Active Ingredient: Lanthanum
Lanthanum is indicated in adult patients as a phosphate binding agent for use in the control of hyperphosphataemia in chronic renal failure patients on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD).
Lanthanum is also indicated in adult patients with chronic kidney disease not on dialysis with serum phosphate levels ≥1.78 mmol/L in whom a low phosphate diet alone is insufficient to control serum phosphate levels.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Oral, 750 milligrams lanthanum, divided daily, over the duration of 2 to 3 weeks. Afterwards, oral, between 750 milligrams lanthanum and 3,000 milligrams lanthanum, divided daily.
Serum phosphate levels should be monitored and the dose of lanthanum titrated every 2-3 weeks until an acceptable serum phosphate levels is reached, with regular monitoring thereafter.
Control of serum phosphate level has been demonstrated at doses starting from 750 mg per day. The maximum dose studied in clinical trials, in a limited number of patients, is 3750 mg. Patients who respond to lanthanum therapy, usually achieve acceptable serum phosphate levels at doses of 1500-3000 mg lanthanum per day.
Patients with renal insufficiency may develop hypocalcaemia. Serum calcium levels should therefore be monitored at regular time intervals for this patient population and appropriate supplements given.
Lanthanum should be taken with or immediately after food, with the daily dose divided between meals. Patients should adhere to recommended diets in order to control phosphate and fluid intake.
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