碳酸鑭
碳酸鑭是一種口服磷結合劑，主要用於控制末期腎病 (ESRD) 患畜的高血磷症。 雖然限制飲食中的磷是控制慢性腎病 (CKD) 的基礎，但當單靠飲食無法控制或患畜拒絕食用處方飼料時，就需要使用磷結合劑。 > **臨床要點：** 與鈣基結合劑（可能引起高血鈣）或鋁基結合劑（長期使用有鋁中毒風險）不同，鑭不含鈣與鋁，是獸醫臨床上長期控制高血磷的理想選擇。
作用機制: 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.
各物種劑量
- Phosphate binder · 200 mg (total dose) PO (on/in food) 2-3 times daily. · PO · 2-3 times daily · Anecdotally appears safe and effective.
- 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
- Chronic kidney disease (Hyperphosphataemia) · 400-800 mg/cat/day · PO · divided according to feeding schedule (give some with every meal) · Chronic · Recommended starting dose is 400 mg per day. It is important to give some with every meal.
- Chronic kidney disease (Hyperphosphataemia) · 100 mg/kg/day · PO · divided between meals · Chronic · Dose adjustments should be based on serum phosphate levels monitored at 4-6 week intervals.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- 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)
不良反應
- Vomiting
- Nausea
- Inappetence
- None known according to the monograph
- Gastrointestinal upset (nausea, vomiting, diarrhea, or constipation) may occur (Clinical Pearl)
藥物相互作用
- Allopurinol · Potential decreased absorption; separate dosing by 2 hours
- Chloroquine · Potential decreased absorption; separate dosing by 2 hours
- Corticosteroids · Potential decreased absorption; separate dosing by 2 hours
- Digoxin · Potential decreased absorption; separate dosing by 2 hours
- Ethambutol · Potential decreased absorption; separate dosing by 2 hours
- Fluoroquinolones · Potential decreased absorption; separate dosing by 2 hours
- H-2 Antagonists (ranitidine, famotidine) · Potential decreased absorption; separate dosing by 2 hours
- Iron Salts · Potential decreased absorption; separate dosing by 2 hours
- Isoniazid · Potential decreased absorption; separate dosing by 2 hours
- Penicillamine · Potential decreased absorption; separate dosing by 2 hours
- Phenothiazines · Potential decreased absorption; separate dosing by 2 hours
- Tetracyclines · Potential decreased absorption; separate dosing by 2 hours
- Thyroid Hormones · Potential decreased absorption; separate dosing by 2 hours
監測
- Serum phosphorous
- Serum potassium
- Serum calcium
- 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
過量
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.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。