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Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
Tablets can be crushed and put down a NG tube. (Kitajima Y, Takahashi t, Sato Y, et al. Efficacy of crushed lanthanum carbonate for hyperphosphataemia in hemodialysis patients undergoing tube feeding. Nephrol Dial Transplant. 2011; 4(4): 253–5.
Metabolic bone disease
Published in Philip E. Harris, Pierre-Marc G. Bouloux, Endocrinology in Clinical Practice, 2014
Philip E. Harris, Pierre-Marc G. Bouloux
It is possible to slow down the progression of bone disease by treatments aimed at reducing phosphate levels, usually by use of phosphate binders and the use of calcitriol, or analogs of calcitriol less prone to causing hypercalcemia.75 The development of calcimimetic drugs has heralded in a new therapeutic era for reducing PTH levels. In secondary hyperparathyroidism in patients with end stage renal disease on dialysis, cinacalcet is started at a dose of 30 mg daily and adjusted every 2–4 weeks to a maximum dose of 180 mg/day. Aluminum hydroxide is now rarely used as a phosphate binder because of its propensity to cause adynamic bone disease. Rather, calcium salts, sevelamer hydrochloride, or carbonate (2.4–4.8 g daily in divided doses with meals, or lanthanum carbonate hydrate, 1.5–3 g daily) are used as phosphate-binding agents. Adynamic bone disease can occur in patients in whom secondary hyperparathyroidism has been reversed. The relationship of adynamic bone disease to PTH level, however, is variable, and an iliac crest bone biopsy may be necessary to establish the diagnosis.76
Chronic Renal Failure
Published in Anthony R. Mundy, John M. Fitzpatrick, David E. Neal, Nicholas J. R. George, The Scientific Basis of Urology, 2010
There are a number of phosphate binders currently available, which fall into two categories: calcium-based binders (calcium acetate and calcium carbonate) and non-calcium-based binders (sevelamer hydrochloride and lanthanum carbonate). Use of the calcium-based preparations is limited by the fact that patients with CKD should not take in more than 2 g of elemental calcium per day, as this may again promote vascular calcification.
In vitro cytogenetic analysis of two different anti-phosphates (sevelamer hydrochloride and calcium carbonate) agents used by patients with hyperphosphatemia
Published in Drug and Chemical Toxicology, 2023
Goulzar Ulaya, Hasan Basri İla
In a different study with lanthanum carbonate, an effective oral phosphate binder, like our test substances and used by patients with hyperphosphatemia different independent test protocols were applied in the study of potential genotoxicity using some in vitro and in vivo assays, in the presence and absence of the post-mitochondrial fraction (S9). According to the results of that study, lanthanum carbonate is not an in vivo genotoxin, but some genomic damage like chromatid and chromosome type deletion and exchange increased in an in vitro cytogenetic assay using Chinese hamster ovary (CHO) cells (Damment et al.2005). However, non-clinical evidence has been presented to suggest that lanthanum carbonate is safe to use and is compatible with the good safety profile of long-term studies in dialysis patients (D'Haese et al.2003, Behets et al.2004).
An update on phosphate binders for the treatment of hyperphosphatemia in chronic kidney disease patients on dialysis: a review of safety profiles
Published in Expert Opinion on Drug Safety, 2022
Hiroaki Ogata, Akiko Takeshima, Hidetoshi Ito
Lanthanum carbonate, which has been approved for the treatment of hyperphosphatemia in patients with CKD in North America, Europe, and Japan, is the second most commonly used non-calcium-based phosphate binder for treating hyperphosphatemia in clinical practice, after sevelamer [35]. Lanthanum is a rare earth element that strongly binds to phosphate in the gastrointestinal tract and is minimally absorbed. Over 99% of orally administered lanthanum carbonate is excreted in the feces [36]. Most of the lanthanum carbonate-related adverse effects are related to gastrointestinal symptoms, including abdominal discomfort, nausea, constipation, and loose stool, which are consistent with those of other non-calcium phosphate binders [36]. In a meta-analysis of 16 RCTs on dialysis patients, vomiting was more frequent in lanthanum carbonate users than in calcium-based phosphate binder users, but abdominal pain was lower in lanthanum carbonate users [37]. No significant differences were observed in the incidence rates of nausea, constipation, or dyspepsia.
Safety and effectiveness of lanthanum carbonate for hyperphosphatemia in chronic kidney disease (CKD) patients: a meta-analysis
Published in Renal Failure, 2021
Lijuan Zhao, An Liu, Guoshuang Xu
Lanthanum carbonate (LC), as a new non-calcium-based PB, is used to treat hyperphosphatemia in patients with CKD through binding phosphate via its trivalent cation [6,11]. Reportedly, healthy individuals receiving a dose of 3000 mg/day of LC can reduce urinary phosphorus excretion [12]. In addition, a multicenter, randomized, and double-blind study showed that LC is a well-tolerated and efficacious oral PB with mild adverse effects for hemodialysis and patients with CKD [13]. To further analyze the efficacy and safety of LC, the present meta-analysis was performed via comparing the effects of LC on serum biochemical parameters, various adverse events, and patient-level outcomes versus calcium salts (calcium acetate and calcium carbonate), sevelamer hydrochloride (SH), non-LC PBs (PBs) or placebo.