Lanthanum carbonate

CLINICAL USE

Phosphate binder in patients with CKD 5

DOSE IN NORMAL RENAL FUNCTION

Usually 750 mg – 1.5 g 3 times a day with meals

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :457.8

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>99.7

%Excreted unchanged in urine &nbsp &nbsp : Negligible

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :Not absorbed

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :36

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :Not dialysed. Dose as in normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antifungals: absorption of ketoconazole reduced – give at least 2 hours apart

Antimalarials: absorption of chloroquine and hydroxychloroquine possibly reduced – give at least 2 hours apart

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

Must be chewed WITH food; do not take before meals

OTHER INFORMATION

Following ingestion, lanthanum carbonate is converted in the GI tract to the insoluble lanthanum phosphate, which is not readily absorbed into the blood

Bioavailability of drugs administered concomitantly may be reduced due to binding by lanthanum carbonateVery little is absorbed If not taken with meals, may result in vomiting

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