Additional Reduction in Serum Phosphorus Levels by Pulverized Lanthanum Carbonate Chewable in Hemodialysis Patients

Lanthanum carbonate (LC) is one of the relatively new phosphate binders. The general LC dosage form is a chewable pharmaceutical preparation. This investigation was targeted to subjects who do not chew LC chewable preparations adequately, for the purpose of studying the clinical efficacy of changing to pulverized prescriptions, such as changes in serum phosphorus levels (P levels). The study took place at Minamisenju Hospital in October 2011, with 41 subjects on maintenance hemodialysis. We pulverized all of the LC chewable medicines of the LC insufficient mastication group (non-chewing: NC group, n=18) using a crusher, and changed them to pulverized prescriptions. The testing period was set at 10 weeks. In the NC group, there was a significant lowering of P levels from 5.86 +/- 1.31mg/dL before pulverization of the LC chewable preparation (week 0) to 5.38 +/- 1.26mg/dL after 2 weeks of administration of the pulverized medication (P=0.0310), 5.20 +/- 1.25mg/dL after 4 weeks (P=0.0077), and 5.12 +/- 1.34mg/dL after 6 weeks (P=0.0167). P levels in other patients than NC group showed no significant change. In this study, the P levels in the NC group was lowered significantly by changing the LC chewable to the pulverized prescription, and the residual LC images on the abdominal X-rays disappeared to the point where they could barely be confirmed.