From the Guidelines
Lanthanum carbonate is used as a phosphate binder in patients with chronic kidney disease to control phosphate levels in the blood, particularly in those with progressively or persistently elevated serum phosphate levels. The medical use of lanthanum carbonate is primarily focused on managing hyperphosphatemia in patients with chronic kidney disease (CKD) stages G3a to G5D 1.
Key Points:
- Lanthanum carbonate works by binding to dietary phosphate in the gastrointestinal tract, preventing its absorption into the bloodstream 1.
- The decision to use phosphate-lowering treatment, including lanthanum carbonate, should be based on progressively or persistently elevated serum phosphate levels 1.
- Restricting the dose of calcium-based phosphate binders is suggested in adult patients with CKD G3a to G5D receiving phosphate-lowering treatment 1.
- Lanthanum carbonate may be considered as an alternative to calcium-based phosphate binders, as it does not contribute to positive calcium balance and may have a more favorable effect on coronary and aortic calcification 1.
Clinical Considerations:
- The typical dosage of lanthanum carbonate ranges from 750-3000 mg daily, divided with meals.
- It is essential to monitor serum phosphate levels and adjust the dose of lanthanum carbonate accordingly to achieve optimal phosphate control.
- Lanthanum carbonate should be used with caution in patients with gastrointestinal disorders or those at risk of gastrointestinal adverse effects.
From the FDA Drug Label
The medical use of Lanthanum carbonate is not explicitly stated in the provided text.
The FDA drug label does not answer the question.
From the Research
Medical Use of Lanthanum Carbonate
Lanthanum carbonate is used to treat hyperphosphatemia, a condition characterized by elevated levels of phosphate in the blood, commonly found in patients with chronic kidney disease (CKD) 2, 3, 4, 5, 6.
Mechanism of Action
The drug works by binding to dietary phosphate in the gastrointestinal tract, forming insoluble complexes that are then excreted in the feces, thereby reducing phosphate absorption into the bloodstream 3.
Efficacy
Studies have shown that lanthanum carbonate is effective in lowering serum phosphate levels in patients with CKD, with some studies suggesting it may be more efficacious than other phosphate binders such as sevelamer carbonate 2, 5.
Safety and Tolerability
Lanthanum carbonate has been found to be generally safe and well-tolerated, although it can cause gastrointestinal side effects such as nausea and abdominal pain 3, 5.
Clinical Applications
The use of lanthanum carbonate has been associated with several clinical benefits, including:
- Reduced risk of hypercalcemia compared to calcium-containing phosphate binders 3
- Improved nutritional status compared to other phosphate binders 3
- Lower risk of cardiovascular events and mortality compared to other phosphate binders 3, 5
- Effective management of hyperphosphatemia in patients with end-stage renal disease 3 and those undergoing hemodialysis 6
Administration
Lanthanum carbonate can be administered orally as chewable tablets or powder, and can also be crushed and mixed with enteral nutrients for patients undergoing tube feeding 6.
Cost-Effectiveness
Studies have found that lanthanum carbonate is a cost-effective treatment option for hyperphosphatemia in patients with CKD, particularly when used as a second-line treatment after failure of calcium-based binders 4.
Key Findings
Key findings from studies on lanthanum carbonate include:
- Significant reductions in serum phosphate levels compared to other phosphate binders 2, 5
- Improved control of serum phosphorus and calcium-phosphorus product compared to other treatments 5
- Reduced risk of adverse events such as hypotension, abdominal pain, and diarrhea compared to other phosphate binders 5