What is Lanthanum Carbonate: Uses, Dosage, Side Effects and More

Lanthanum carbonate is a prescription medication that helps control high phosphorus levels in people with kidney disease. If you're dealing with chronic kidney disease or you're on dialysis, your doctor might prescribe this medication to help protect your bones and heart from the harmful effects of too much phosphorus in your blood.

This medication works like a sponge in your digestive system, soaking up excess phosphorus from the food you eat before it can enter your bloodstream. Think of it as giving your already-stressed kidneys a helping hand with one of their most important jobs.

What is Lanthanum Carbonate?

Lanthanum carbonate is a phosphate binder that belongs to a class of medications called rare earth elements. It's specifically designed to reduce phosphorus absorption in your intestines, which becomes crucial when your kidneys can't filter phosphorus properly on their own.

Unlike some other phosphate binders, lanthanum carbonate doesn't contain calcium or aluminum, making it a safer long-term option for many people. The medication comes in chewable tablets that you take with meals, and it's been helping people manage their phosphorus levels for over two decades.

Your body doesn't actually absorb much of this medication into your bloodstream. Instead, it does its work right in your digestive tract, binding to phosphorus and helping you eliminate it through your stool.

What is Lanthanum Carbonate Used For?

Lanthanum carbonate is primarily used to treat high phosphorus levels (hyperphosphatemia) in people with chronic kidney disease who are on dialysis. When your kidneys aren't working properly, they can't remove excess phosphorus from your blood effectively, leading to dangerous buildup.

High phosphorus levels can cause serious complications over time. Your body might start pulling calcium from your bones to balance the phosphorus, leading to weak, brittle bones that break easily. The excess phosphorus can also combine with calcium in your blood, forming deposits in your heart, blood vessels, and other soft tissues.

Your doctor might prescribe this medication if you're already following a low-phosphorus diet but your levels are still too high. It's particularly helpful for people who need a phosphate binder that won't add extra calcium or aluminum to their system, which can cause other health problems.

How Does Lanthanum Carbonate Work?

Lanthanum carbonate works by binding to phosphorus in your stomach and intestines, preventing it from being absorbed into your bloodstream. This is a gentle but effective approach that targets the problem right where phosphorus enters your body from food.

When you chew the tablet with your meal, the lanthanum breaks down in your stomach acid and becomes available to grab onto phosphorus molecules from your food. This creates a compound that your body can't absorb, so the phosphorus passes through your digestive system and leaves your body naturally.

The medication is considered moderately strong among phosphate binders. It's more effective than some older options like calcium carbonate, but it works more gently than some newer alternatives. Most people find it provides steady, reliable phosphorus control without causing dramatic swings in their levels.

How Should I Take Lanthanum Carbonate?

You should take lanthanum carbonate exactly as your doctor prescribes, typically with or immediately after meals. The tablets need to be chewed completely before swallowing, not crushed or swallowed whole, because chewing helps the medication mix properly with your food.

Take the medication with water, milk, or another beverage of your choice. You don't need to avoid any particular drinks, but staying well-hydrated helps your digestive system process the medication more comfortably. If you have trouble with the taste, you can drink something flavorful after chewing the tablet.

Timing your doses with meals is important because the medication needs to be present in your stomach when phosphorus from food arrives. If you eat multiple meals throughout the day, your doctor will likely have you split your total daily dose across these meals rather than taking it all at once.

How Long Should I Take Lanthanum Carbonate For?

Most people with chronic kidney disease need to take lanthanum carbonate for months or years, often as a long-term treatment. Your phosphorus levels will likely return to being too high if you stop taking the medication, since the underlying kidney problem that caused the issue in the first place usually doesn't go away.

Your doctor will monitor your phosphorus levels regularly through blood tests, typically every few months once your levels are stable. Based on these results, they might adjust your dose or switch you to a different phosphate binder if needed.

Some people might be able to reduce their dose or stop the medication if their kidney function improves significantly, such as after a successful kidney transplant. However, this decision should always be made with your healthcare team, never on your own.

What Are the Side Effects of Lanthanum Carbonate?

Like all medications, lanthanum carbonate can cause side effects, though many people tolerate it well. The most common side effects affect your digestive system, which makes sense since that's where the medication does its work.

Here are the side effects you might experience, and it's helpful to know that most of these tend to improve as your body adjusts to the medication:

• Nausea and stomach upset, especially during the first few weeks
• Vomiting, which usually decreases over time
• Diarrhea or loose stools
• Constipation in some people
• Stomach pain or cramping
• Headache
• Dizziness

Most of these digestive side effects are mild and temporary. Your doctor might suggest starting with a lower dose and gradually increasing it to help your body adjust more comfortably.

There are also some less common but more serious side effects that require immediate medical attention. While these are rare, it's important to know what to watch for so you can get help quickly if needed:

• Severe abdominal pain that doesn't go away
• Signs of bowel obstruction, such as severe constipation, vomiting, and inability to pass gas
• Unusual fatigue or weakness
• Irregular heartbeat
• Severe allergic reactions, including rash, swelling, or difficulty breathing

Very rarely, some people might develop deposits of lanthanum in their tissues over many years of use, though this doesn't usually cause symptoms. Your doctor will monitor you for any signs of this through regular check-ups.

Who Should Not Take Lanthanum Carbonate?

Lanthanum carbonate isn't right for everyone, and your doctor will carefully consider your medical history before prescribing it. The medication is generally not recommended for people with certain digestive conditions or those who might have trouble processing it safely.

You should not take lanthanum carbonate if you have a known allergy to lanthanum or any other ingredients in the medication. People with severe liver disease might also need to avoid this medication, as their bodies might have difficulty processing it properly.

Certain digestive conditions can make lanthanum carbonate unsafe or ineffective. These include active stomach ulcers, severe inflammatory bowel disease, or a history of bowel obstruction. The medication could potentially worsen these conditions or become less effective.

Your doctor will also be cautious about prescribing this medication if you're pregnant or breastfeeding, as there isn't enough research to confirm its safety in these situations. If you become pregnant while taking lanthanum carbonate, contact your healthcare provider right away to discuss your options.

Lanthanum Carbonate Brand Names

The most common brand name for lanthanum carbonate is Fosrenol, which is manufactured by Takeda Pharmaceuticals. This is the original brand that was first approved by the FDA and remains widely prescribed today.

Generic versions of lanthanum carbonate are also available, which contain the same active ingredient but may be less expensive. Your pharmacy might automatically substitute a generic version unless your doctor specifically requests the brand name.

Whether you take the brand name or generic version, the medication should work the same way. However, some people find that they tolerate one version better than another, so let your doctor know if you notice any differences when switching between brands.

Lanthanum Carbonate Alternatives

If lanthanum carbonate doesn't work well for you or causes too many side effects, there are several other phosphate binders your doctor might consider. Each has its own advantages and potential drawbacks, so the choice depends on your specific situation.

Calcium-based phosphate binders like calcium carbonate or calcium acetate are often tried first because they're less expensive. However, they can cause too much calcium buildup in some people, especially those who are also taking vitamin D supplements.

Sevelamer (Renagel or Renvela) is another non-calcium, non-aluminum option that works similarly to lanthanum carbonate. Some people find it easier to tolerate, though it requires taking more pills and can be more expensive.

Iron-based phosphate binders like ferric citrate (Auryxia) can help with both phosphorus control and iron deficiency, which is common in people with kidney disease. Your doctor might suggest this if you need both benefits.

Is Lanthanum Carbonate Better Than Sevelamer?

Both lanthanum carbonate and sevelamer are effective phosphate binders, but they have different advantages that might make one better for your specific situation. Neither is universally "better" than the other, and the choice often comes down to what works best for your body and lifestyle.

Lanthanum carbonate typically requires fewer pills per day compared to sevelamer, which can make it easier to stick to your medication routine. Many people find it more convenient to chew one or two lanthanum tablets with meals rather than swallowing multiple sevelamer capsules.

However, sevelamer might cause fewer digestive side effects for some people, especially those who are sensitive to the taste or texture of chewable tablets. Sevelamer also has additional benefits beyond phosphorus control, such as helping to lower cholesterol levels and reduce inflammation.

Your doctor will consider factors like your other medications, your phosphorus levels, any side effects you've experienced, and your personal preferences when deciding between these options. Some people even use both medications together if one alone isn't enough to control their phosphorus levels.