Lanthanum Carbonate

How it works

In the gastrointestinal tract lanthanum binds dietary phosphate to form insoluble, poorly absorbed lanthanum phosphate, reducing phosphate absorption.

Prescribing in practice

• Tablets must be chewed thoroughly and taken with or immediately after food to bind phosphate effectively and reduce the risk of gastrointestinal obstruction.
• Gastrointestinal effects, and rarely bowel obstruction, perforation or ileus, can occur, so use caution in patients with gut motility disorders.
• Separate administration from other oral medicines whose absorption may be impaired by binders.

Monitoring

Monitor serum phosphate, and calcium, to guide dose titration to target while avoiding over-suppression.

Counselling the patient

• Always chew the tablets fully and take them with food, never on an empty stomach.
• Report persistent constipation, severe abdominal pain or vomiting.
• Take other tablets at a different time from your phosphate binder as advised.

Evidence & guidelines

Renal mineral and bone guidance supports phosphate binders such as lanthanum carbonate for managing hyperphosphataemia in CKD.