炭酸ランタン
Lanthanum Carbonate
Lanthanum carbonate (octa-hydrate)
別名: Fosrenol · Lantharenol · Renalzin · Bay-78-1887 · Lanthanum
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Chronic kidney disease (Hyperphosphataemia) | 100 mg/kg/day | PO | divided between meals | Chronic | 🌍 EU |
- Chronic kidney disease (Hyperphosphataemia): Dose adjustments should be based on serum phosphate levels monitored at 4-6 week intervals.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Phosphate binder | 200 mg (total dose) PO (on/in food) 2-3 times daily. | PO | 2-3 times daily | — | 🌎 NA |
| Phosphate binder (using Renalzin) | 2 mLs (400 mg) applied in the cat's food, once or twice daily depending on the cat's feeding regimen. | PO | once or twice daily | — | 🌎 NA |
| Chronic kidney disease (Hyperphosphataemia) | 400-800 mg/cat/day | PO | divided according to feeding schedule (give some with every meal) | Chronic | 🌍 EU |
- Phosphate binder: Anecdotally appears safe and effective.
- Chronic kidney disease (Hyperphosphataemia): Recommended starting dose is 400 mg per day. It is important to give some with every meal.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
炭酸ランタンは、主に末期腎疾患（ESRD）患者の高リン血症を管理するために使用される経口リン吸着剤です。
食事によるリン制限は慢性腎臓病（CKD）管理の基本ですが、食事療法だけでは不十分な場合や患者が療法食を拒否する場合にリン吸着剤が適応となります。
臨床のポイント： カルシウムベースの吸着剤（高カルシウム血症を引き起こす可能性がある）やアルミニウムベースの吸着剤（長期使用でアルミニウム中毒のリスクがある）とは異なり、ランタンはカルシウムもアルミニウムも含んでいないため、獣医療における高リン血症の長期管理において魅力的な選択肢となります。
作用機序
Lanthanum carbonate acts locally in the gastrointestinal tract.
- It dissociates in the acidic environment of the upper GI tract (stomach) to release lanthanum ions (La³⁺).
- These ions bind to dietary phosphate → forming highly insoluble lanthanum phosphate complexes.
- These complexes cannot cross the intestinal mucosa and are subsequently eliminated in the feces, thereby reducing net intestinal absorption of phosphorus.
安全性・警告
禁忌
- Patients with non-intact GI tract (e.g., GI ulcers, colitis) - use with caution due to increased risk of systemic absorption
- Acute renal crisis (patients should be stabilized first)
有害事象
- Inappetence
- None known according to the monograph
- Gastrointestinal upset (nausea, vomiting, diarrhea, or constipation) may occur (Clinical Pearl)
注意事項
There are no listed absolute contraindications, but it should be used with caution in patients where the GI tract is not intact (e.g., GI ulcers, colitis) as there is an increased chance for oral absorption. Safe for use during pregnancy and nursing.
医薬品相互作用
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Potential decreased absorption; separate dosing by 2 hours
Lanthanum may bind to other drugs in the GI tract, reducing their absorption. Should be given at least 1 hour before or 3 hours after other medications.
監視
- Serum phosphorous
- Serum potassium
- Serum bicarbonate
- Serum chloride
- Serum phosphate levels (at 4-6 week intervals to adjust dosage and achieve target concentrations)
- Renal parameters (BUN, Creatinine, SDMA)
- Serum calcium levels
薬物動態
半減期
吸収
Following oral doses, lanthanum bioavailability is very low (less than 0.002%).
分布
Systemically available lanthanum is very highly bound to plasma proteins (>99%). Tissue levels increase over time and can be several orders of magnitude higher than plasma levels. Highest levels found in GI tract, bone, and liver.
代謝
Not metabolized. It is an inorganic salt.
消失
Absorbed lanthanum is cleared primarily via biliary excretion into the feces. In dogs, mean recovery of an oral dose averages 94%.
過剰投与
No specific information located, but acute overdose is likely tolerated with potential for GI effects. Only supportive treatment should be required. In cats, oral dosages up to 1 gram/kg were tolerated, but repeated vomiting occurred at 2 grams/kg.
製品
製剤
- Chewable tablets
- Pump gel/paste
- 500 mg chewable tablet
- 750 mg chewable tablet
- 1 g chewable tablet
動物用医薬品
- Renalzin (lanthanum carbonate, kaolin, vitamin E) pump gel/paste (200 mg/mL) - Available in some countries outside USA/Canada
- Lantharenol (General sale / Feed additive - availability varies)
ヒト用医薬品
- Fosrenol Oral Chewable Tablet 500 mg, 750 mg, & 1,000 mg
- Fosrenol 500 mg chewable tablets
- Fosrenol 750 mg chewable tablets
- Fosrenol 1 g chewable tablets
規制ステータス
Fosrenol is POM; Lantharenol has been marketed as a general sale feed additive.
Fosrenol is POM; Lantharenol has been marketed as a general sale feed additive.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store tablets at room temperature (25°C, 77°F); excursions are permitted to 15°-30°C (59°-86°F). Protect from moisture.
飼主向け情報
- 投与方法： 動物に錠剤を丸飲みさせないでください。錠剤を砕いて、動物の食事にしっかりと混ぜてください。
- タイミング： 食事中のリンと結合させるため、必ず食事と一緒に与えることが重要です。
- 市販の動物用製品： 特定の動物用ゲル/ペーストを使用する場合は、ラベルに記載されている正確な投与指示に従ってください。
- 副作用： 嘔吐や食欲不振がないか観察し、これらの症状が現れた場合は獣医師に連絡してください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。