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Last updated: Lesson of the Month - October 2017…
on 17 Oct 2017

Lanthanum

  • Hyperphosphataemia in patients on dialysis or patients with CKD and with a serum phosphate >1.78 mmol/l

  • Lanthanum carbonate (hydrate) is a non-calcium, non-aluminium containing phosphate binding agent
  • Fosrenol®: Tablets: 500mg, 750mg and 1g; Oral powder sachets: 750mg and 1g

  • Hypophosphataemia

  • Bowel obstruction. Abdominal x-rays of patients taking lanthanum may have a radio-opaque appearance typical of an imaging agent

  • Nausea, hypocalcaemia, abdominal pain or cramps

  • 750 mg - 1g TDS chewed with or immediately after meals, adjusted according to serum-phosphate concentration every 2–3 weeks with meals and phosphate rich snacks
  • Maximum licensed dose is 3g daily in divided doses

  • As in normal renal function

  • Reduced absorption of ketoconazole, doxycycline, ciprofloxacin and chloroquine
  • Separate doses by 2 hours

Lanthanum#750mg#see prescribing section#PO#8 12 18

  • Chew the tablets well, do not swallow whole. Take during meals and not on an empty stomach
  • Lanthanum oral powder is intended to be mixed with a small quantity of soft food (e.g. apple sauce or other similar food product) and consumed immediately (within 15 minutes). Lanthanum oral powder is insoluble and must not be dissolved in liquid for administration. Sprinkle the powder on soft food and do not try to dissolve in water
  • Adhere to the dietary advice from your renal dietician. Phosphate binders work better if taken with foods containing phosphate. They should be taken with meals or snacks which include meat, fish, eggs, cheese, milk or pulses. They should not be taken with meals or snacks which do not include phosphate, such as toast, jam or salad sandwiches, biscuits or fruit