Lanthanum

Class: Phosphate-removing Agents
VA Class: GU900
Chemical Name: Dilanthanum tricarbonate hydrate
Molecular Formula: La₂(CO₃)₃ • H₂O
CAS Number: 54451-24-0
Brands: Fosrenol

Medically reviewed by Drugs.com on Apr 21, 2022. Written by ASHP.

Introduction

Phosphate binder used to reduce the intestinal absorption of phosphates.

Uses for Lanthanum

Hyperphosphatemia

Reduction of serum phosphorus in patients with end-stage renal disease (ESRD). Reductions in serum phosphorus concentrations are similar to those achieved with alternative phosphate binders (e.g., calcium salts, sevelamer).

Risk of hypercalcemia apparently is less than with calcium (e.g., calcium carbonate) salts.

Lanthanum Dosage and Administration

Administration

Oral Administration

Administer orally in divided doses with or immediately after meals (in order to bind dietary phosphates efficiently).

Chew tablets completely before swallowing; do not swallow intact tablets.

Dosage

Available as lanthanum carbonate; dosage expressed in terms of lanthanum.

Adults

Hyperphosphatemia

ESRD

Initially, 750 mg–1.5 g daily.

Adjust dosage at 2- to 3-week intervals until serum phosphorus concentration is acceptable; generally titrated in increments of 750 mg daily in clinical studies.

Dosage of 1.5–3 g daily usually is required to reduce serum phosphorus concentrations to <6 mg/dL; dosages up to 3.75 g daily have been studied.

Monitor serum phosphorus concentrations as needed during titration and regularly thereafter.

Cautions for Lanthanum

Contraindications

• No known contraindications.

Warnings/Precautions

General Precautions

GI Disease

Safety and efficacy not established in active peptic ulcer disease, ulcerative colitis, Crohn’s disease, or bowel obstruction; use with caution in patients with these disorders.

Radiographic Examinations

Abdominal radiographs performed in patients taking lanthanum may have the typical radiopaque appearance of a radiograph performed using an imaging agent.

Chronic Use

No differences in fracture or mortality rates were observed between patients receiving lanthanum and those receiving alternative therapy for up to 3 years in clinical studies; however, data are insufficient to conclude lanthanum has no effect on fracture or mortality rates beyond 3 years of use.

Specific Populations

Pregnancy

Category C.

Lactation

Not .