication.

Lanthanum carbonate does not contain calcium and should not directly cause hypercalcemia.

Conversely, in clinical trials of 1 year and 6 months duration comparing calcium carbonate to lanthanum carbonate, a small incidence of hypercalcemia was reported in patients receiving lanthanum carbonate.

Serious cases of GI obstruction, perforation, and ileus have been reported, particularly in association with unchewed or incompletely chewed lanthanum tablets.

Indications

  • hyperphosphatemia

For the treatment of hyperphosphatemia in patients with end stage renal disease (ESRD)

NOTE: In addition to reduction of intestinal phosphate absorption with phosphate binders, management of hyperphosphatemia in ESRD patients usually also includes reduction in dietary intake of phosphate and removal of phosphate by dialysis.

Side Effects

  1. abdominal pain
  2. constipation
  3. diarrhea
  4. dyspepsia
  5. GI obstruction
  6. GI perforation
  7. hypocalcemia
  8. hypophosphatemia
  9. ileus
  10. nausea
  11. skin irritation
  12. vomiting

Monitoring Parameters

  • serum calcium
  • serum phosphate

Contraindications

  • breast-feeding
  • children
  • constipation
  • Crohn’s disease
  • diverticulitis
  • fecal impaction
  • gastric cancer
  • gastroparesis
  • GI disease
  • GI obstruction
  • ileus
  • infants
  • neonates
  • peptic ulcer disease
  • peritonitis
  • pregnancy
  • surgery
  • ulcerative colitis

Interactions

  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Amlodipine; Benazepril
  • Angiotensin-converting enzyme inhibitors
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Benzhydrocodone; Acetaminophen
  • Bisphosphonates
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Cefdinir
  • Cefditoren
  • Cefpodoxime
  • Cefuroxime
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Cysteamine
  • Delafloxacin
  • Delavirdine
  • Dextromethorphan; Quinidine
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Erdafitinib
  • Ethotoin
  • Fluphenazine
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Gabapentin
  • Gemifloxacin
  • HMG-CoA reductase inhibitors
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydroxychloroquine
  • Iron
  • Lactulose
  • Levofloxacin
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Liothyronine
  • Lisinopril
  • Mesoridazine
  • Moexipril
  • Moxifloxacin
  • Mycophenolate
  • Nitrofurantoin
  • Norfloxacin
  • Ofloxacin
  • Perindopril
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenytoin
  • Prochlorperazine
  • Protease inhibitors
  • Quinapril
  • Quinidine
  • Quinine
  • Ramipril
  • Sucralfate
  • Tetracyclines
  • Thioridazine
  • Thyroid hormones
  • Trandolapril
  • Trandolapril; Verapamil
  • Trifluoperazine
  • Valproic Acid, Divalproex Sodium
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