Lanthanum Mylan (Lanthanum)

Lanthanum Mylan is a phosphate binder used to manage disorders of phosphate metabolism in chronic kidney disease.

• Hyperphosphatemia in CKD patients on dialysis: lowers serum phosphate to target ranges.
• Hyperphosphatemia in CKD patients not yet on dialysis: assists in maintaining phosphate balance.
• Patients awaiting kidney transplantation: helps control phosphate while awaiting graft.
• Secondary hyperparathyroidism associated with CKD: contributes to reduced parathyroid hormone stimulation by lowering phosphate.

• Lanthanum binds dietary phosphate in the gastrointestinal tract, forming insoluble lanthanum‑phosphate complexes that are not absorbed. This reduces the amount of phosphate available for intestinal uptake, thereby decreasing serum phosphate concentrations in patients with impaired renal excretion.

Lanthanum may cause gastrointestinal and systemic reactions.

Common Side Effects

• Nausea: mild to moderate discomfort in the stomach.
• Constipation: reduced bowel movements, sometimes requiring laxatives.
• Abdominal pain: cramping or discomfort in the abdomen.
• Diarrhea: loose stools, usually transient.
• Vomiting: occasional expulsion of stomach contents.
• Metallic taste: a lingering metallic sensation in the mouth.

Serious or Rare Side Effects

• Severe constipation or bowel obstruction: may require medical evaluation.
• Allergic reactions: rash, itching, or swelling of the face and throat.
• Liver enzyme elevation: abnormal liver function tests.
• Hypercalcemia: elevated calcium levels when combined with calcium‑based binders.
• Gastrointestinal bleeding: rare but serious bleeding events.

Patients should be monitored for safety and optimal therapeutic effect.

• Serum phosphate monitoring: check levels regularly to adjust therapy.
• Calcium level assessment: avoid hypercalcemia when used with calcium‑based binders.
• Gastrointestinal evaluation: watch for signs of obstruction or severe constipation.
• Hepatic function review: monitor liver enzymes in patients with liver disease.
• Dose adjustment in renal impairment: consider reduced absorption in severe kidney failure.
• Store at ambient temperature: keep in the original container, protect from moisture and heat.

Lanthanum can affect the absorption of several concomitant medications. Major Interactions (Avoid):\n- Other phosphate binders: concurrent use may diminish binding efficiency.

• Aluminum or magnesium antacids: can bind with lanthanum, reducing its effectiveness.
• Iron supplements: may interfere with lanthanum binding capacity.

Moderate Interactions (Monitor Closely)

• Calcium carbonate: may increase calcium load; monitor serum calcium.
• Vitamin D analogues: combined effect on mineral metabolism requires observation.
• Certain antibiotics (e.g., quinolones, tetracyclines): may have reduced absorption; separate dosing times.