Lanthanum Viatris

What Is Lanthanum Viatris and What Is It Used For?

When the kidneys function normally, they efficiently regulate the body's phosphate balance by excreting excess phosphate through urine. However, in patients with chronic kidney disease – particularly those in advanced stages (CKD stages 3b–5) or on dialysis – the kidneys progressively lose this ability. As a result, phosphate accumulates in the blood, a condition known as hyperphosphatemia. This is a serious and common complication affecting approximately 70–80% of patients on dialysis worldwide, according to data from the Kidney Disease: Improving Global Outcomes (KDIGO) working group.

Uncontrolled hyperphosphatemia has profound consequences for health. Elevated phosphate levels stimulate the parathyroid glands to produce excess parathyroid hormone (PTH), leading to secondary hyperparathyroidism. This cascade triggers the release of calcium from bones, weakening the skeletal system and increasing the risk of fractures. Furthermore, excess phosphate combines with calcium in the bloodstream, forming deposits in blood vessels, heart valves, and soft tissues – a process known as vascular calcification. Multiple large-scale studies, including the landmark Dialysis Outcomes and Practice Patterns Study (DOPPS), have demonstrated that hyperphosphatemia is independently associated with increased cardiovascular mortality and all-cause death in CKD patients.

Lanthanum Viatris contains the active substance lanthanum in the form of lanthanum carbonate octahydrate. Lanthanum is a rare earth element with a particularly high affinity for phosphate ions. When the chewable tablet is taken with food and chewed thoroughly, lanthanum dissociates in the acidic environment of the stomach and upper intestine. The released lanthanum ions then bind to dietary phosphate, forming insoluble lanthanum phosphate complexes. These complexes cannot be absorbed through the intestinal wall and are instead excreted in the feces. This mechanism effectively reduces the amount of phosphate entering the bloodstream from the diet.

One of the key pharmacological advantages of lanthanum carbonate is its extremely low systemic absorption. Less than 0.002% of the administered dose is absorbed into the body, which minimizes the risk of systemic side effects and long-term tissue accumulation compared to some older phosphate binders. Lanthanum is not metabolized by the cytochrome P450 enzyme system, and it maintains effective phosphate-binding activity across a wide pH range (pH 1–7), making it functional throughout the entire gastrointestinal tract.

The KDIGO 2024 guidelines for CKD-Mineral and Bone Disorder (CKD-MBD) recommend maintaining serum phosphate levels toward the normal range in dialysis patients. Phosphate binders, including lanthanum carbonate, are a cornerstone of this management strategy, used alongside dietary phosphate restriction and adequate dialysis. Lanthanum Viatris is manufactured by Viatris (formerly Mylan) and is available as a generic alternative to the original lanthanum carbonate product.

What Should You Know Before Taking Lanthanum Viatris?

Contraindications

Lanthanum Viatris must not be taken in the following situations:

• Allergy to lanthanum or excipients: If you are allergic to lanthanum or any of the other ingredients in this medicine (listed in the composition section), you must not use this product. Allergic reactions may manifest as skin rash, itching, swelling, or difficulty breathing.
• Hypophosphatemia: If your blood phosphate levels are already too low, taking a phosphate binder would further deplete this essential mineral, potentially leading to muscle weakness, bone pain, respiratory failure, and cardiac complications.
• Bowel obstruction (intestinal obstruction): Patients with a known blockage in the intestines must not take Lanthanum Viatris, as the medication could worsen the obstruction and lead to life-threatening complications including bowel perforation and peritonitis.

Warnings and Precautions

Talk to your doctor or pharmacist before taking Lanthanum Viatris if you have or have had any of the following conditions:

• Cancer of the stomach or intestines: Gastrointestinal malignancies may alter the integrity of the intestinal wall, increasing the risk of complications from undissolved tablet residue.
• Inflammatory bowel disease: Conditions such as ulcerative colitis or Crohn's disease may increase susceptibility to gastrointestinal adverse effects and should be carefully evaluated before starting treatment.
• Previous abdominal surgery or peritonitis: Prior surgical procedures or infections involving the abdominal cavity may create adhesions or structural changes that increase the risk of bowel obstruction.
• Peptic ulcers: Active stomach or intestinal ulcers may be aggravated by the mechanical action of chewing the tablets and the local effects of the medication.
• Reduced bowel motility: Conditions causing constipation or slow intestinal transit, including diabetes-related gastroparesis, may increase the risk of tablet accumulation and subsequent obstruction.

Kidney and Liver Function

If you have impaired kidney function (which is likely, given the indication for this medication), your doctor may monitor your blood calcium levels periodically. Lanthanum can potentially lower calcium absorption, and if hypocalcemia develops, calcium supplementation may be necessary. Regular monitoring of parathyroid hormone (PTH) levels is also standard practice in CKD patients taking phosphate binders.

For patients with impaired liver function, your doctor should closely monitor liver function values. Although lanthanum has very low systemic absorption and is not metabolized by liver enzymes, regular liver function tests may be recommended as a precautionary measure, particularly during long-term use.

Medical Imaging Considerations

If you need to undergo X-ray imaging, inform your healthcare provider that you are taking Lanthanum Viatris. Lanthanum is a radiopaque substance, meaning it can appear on X-ray images and may be mistaken for other findings, potentially complicating diagnostic interpretation. Similarly, if you are scheduled for a gastrointestinal endoscopy, inform the examining physician, as lanthanum residues may be visible in the digestive tract and could be confused with other pathological findings.

Pregnancy and Breastfeeding

Lanthanum Viatris should not be used during pregnancy. There is insufficient data from clinical studies to establish the safety of lanthanum carbonate in pregnant women. Animal reproduction studies are not always predictive of human response, and the potential risks to the developing fetus have not been adequately characterized. Women of childbearing potential should use effective contraception during treatment.

Breastfeeding is not recommended during treatment with Lanthanum Viatris. It is not known whether lanthanum is excreted in human breast milk. Given the uncertainty about potential effects on the nursing infant, a decision should be made whether to discontinue breastfeeding or to discontinue the medication, taking into account the importance of the treatment for the mother. Consult your healthcare provider before making any changes to your medication or feeding plan.

Driving and Operating Machinery

Dizziness and vertigo are uncommon side effects reported by patients taking lanthanum carbonate. If you experience these symptoms, your ability to drive vehicles or operate machinery may be impaired. You are responsible for assessing whether you are fit to perform activities requiring alertness and coordination. Read all the information in this guide for additional context about potential side effects that could affect these abilities.

How Does Lanthanum Viatris Interact with Other Drugs?

Lanthanum carbonate can form complexes with certain co-administered medications in the gastrointestinal tract, reducing their bioavailability and potentially diminishing their therapeutic effect. Understanding these interactions and adhering to recommended dosing intervals is critical for maintaining the efficacy of all your medications. Always inform your doctor or pharmacist about all medications you are taking, have recently taken, or plan to take.

The mechanism behind these interactions relates to lanthanum's ability to bind not only phosphate but also other negatively charged molecules and certain drug formulations. Unlike calcium-based phosphate binders, lanthanum does not significantly affect the absorption of most common medications. However, several clinically important interactions have been identified through pharmacokinetic studies and post-marketing surveillance.

Major Interactions

Additional Considerations

Importantly, lanthanum carbonate is not metabolized by the cytochrome P450 enzyme system. This means it does not induce or inhibit the liver enzymes responsible for metabolizing most drugs, reducing the potential for metabolic drug interactions. Similarly, lanthanum does not affect the absorption of commonly prescribed CKD medications such as warfarin, digoxin, or most antihypertensive agents in clinically significant ways, based on dedicated interaction studies.

Nevertheless, as a general precaution, any oral medication should ideally be taken with a time separation from lanthanum carbonate to minimize any theoretical risk of binding interaction. This is particularly important for medications with a narrow therapeutic index, where even small changes in absorption could have significant clinical consequences. Your nephrologist and pharmacist can help coordinate the optimal dosing schedule for all your medications.

What Is the Correct Dosage of Lanthanum Viatris?

Always take Lanthanum Viatris exactly as your doctor or pharmacist has instructed. The dosage is individualized based on your dietary phosphate intake and your serum phosphate levels, which are regularly monitored through blood tests. Do not adjust your dose without consulting your healthcare provider.

Adults

Children and Adolescents

Elderly Patients

Dietary Changes

Because Lanthanum Viatris works by binding phosphate in food, changes to your diet can affect how much medication you need. If you significantly change what you eat – for example, switching to a diet with more or fewer dairy products, meats, or processed foods (which are high in phosphate) – contact your doctor. Your dose may need adjustment to match your new dietary phosphate intake. Regular dietary counseling from a renal dietitian is recommended alongside phosphate binder therapy.

Missed Dose

It is important to take Lanthanum Viatris with every meal for optimal phosphate control. If you forget to take your tablets with a meal, take them with your next meal at the usual dose. Do not take a double dose to make up for a missed one. Missing occasional doses may temporarily increase your phosphate levels, but this is unlikely to cause immediate harm. However, consistently missing doses will reduce the effectiveness of your treatment and may lead to elevated phosphate levels over time.

Overdose

If you take more Lanthanum Viatris than prescribed, or if a child accidentally ingests the medication, contact your healthcare provider or poison control center for assessment and advice. Symptoms of overdose may include nausea and headache. Given the very low systemic absorption of lanthanum, significant systemic toxicity from overdose is unlikely. However, large doses may cause increased gastrointestinal side effects. There is no specific antidote for lanthanum overdose; treatment is supportive and symptomatic.

What Are the Side Effects of Lanthanum Viatris?

Like all medicines, Lanthanum Viatris can cause side effects, although not everybody gets them. The gastrointestinal side effects are the most frequently reported and are related to the medication's mechanism of action in the digestive tract. Many patients find that these symptoms are most pronounced during the first few weeks of treatment and tend to diminish as the body adjusts to the medication.

Not known (frequency cannot be estimated from available data): Presence of medication residue in the digestive tract, which may be visible during endoscopy.

Managing Side Effects

Most gastrointestinal side effects are transient and tend to improve within the first few weeks of treatment. The following strategies may help manage common side effects:

• Nausea and vomiting: Ensure you always take lanthanum with or immediately after food, never on an empty stomach. Taking the medication before meals significantly increases the risk of these symptoms.
• Constipation: Maintain adequate fluid intake (as permitted by your fluid restriction plan), consume fiber-rich foods within your dietary guidelines, and discuss stool softeners with your doctor if needed. Report new or worsening constipation promptly.
• Hypocalcemia: Your doctor will monitor calcium levels and may prescribe calcium supplements if your levels fall below normal.

How Should You Store Lanthanum Viatris?

Proper storage of Lanthanum Viatris ensures the medication remains effective and safe throughout its shelf life. Follow these storage guidelines carefully:

• Temperature: No special temperature storage conditions are required. Store at room temperature and avoid extreme heat or cold.
• Light protection: Keep the tablets in the original container. The medication is light-sensitive, meaning prolonged exposure to light may degrade the active ingredient.
• Children: Store this medicine out of the sight and reach of children. Accidental ingestion by children should be treated as a potential overdose situation.
• Expiry date: Do not use Lanthanum Viatris after the expiry date stated on the carton and container after "EXP." The expiry date refers to the last day of the stated month.
• Disposal: Do not dispose of medications via wastewater or household waste. Return unused or expired medicines to your pharmacy for proper disposal. These measures help protect the environment.

What Does Lanthanum Viatris Contain?

Active Ingredient

The active substance is lanthanum (as lanthanum carbonate octahydrate). Each chewable tablet contains lanthanum carbonate octahydrate equivalent to:

• 500 mg lanthanum (in the 500 mg strength)
• 750 mg lanthanum (in the 750 mg strength)
• 1000 mg lanthanum (in the 1000 mg strength)

Inactive Ingredients (Excipients)

The other ingredients are: hypromellose, microcrystalline cellulose and guar gum, microcrystalline cellulose, hydroxypropylcellulose, colloidal anhydrous silica, acesulfame potassium (sweetener), and magnesium stearate. These excipients serve various functions including binding, stabilizing, and improving the taste and texture of the chewable tablet.

Tablet Appearance and Packaging

Not all pack sizes may be marketed in every country. Lanthanum Viatris is manufactured by Mylan Hungary Kft (Komarom, Hungary) and Mylan Germany GmbH (Bad Homburg, Germany). The marketing authorization holder is Viatris Limited, Dublin, Ireland.

References

This article is based on the following peer-reviewed sources, international guidelines, and regulatory documents:

1. KDIGO 2024 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD). Kidney International Supplements. 2024.
2. European Medicines Agency (EMA). Summary of Product Characteristics – Lanthanum carbonate. EMA/CHMP Assessment Report.
3. Hutchison AJ, et al. Long-term efficacy and tolerability of lanthanum carbonate: results from a 3-year study. Nephron Clinical Practice. 2008;110(1):c15–c23.
4. Malluche HH, et al. Lanthanum carbonate for the treatment of hyperphosphatemia: results of a comparative, dose-ranging study. Nephrology Dialysis Transplantation. 2008;23(10):3277–3284.
5. Block GA, et al. Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney International. 2007;71(5):438–441.
6. Toussaint ND, et al. A randomized trial on the effect of phosphate reduction on vascular end points in CKD (IMPROVE-CKD). Journal of the American Society of Nephrology. 2020;31(11):2627–2636.
7. National Institute for Health and Care Excellence (NICE). Chronic kidney disease: assessment and management. NICE guideline [NG203]. Updated 2024.
8. ERA-EDTA (European Renal Association – European Dialysis and Transplant Association). Clinical Practice Guidelines for Diagnosis and Treatment of CKD-MBD. Nephrology Dialysis Transplantation. 2023.
9. World Health Organization (WHO). ATC/DDD Index. Lanthanum carbonate classification.
10. Daugirdas JT, et al. Handbook of Dialysis. 5th edition. Wolters Kluwer. 2015.

Editorial Team

Last medical review: January 27, 2026 | Next scheduled review: July 2026