LANTHANUM CARBONATE
Background and Date of Approval
Lanthanum carbonate received its initial approval from the United States Food and Drug Administration (FDA) on October 26, 2004.
Uses
Lanthanum carbonate is primarily used to manage hyperphosphatemia, a condition characterized by elevated levels of phosphate in the blood, commonly seen in individuals with chronic kidney disease (CKD) or end-stage renal disease (ESRD). Binding to dietary phosphate in the gastrointestinal tract and inhibiting its absorption helps control and reduce phosphate levels in the body, thereby preventing complications such as bone disorders and cardiovascular issues resulting from high phosphate levels in these patient populations.
How is it administered?
Lanthanum carbonate is primarily administered orally. It is available in various forms, including liquid solutions, syrups, and powders, that are meant to be taken by mouth. Always follow your healthcare provider's instructions regarding the appropriate route and dosage for its administration.
Side Effects
Lanthanum carbonate, like many medications, can cause a range of side effects, both common and less common. Common side effects may include nausea, vomiting, diarrhea, abdominal pain, constipation, and stomach upset. On the other hand, although less frequent, serious side effects can occur, including allergic reactions, intestinal blockage, low levels of vitamins and minerals, excessively low phosphate levels (hypophosphatemia), and gastrointestinal ulcers.
Warnings
Lanthanum carbonate may cause allergic reactions in some individuals. Prolonged use of this medication can affect the absorption of calcium and vitamin D. This medication is intended to lower phosphate levels in the blood. Its abrupt cessation may lead to an increase in phosphate levels.
Precautions
If you experience hives, itching, rash, swelling of the face, lips, tongue, or throat, or have difficulty breathing after Lanthanum carbonate, seek immediate medical attention. Regular monitoring of calcium and vitamin D levels is necessary, and supplementation may be required based on your healthcare provider's recommendations.
Word of Advice
Lanthanum carbonate requires ongoing supervision by a healthcare provider to monitor your condition and modify your treatment plan if needed. Inform your healthcare provider of any kidney-related conditions or changes in kidney function during treatment, as dosage adjustments may be required. If you have a history of gastrointestinal disorders such as inflammatory bowel disease or bowel obstructions, discuss these with your healthcare provider before starting treatment. Notify your surgeon and healthcare provider that you are taking this medication if you are scheduled for dental surgery. If you are following a phosphate-restricted diet, work with a dietitian or nutritionist to align your dietary choices with your treatment goals and avoid phosphate-rich foods and beverages. Regular monitoring of calcium and vitamin D levels may be needed during prolonged use, as this medication can affect their absorption.
References
Mylan, Electronic Medicines Compendium (EMC), [Revised on 16th Aug 2023] [Accessed on 2nd September 2023], https://www.medicines.org.uk/emc/product/12802/smpc#gref J. Goddard, A.N. Turner, Kidney and urinary tract disease, Davidson's Principles & Practice of Medicine, 22nd Edition, 2014, 461-523. Daniel D. Bikle, Agents That Affect Bone Mineral Homeostasis, Lange's Basic & Clinical Pharmacology, 14th Edition, 2018, 772-791 Mylan, US Food and Drug Administration, [Revised on August 2022] [ Accessed on 2nd September 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021468s023,204734s005lbl.pdf
Frequently Asked Questions
How long does it take for lanthanum carbonate to start lowering phosphate levels?
The time it takes for lanthanum carbonate to lower phosphate levels can vary among individuals. It may take several weeks of consistent use to see significant reductions in phosphate levels. Your healthcare provider will monitor your progress and adjust your treatment plan.
Can I crush or split lanthanum carbonate tablets if I have difficulty swallowing them?
Lanthanum carbonate tablets should not be crushed or split. Discuss alternative dosage forms (such as chewable tablets or liquid formulations) with your healthcare provider if you have difficulty swallowing tablets.
What happens if I miss a dose of lanthanum carbonate?
If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Are there any dietary restrictions when taking lanthanum carbonate?
Yes, following dietary recommendations provided by your healthcare provider or dietitian is essential. Managing phosphate intake through diet is an important aspect of controlling hyperphosphatemia. You may be advised to limit phosphate-rich foods and beverages.
Can lanthanum carbonate interact with over-the-counter antacids or other medications I take for stomach issues?
Lanthanum carbonate should be taken separately from antacids and other medications for stomach issues, as it can interact with them. Follow your healthcare provider's instructions on timing and dosing.
Are there any serious side effects associated with lanthanum carbonate?
Rare but serious side effects can include allergic reactions, intestinal blockage, low levels of vitamins and minerals, excessively low phosphate levels, and gastrointestinal ulcers.