A non-calcium phosphate binder for high phosphate in kidney disease
Lanthanum carbonate
A non-calcium phosphate binder taken with meals to lower high phosphate levels in people with kidney disease.
What is Lanthanum carbonate?
Lanthanum carbonate is a phosphate binder used to lower high phosphate levels in people with advanced kidney disease, especially those on dialysis. It works in the gut by mopping up phosphate from food so less is absorbed into the body. Because it acts on food, it must be taken with or just after meals, and the chewable tablets need to be chewed thoroughly rather than swallowed whole. It does not contain calcium, which can make it useful for people who need to avoid extra calcium. The most common problems are stomach-related, such as nausea and feeling sick.
Education and reference only. This is a plain-language guide to Lanthanum carbonate — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Lanthanum carbonate is a phosphate binder, a type of medicine that helps control the amount of phosphate the body takes in from food. People with advanced kidney disease, particularly those on dialysis, cannot remove phosphate properly, so it builds up in the blood and over time harms the bones, blood vessels and heart. Lanthanum carbonate is a non-calcium binder, meaning it lowers phosphate without adding to the body's calcium load, which can be helpful for some people. It is taken by mouth as chewable tablets or oral powder, always with food.
How it works
When phosphate from food reaches the gut, lanthanum carbonate binds to it and forms a substance that the body cannot absorb, so it passes out in the stool instead of entering the bloodstream. This lowers the amount of phosphate building up in the blood. Because it only works on phosphate that is in the gut at the same time, it has to be taken with or just after meals to catch the phosphate in the food. Taking it away from food means there is little phosphate for it to bind, so it would not work properly.
Company & origin
Originated / developed by: Specialist manufacturer.
A medicine used in the UK to control high phosphate levels in people with advanced kidney disease, particularly those on dialysis.
What it treats
Conditions Lanthanum carbonate is used for
Practical use
How to take Lanthanum carbonate
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it with or immediately after meals so it can bind the phosphate in your food.
- Chew the chewable tablets thoroughly, or crush them, rather than swallowing them whole.
- Spread your binders across the meals of the day, taking more with larger or higher-phosphate meals as advised.
- Keep it apart from some other medicines, such as certain antibiotics and thyroid tablets, by a couple of hours.
- Follow the low-phosphate diet you are given, as the medicine works best alongside it.
Weighing it up
Advantages & disadvantages of Lanthanum carbonate
Advantages
- Effectively lowers high phosphate levels in advanced kidney disease.
- Does not contain calcium, which suits people who need to limit their calcium load.
- Comes as chewable tablets and powder, which can be easier than swallowing large tablets.
Disadvantages
- Must be taken with food and chewed properly, which takes planning around meals.
- Commonly causes stomach-related side effects such as nausea and constipation.
- Can reduce how well some other medicines are absorbed, so timing needs care.
Practical use
Good to know
The most important thing to get right with lanthanum carbonate is the timing: it must be taken with or immediately after meals so it can bind the phosphate in your food. The chewable tablets need to be chewed thoroughly, or crushed if you cannot chew them, rather than swallowed whole, because they need to be broken up to work and to avoid getting stuck. The most common side effects are stomach-related, such as nausea, feeling sick or constipation. It can also reduce how well some other medicines are absorbed, so certain tablets, such as some antibiotics and thyroid medicine, should be kept apart from it by a couple of hours. A low-phosphate diet and, for many people, dialysis are usually part of the overall plan alongside it.
Who should not take it / use with caution
- People who have had a serious allergic reaction to lanthanum carbonate should not take it.
- It is used with care in people with certain bowel problems, such as a blockage or severe constipation.
- It should be used under the supervision of a kidney team, with regular phosphate monitoring.
Monitoring
- Regular blood tests to check phosphate levels and adjust the dose.
- Reviewing calcium and bone-related blood tests over time.
- Checking for stomach side effects and any bowel problems.
Side effects
- Nausea, feeling sick or vomiting, especially early in treatment.
- Constipation, tummy pain or other stomach upset.
- Rarely, bowel problems such as blockage, particularly in people already prone to constipation.
Key interactions
- It can reduce the absorption of some antibiotics, such as tetracyclines and quinolones, so separate the timing.
- It can reduce the absorption of thyroid medicine, so keep these well apart.
- Antacids and some other medicines may need careful spacing, guided by your kidney team.
Available as: Chewable tablets and oral powder taken with food.
Answers
Lanthanum carbonate: frequently asked questions
What is lanthanum carbonate used for?
It is used to lower high phosphate levels in people with advanced kidney disease, especially those on dialysis, by binding phosphate from food in the gut.
Why must I take it with meals?
It works by binding the phosphate in your food, so it must be taken with or just after meals; taken on an empty stomach there is little phosphate for it to catch.
Do I have to chew the tablets?
Yes, the chewable tablets need to be chewed thoroughly, or crushed if you cannot chew them, rather than swallowed whole, so they can work properly.
Does it contain calcium?
No. Lanthanum carbonate is a non-calcium phosphate binder, which can be useful for people who need to avoid adding to their calcium load.
Can it affect my other medicines?
It can reduce how well some medicines, such as certain antibiotics and thyroid tablets, are absorbed, so keep these apart from it by a couple of hours.
The wider class
About Phosphate binder (non-calcium)
Lanthanum carbonate belongs to the phosphate binder (non-calcium) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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