Lanfos is a phosphate binder indicated to reduce serum phosphate in patients with end-stage renal disease (ESRD).
Lanthanum Carbonate is a phosphate binder that reduces absorption of phosphate by forming insoluble Lanthanum phosphate complexes that pass through the Gl tract unabsorbed. Both serum phosphate and calcium phosphate product are reduced as a consequence of the reduced dietary phosphate absorption. In vitro studies have shown that Lanthanum binds phosphate in the physiologically relevant pH range of 3 to 7. In simulated gastric fluid, Lanthanum binds approximately 97% of the available phosphate at pH 3-5 and 67% at pH 7, when Lanthanum is present in a two-fold molar excess to phosphate. Bile acids have not been shown to affect the phosphate binding affinity of Lanthanum. In order to bind dietary phosphate, Lanthanum Carbonate must be administered with or immediately after meals.
The recommended initial total daily dose of Lanthanum Carbonate is 1,500 mg in divided doses. Titrate every 2 to 3 weeks based on serum phosphate level. Take Lanthanum Carbonate with or immediately after meals. Lanthanum Carbonate Chewable Tablets: Do not swallow tablets whole. Chew or crush tablet completely before swallowing.
The most common adverse reactions for Lanfos were gastrointestinal events, such as nausea, vomiting, and abdominal pain and they generally abated over time with continued dosing. The following adverse reactions have been identified during post-approval use of Lanfos constipation, dyspepsia, allergic skin reactions, and tooth injury while chewing the tablet.
Always consult a registered doctor before taking any medicine. This information is for general knowledge only.
Contraindicated in bowel obstruction, including ileus and fecal impaction.
Drugs Binding to Antacids : There is a potential for Lanfos to interact with compounds which bind to cationic antacids (i.e., aluminum-,magnesium-, or calcium-based); therefore, do not administer such compounds within 2 hours of dosing with Lanfos. Quinolone Antibiotic s: Co-administration of Lanfos with quinolone antibiotics may reduce the extent of their absorption. The bioavailability of oral ciprofloxacin was decreased by approximately 50% when taken with Lanfos in a single-dose study in healthy volunteers. Administer oral quinolone antibiotics at least 1 hour before or 4 hours after Lanfos. When oral quinolones are given for short courses, consider eliminating the doses of Lanfos that would normally be scheduled near the time of quinolone intake to improve quinolone absorption. Levothyroxine : the bioavailability of levothyroxine was decreased by approximately 40% when taken together with Lanfos. Administer thyroid hormone replacement therapy at least 2 hours before or 2 hours after dosing with Lanfos and monitor thyroid stimulating hormone (TSH).
Gastrointestinal Adverse Effects: Serious cases of gastrointestinal obstruction, ileus, subileus, gastrointestinal perforation, and fecal impaction have been reported in patients taking Lanfos, some requiring surgery or hospitalization. During treatment with Lanfos, physicians and patients should remain vigilant for signs and symptoms of gastrointestinal disorders, especially constipation and abdominal pain/distention, which may indicate bowel obstruction, ileus, or subileus. Treatment with Lanfos should be re-evaluated in patients who develop severe constipation or other severe gastrointestinal signs and symptoms. Advise patients who are prescribed Lanfos Chewable Tablets to chew the tablet completely and not to swallow them whole. Serious gastrointestinal complications have been reported in association with unchewed or incompletely chewed tablets.