Phosphate-binding efficacy of crushed vs. chewed lanthanum carbonate in hemodialysis patients.
Lanthanum carbonate, a chewable noncalcium-containing phosphorus (P) binder, is useful for treating secondary hyperparathyroidism in patients who have hypercalcemia and cannot swallow whole tablets. However, some patients cannot chew tablets or prefer to crush and mix them with food. This study was conducted to determine the P-binding efficacy of crushed lanthanum and compare it with chewed lanthanum in hemodialysis (HD) patients. After a 1-week washout period, 11 hemodialysis patients (7 men, 4 women) were randomized to receive, in a crossover fashion, lanthanum 1000 mg 3 times daily chewed with meals and lanthanum 1000 mg 3 times daily crushed into a fine powder, mixed with applesauce and taken with meals, for 4 weeks each. Serum P was measured at the end of each washout (baseline) and weekly during treatment. Changes in serum P from baseline for crushed lanthanum were compared with chewed lanthanum using paired sample t test. Administration of crushed lanthanum resulted in a significant reduction in serum P from baseline (P reduction [mg/dL] for crushed lanthanum in week 1: 2.1 ± 0.4, week 2: 1.7 ± 0.5, week 3: 1.7 ± 0.5, week 4: 1.7 ± 0.4, P<0.05). No statistically significant differences were observed in serum P reduction from baseline and serum P attained during treatment with crushed when compared with chewed lanthanum. Crushed lanthanum is effective in reducing serum P and have similar P-binding efficacy to chewed lanthanum. Crushing lanthanum and mixing it with food can thus be an option for patients who are unable to chew or swallow whole tablets.
Departments of Pharmacy PracticeMedicine, Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois, USA.
Priscilla P
PP
How
Departments of Pharmacy PracticeMedicine, Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois, USA.
Prathana
P
Anattiwong
Departments of Pharmacy PracticeMedicine, Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois, USA.
Darius L
DL
Mason
Departments of Pharmacy PracticeMedicine, Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois, USA.
Jose A
JA
Arruda
Departments of Pharmacy PracticeMedicine, Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois, USA.
Alan H
AH
Lau
D000284:Administration, Oral; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D007811:Lanthanum / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis / Q000379:methods*; D013607:Tablets / Q000032:analysis*
D010710:Phosphates; D013607:Tablets; D010758:Phosphorus; C119467:lanthanum carbonate; D007811:Lanthanum