Lanthanum

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking lanthanum,

• tell your doctor and pharmacist if you are allergic to lanthanum, any other medications, or any of the ingredients in lanthanum chewable tablets or oral powder. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may tell you to take your medications at certain times before or after you take lanthanum, change the doses of your medications, or monitor you more carefully for side effects. Be sure to mention any of the following: calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Cartia, Diltzac, others), felodipine, isradipine, nicardipine (Cardene), nifedipine (Adalat, Afeditab, Procardia), nimodipine (Nymalize), nisoldipine (Sular), or verapamil (Calan, Covera, Verelan, in Tarka). If you are taking an angiotensin-converting enzyme (ACE) inhibitor such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Epaned, Vasotec), fosinopril, lisinopril (Qbrelis, Prinivil, in Zestoretic), moexipril, or perindopril (Aceon, in Prestalia); ampicillin; a tetracycline antibiotic such as demeclocycline, doxycycline (Doryx, Monodox, Oracea, others), minocycline (Dynacin, Minocin), or tetracycline (Achromycin V, in Pylera); a cholesterol-lowering medication (statins) such as atorvastatin (Lipitor) or rosuvastatin (Crestor); a medication for the treatment of malaria; or a thyroid medication such as levothyroxine (Levo-T, Synthroid, Tirosint, others), you should take it at least 2 hours before or 2 hours after you have taken lanthanum. Take fluoroquinolone antibiotics such as ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), or moxifloxacin (Avelox, Moxeza) at least 1 hour before or 4 hours after taking lanthanum. Many other medications may interact with lanthanum, so be sure to tell your doctor and pharmacist about all the medications you are taking, even if they do not appear on this list.
• tell your doctor if you have paralytic ileus (condition in which digested food does not move through the intestines), or any condition where the bowels are blocked, including fecal impaction (a large amount of dry, hard stool stuck in the rectum). Your doctor will probably tell you not to take lanthanum.
• tell your doctor if you have or have ever had an ulcer, ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum), peritonitis (inflammation of the lining of the stomach), Crohn's disease (a condition in which the body attacks the lining of the intestines causing pain, diarrhea, weight loss, and fever), stomach or colon cancer, diabetes, gastroparesis (slowed movement of food from the stomach to the small intestine), or if you have gastrointestinal problems such as ongoing constipation. Also tell your doctor if you ever had any kind of surgery on your stomach or intestines.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking lanthanum, call your doctor.

• Fosrenol^®

Reduction of serum phosphorous: Oral: Initial: 1,500 mg daily divided and taken with or immediately after meals; typical increases of 750 mg daily every 2 to 3 weeks are suggested as needed to reduce the serum phosphate level <6 mg/dL (1.92 mmol/L); usual dosage range: 1,500 to 3,000 mg daily; doses of up to 4,500 mg have been evaluated

Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from moisture. Do not open oral powder until ready to use.

Commonly reported side effects of lanthanum carbonate include: dialysis graft complication, nausea, and vomiting. Other side effects include: dialysis graft occlusion, and abdominal pain. See below for a comprehensive list of adverse effects.

Applies to lanthanum carbonate: oral powder, oral tablet chewable

Along with its needed effects, lanthanum carbonate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking lanthanum carbonate:

• Bone pain
• convulsions
• difficulty having a bowel movement (stool)
• itching skin or rash
• loss of appetite
• trouble breathing
• unusual tiredness or weakness

Get emergency help immediately if any of the following symptoms of overdose occur while taking lanthanum carbonate:

• Headache
• nausea
• vomiting

Some side effects of lanthanum carbonate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Abdominal or stomach pain

• Belching
• heartburn
• indigestion
• stomach discomfort or upset
• tooth injury

Initial dose: 1500 mg orally daily; take in divided doses with meals
Titrate in increments of 750 mg/day every 2 to 3 weeks until an acceptable serum phosphate level is reached
Maximum dose: 4500 mg/day

Comments: Most patients will require daily doses between 1500 and 3000 mg to reduce plasma phosphate levels to less than 6 mg/dL.

Use: To reduce serum phosphate levels in patients with end stage renal disease.

No adjustment recommended

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.