Pharmacologic class: Phosphate binder
Therapeutic class: Renal and genitourinary agent
Pregnancy risk category C
Dissociates in acidic environment of upper GI tract to release lanthanum ions, which bind dietary phosphate released from food during digestion and inhibit phosphate absorption by forming highly insoluble lanthanum phosphate complexes
Tablets (chewable): 500 mg, 750 mg, 1,000 mg
Indications and dosages
➣ To reduce serum phosphate level in patients with end-stage renal disease
Adults: Initially, 1,500 mg P.O. (chewed) daily in divided doses with meals; titrate every 2 to 3 weeks until serum phosphate falls to acceptable level.
• Bowel obstruction, ileus, or fecal impaction
Use cautiously in:
• acute peptic ulcer, Crohn's disease, ulcerative colitis
• pregnant or breastfeeding patients
• children (safety and efficacy not established).
• Give before meals; ensure that patient chews tablets completely before swallowing to reduce risk of serious adverse GI events.
GI: nausea, vomiting, diarrhea, constipation, abdominal pain
Respiratory: bronchitis, rhinitis
Other: dialysis graft complication or occlusion
Drug-diagnostic tests. Serum calcium: increased
• Monitor serum calcium and phosphorus levels periodically.
• Instruct patient to take drug with or immediately after meals and to chew tablets completely before swallowing.
• Advise patient to discuss any planned dietary changes with prescriber.
• Inform female patient with childbearing potential that drug isn't recommended during pregnancy.
• Instruct female patient to tell prescriber if she's breastfeeding.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the tests mentioned above.
lanthanum carbonate(lan-than-um) ,
Pharmacologic: phosphate binders
Time/action profile (effect on phosphate levels)
Adverse Reactions/Side Effects
- nausea (most frequent)
- vomiting (most frequent)
- fecal impaction
- GI obstruction
Fluid and Electrolyte
Drug-Drug interactionMay ↓ abosrption of fluoroquinolones, tetracyclines, and levothyroxine ; administer at least 1 hr before or 3 hr after lanthanum carbonate.
- Assess patient for nausea and vomiting during therapy.
- Lab Test Considerations: Monitor serum phosphate levels prior to and periodically during therapy.
Potential Nursing DiagnosesNausea (Side Effects)
- Do not confuse lanthanum carbonate with lithium carbonate.
- Divide total daily dose and administer with meals.
- Oral: Administer with or immediately after meals. Tablets should be crushed or chewed completely before swallowing; intact tablets should not be swallowed.
- Instruct patient to take lanthanum as directed.
- Decrease in serum phosphate to below than 6.0 mg/dL in patients with end stage renal disease.