Usage and dosage of lanthanum carbonate_industrial additives

Usage and dosage of lanthanum carbonate: Lanthanum carbonateUsage and dosage:

This product is for oral use and must be chewed before swallowing. Do not swallow the whole tablet. Tablets may be crushed to make chewing easier. This product should be taken with food or immediately after a meal, and the dose taken is the daily dose divided by the number of meals. Patients should follow recommended diets to control phosphorus and fluid intake. This product is a chewable tablet to avoid excessive liquid intake. Serum phosphorus should be monitored when using this product, and the dosage should be gradually adjusted every 2 to 3 weeks until the serum phosphorus reaches an acceptable level. Serum phosphorus needs to be monitored regularly thereafter.

Usage and dosage of lanthanum carbonate [Background and Overview]

Hyperphosphatemia is a risk factor for cardiovascular disease, renal osteodystrophy and other diseases. Therefore, controlling blood phosphate is very important for patient prognosis. Restricting dietary phosphorus intake can lower serum phosphorus, but due to its operational difficulty, phosphorus binders are necessary. An ideal phosphorus binder should have the characteristics of low absorption and few side effects.
Studies have shown that hyperphosphatemia increases the morbidity, mortality and hospitalization rates of patients with chronic kidney disease (CKD), and is an independent risk factor for reduced quality of life and increased treatment costs. Hyperphosphatemia can also lead to serious complications and is associated with cardiovascular morbidity and all-cause mortality. At present, the main methods to treat hyperphosphatemia include controlling dietary phosphorus intake, hemodialysis, and oral phosphate binders. However, the first two and traditional phosphate binders have limited therapeutic effects or have obvious adverse reactions.

Lanthanum carbonate As a new phosphorus-lowering drug, it has been used abroad for many years. FOSRENOL of the United States discovered that the combination of rare earth metal lanthanum ions and phosphorus ions produces insoluble precipitates, which are excreted through the digestive tract and do not enter the blood circulation system. A large number of sick subjects did not produce adverse side effects, and the efficacy was significantly better than using calcium carbonate, calcium acetate, and aluminum carbonate. Since its invention, lanthanum carbonate chewable tablets, especially in recent years, have been promoted in 42 countries around the world, and 90% of hyperphosphatemia patients in the United States have recovered. This drug entered China in 2012 and has now become the only recommended drug in the country for the treatment of hyperphosphatemia. Hundreds of thousands of patients are using it and enjoying the results of high technology. As we all know, China is a country rich in rare earth resources and has abundant rare earth lanthanum resources. China has a large population, and the number of patients suffering from chronic kidney disease reaches 10.2%, and there are almost 120 million kidney disease patients. At present, the number of people suffering from uremia in our country has exceeded 3 million, and the number of patients is increasing by 11% every year. About 80% of kidney disease patients die from improper treatment. The number of people who can receive high-tech treatment is limited and not popular. The most important thing is The reason is based on two points. One is that the price of Fossilinol lanthanum carbonate chewable tablets in the United States is very expensive and is not covered by medical insurance. Most patients cannot bear the pressure of huge dialysis fees, and even more difficult to accept the high price of lanthanum carbonate, so they give up treatment; the second is scientific Publicity is not yet widespread. Not only patients with renal failure are afraid of myocardial infarction and cardiovascular and cerebrovascular necrosis caused by hyperphosphatemia; hyperphosphatemia is also harmful to cardiovascular and cerebrovascular patients, diabetics, and hypertensive patients, and can also cause myocardial infarction. Phosphorus education urgently needs to be strengthened. In the U.S. Medical Prescription Insurance Plan (Medicare Part D) in 2008, the annual prescription cost of lanthanum carbonate was US$48.82 million, ranking fifth among the medications used by dialysis patients. However, it has been used in my country for a short time and has relatively insufficient experience.

Usage and dosage of lanthanum carbonate [Physical and chemical properties]

The chemical formula of lanthanum carbonate is La₂(CO₃)₃·8H₂O. Molecular weight 601.97. White crystal. Relative density 2.6~2.7. Insoluble in water and acetone, soluble in dilute acid, slightly soluble in CO₂ aqueous solution. Soluble in alkali metal carbonates, it can crystallize after dilution to form complexes such as K[La(CO₃)₂]·6H₂O Salt. CO₂ is released when heated. When heated, alkaline carbonates are first generated, and then burned to generate oxides. Lanthanum carbonate has high phosphorus binding capacity and can exert a good phosphorus-lowering effect in the entire digestive tract. It has less adverse reactions, is cost-effective and has good clinical compliance. It is an ideal phosphorus binding agent so far.

Usage and dosage of lanthanum carbonate [Indications]

Hyperphosphatemia. This product is a phosphate binder, used for the treatment of hyperphosphatemia in patients with chronic renal failure undergoing hemodialysis or continuous ambulatory peritoneal dialysis (CAPD)

[Specifications]

Tablets: 500mg, 750mg, 1000mg

Usage and dosage of lanthanum carbonate [taboo]

1. Those who are allergic to lanthanum carbonate or any excipients in this product.

2. Hypophosphatemia.

3. Intestinal obstruction, intestinal obstruction and fecal impaction.

Usage and dosage of lanthanum carbonate [Precautions]

1. Patients who are prone to gastrointestinal obstruction, intestinal obstruction, incomplete intestinal obstruction and gastrointestinal perforation should use it with caution.

2. Patients with acute peptic ulcer, ulcerative colitis, Crohn’s disease or intestinal obstruction need to carefully evaluate the benefits and risks.

3. Patients prone to intestinal obstruction (such as previous abdominal surgery, peritonitis) should use it with caution.

4. Patients are advised to chew the tablets thoroughly to reduce the risk of the above-mentioned serious gastrointestinal adverse events.

5. Chew or crush the tablets thoroughly before swallowing. Do not swallow the tablets whole.

6. In patients with dental dysfunction,Consider crushing the tablet completely.

7. Patients with renal insufficiency may develop hypocalcemia, and blood calcium levels need to be monitored regularly and supplemented appropriately during use.

Usage and dosage of lanthanum carbonate [Preparation]

Method 1: A production method of high-purity lanthanum carbonate, the steps are as follows:

1) Add lanthanum carbonate to water to form a mixed solution;

2) Add concentrated nitric acid to the mixed solution obtained in step 1) to dissolve, and adjust the pH to 1.5-2 with ammonia. After heating, adjust the pH to 4-4.5 with cerium carbonate to obtain an acid solution;

3) Filter the acid solution obtained in step 2) to obtain the filtrate calcium carbonate;

4) Concentrate the filtrate in step 3). The concentration of the end-point solution is 720-750 g/L based on cerium oxide, and the pH value is 1-1.5;

5) Put the concentrated solution obtained in step 4) into a crystallization tray for natural crystallization, and centrifuge for dehydration;

6) Dissolve and dilute the centrifuged crystals in step 5) with water so that the lanthanum concentration is 70g/L as an oxide;

7) Heat the solution obtained in step 6) to 50°C, add ammonium bicarbonate solution first slowly and then quickly to precipitate, and let it stand after the precipitation is completed;

8) Wash the precipitate processed in step 7) with water, then centrifuge, dehydrate and package.

Method 2: A process for preparing lanthanum carbonate by reacting supercritical carbon dioxide and lanthanum oxide. This method is simple to operate, has no by-products, is low in cost, has high product purity, and does not cause harm to the environment. The technical solution is: put lanthanum oxide (La₂O₃) rare earth raw material with a mass fraction of 50%-99.999% and passed through a 10-200 mesh sieve into supercritical carbon dioxide For the extraction kettle of the extraction instrument, the temperature of the extraction kettle is controlled to be 32°C-100°C and the pressure is 7.5MPa-50Mpa during the reaction process. The carbon dioxide used must have a mass fraction of 99.5% or more and be forced to circulate during the reaction process. After 1-24 hours of reaction, , that is, lanthanum carbonate is prepared in the extraction kettle. The mass fraction of lanthanum carbonate obtained by the present invention is between 40% and 99%. The characteristic of this invention is that the extraction kettle of a supercritical carbon dioxide extraction device is used as a reaction kettle, and carbon dioxide in a supercritical state (critical temperature of carbon dioxide is about 31.4°C, critical pressure is about 7.39Mpa) reacts with lanthanum oxide to generate lanthanum carbonate in one step , the chemical reaction equation is as follows:

Usage and dosage of lanthanum carbonate [Main reference materials]

[1] Meng Xiaoqin, Huang Zhiyong. Application of lanthanum carbonate in hyperphosphatemia in chronic renal failure [J]. Chinese Journal of Practical Medicine, 2016 (12): 29-30.

[2] Bai Zhiyu. Research progress on adverse reactions of lanthanum carbonate[J] Bromopyridine. Chinese Prescription Drugs, 2018, 16(2): 25-26.

[3] Wang Jingao; Wang Ying. Preparation method of rare earth chemical lanthanum carbonate chewable tablets. CN201410815515.7, application date 2014-12-24

[4] Compound Dictionary

[5] Yang Qing. A production method of high-purity lanthanum carbonate. CN201610605195.1, application date 2016-07-28

[6] Yao Maojun. Method for preparing lanthanum carbonate by reacting supercritical carbon dioxide and lanthanum oxide. CN201310099451.0, application date 2013-03-27