Lanthanum carbonate

Lanthanum Carbonate is a medication primarily used in the management of hyperphosphatemia, which is commonly associated with chronic kidney disease (CKD). It functions as a phosphate binder, reducing the absorption of phosphate from the gastrointestinal tract. This article provides a comprehensive overview of lanthanum carbonate, including its mechanism of action, uses, pharmacokinetics, side effects, and contraindications.

Mechanism of Action

Lanthanum carbonate (La2(CO3)3) works by binding to dietary phosphate in the gastrointestinal tract, forming insoluble lanthanum phosphate complexes that are excreted in the feces. This process reduces the amount of phosphate that is absorbed into the bloodstream, thereby lowering serum phosphate levels. The control of phosphate levels is crucial in patients with CKD to prevent the development of secondary hyperparathyroidism and renal osteodystrophy.

Uses

The primary indication for lanthanum carbonate is the treatment of hyperphosphatemia in patients with chronic kidney disease, especially those on dialysis. By maintaining phosphate levels within the normal range, lanthanum carbonate helps to reduce the risk of cardiovascular disease and bone disorders associated with elevated phosphate levels in CKD patients.

Pharmacokinetics

Lanthanum carbonate is minimally absorbed from the gastrointestinal tract. Its action is localized to the gut, where it binds to phosphate present in the ingested food. The bound phosphate-lanthanum complex is then excreted in the feces. Due to its minimal systemic absorption, lanthanum carbonate has a low risk of systemic toxicity.

Side Effects

Common side effects of lanthanum carbonate include gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain. Uncommonly, patients may experience constipation or develop a risk of intestinal obstruction. Due to its action in the gastrointestinal tract, it may also interfere with the absorption of other orally administered medications, necessitating adjustments in dosing schedules.

Contraindications

Lanthanum carbonate is contraindicated in patients with hypersensitivity to lanthanum or any component of the formulation. It should be used with caution in patients with bowel obstruction or severe constipation. The safety and efficacy of lanthanum carbonate in pregnant or breastfeeding women have not been established.

Drug Interactions

Lanthanum carbonate can interact with certain medications by reducing their absorption. It is advisable to administer other orally taken medications at least one hour before or three to four hours after taking lanthanum carbonate to minimize potential interactions.

Conclusion

Lanthanum carbonate is an effective medication for the management of hyperphosphatemia in patients with chronic kidney disease. Its ability to bind dietary phosphate and reduce serum phosphate levels makes it a valuable tool in preventing the complications associated with elevated phosphate levels in CKD. However, patients should be monitored for gastrointestinal side effects and potential interactions with other medications.

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