Lanthanum carbonate
FOSRENOL
What it isNon-absorbed phosphate binder; hyperphosphatemia in dialysis.
Why this oneChewable, calcium-free and effective at a lower tablet burden than sevelamer.
What limits itTablets must be chewed thoroughly or they do not work. GI upset; long-term tissue deposition is of uncertain significance.
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hyperphosphatemia (ESRD) | Adults | 1,500 mg/day in divided doses with meals | 1,500-3,000 mg/day | 4,500 mg/day |
Titration Titrate every 2 to 3 weeks based on serum phosphate
Renal Undefined
Hepatic Undefined
Binds other orally administered drugs — separate their administration
Instructions
- Take with or immediately after meals
- Chew or crush tablet completely before swallowing; do not swallow whole
- Consider oral powder in patients with poor dentition or difficulty chewing
- Separate administration of other oral medications (binds them)
Contraindications
- Bowel obstruction, including ileus and fecal impaction
Cautions
- Serious GI obstruction, ileus, subileus, perforation, and fecal impaction (chew completely)
- Radio-opaque — may appear as an imaging agent on abdominal X-ray
Adverse reactions
- Nausea
- Vomiting
- Abdominal pain
- (Postmarketing) constipation, dyspepsia, tooth injury while chewing
Pregnancy Insufficient data; use a non-lanthanum phosphate binder in pregnancy
Lactation No data; use a non-lanthanum phosphate binder while lactating
NO BOXED WARNINGS
Principal riskTablets must be chewed thoroughly or they do not work
Cost, est. cash$10–$300/month
Generic entry2017
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
Mechanism of action: Lanthanum carbonate ballicule
