Lanthanum carbonate is used as a phosphate binder for hyperphosphatemia in chronic kidney disease, but it competes in a crowded binder landscape.
Common alternatives include:
- sevelamer
- calcium-based binders (calcium acetate/carbonate)
- iron-based binders (ferric citrate, sucroferric oxyhydroxide)
- (and in some settings) older options like aluminum-based binders, limited by safety considerations
Clinical reviews discuss these options and compare effectiveness and tradeoffs such as pill burden and adverse effects.
Bottom line for pharma: Substitution is real and often guided by calcium balance, iron status, pill burden, GI tolerance, and cost rather than lanthanum supply.