lanthanum carbonate (Rx)Brand and Other Names:Fosrenol

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

chewable tablet

  • 500mg
  • 750mg
  • 1000mg

oral powder

  • 750mg
  • 1000mg
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Reduction of Serum Phosphate in ESRD Patients

Initial: 750-1500 mg/day PO in divided doses

Titrate by 750 mg increments q2-3Weeks until acceptable serum phosphate level attained

Doses up to 4500 mg were evaluated in clinical trials; most patients required a total daily dose between 1500-3000 mg to reduce plasma phosphate levels to <6.0 mg/dL

Administration

Take with or immediately after meals

Chewable tablet: Chew or crush tablet completely; do not swallow whole

Oral powder

  • Sprinkle oral powder on a small quantity of applesauce or other similar food and consume immediately
  • Do not open until ready to use
  • Do not store oral powder for future use once mixed with food
  • Oral powder is insoluble, do not attempt to dissolve in liquid for administration
  • Consider using the oral powder formulation in patients with poor dentition, or who have difficulty chewing tablets

Not recommended

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Interactions

Interaction Checker

lanthanum carbonate and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Abdominal pain

            Constipation

            Dialysis graft complication/occlusion

            Diarrhea

            Headache

            Hypertension

            Nausea

            Vomiting

            <1%

            Bronchitis

            Hypercalcemia

            Rhinitis

            Postmarketing Reports

            Dyspepsia

            Allergic skin reactions

            Hypophosphatemia

            Hypocalcemia

            Tooth injury

            Intestinal perforation

            Intestinal obstruction

            Ileus

            Subileus

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            Warnings

            Contraindications

            Bowel obstruction

            Ileus

            Fecal impaction

            Cautions

            Use with caution in PUD, Crohn's disease, ulcerative colitis, bowel obstruction

            Serious cases of gastrointestinal obstruction, ileus, subileus, gastrointestinal perforation and fecal impaction reported; risk factors for gastrointestinal obstruction and gastrointestinal perforation in patients taking chewable tablets include altered gastrointestinal anatomy (e.g., diverticular disease, peritonitis, history of gastrointestinal surgery, gastrointestinal colon cancer, gastrointestinal ulceration), hypomotility disorders (e.g., constipation, ileus, subileus, diabetic gastroparesis) and concomitant medications (e.g., calcium channel blockers); cases were reported in patients with no history of gastrointestinal disease; advise patients prescribed chewable tablets to chew tablet completely to reduce risk of serious adverse gastrointestinal events

            Has radio-opaque properties and therefore may give the appearance typical of an imaging agent during abdominal X-ray procedures

            Chewable tablets should be chewed completely to reduce the risk of serious adverse gastrointestinal events

            Pregnancy, lactation

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Lanthanum forms strong complexes with PO4 that inhibits GI absorption and results in a decrease of serum phosphate and calcium levels

            Pharmacokinetics

            Half-Life, elimination: 53 hr (plasma); 2-3.6 years (bond)

            Peak Plasma: 1 ng/mL

            Bioavailability: 0.002%

            Protein bound: 99%

            Metabolism: Not metabolized

            Excretion: Predominantly feces

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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