I've been taking Fosrenol (500 mg-750 mg with meals depending on what/how much I'm eating) for 6 years and am now contemplating switching to Renvela (nephrologist wrote a script for 2 - 800 mg. tabs w/meals).
My phosphorus runs between 3.1-3.9, so that is not an issue with Fosrenol. Plus, I tolerate it well except when taking too much for the amount of food I eat. Horrible nauseousness.
However, my concerns are over long term effects of lanthanum on the gut/liver and the high cost of the med (seems it goes up by 15% every year - Chinese dirt is quite expensive). I've done the required reading and now would like "real world" feedback from those of you who have used both.
Thanks - Noahvale
Lanthanum Carbonate, "Chinese dirt" as you called it because of the supposedly 'rare earth' element content, is not expensive at all. In fact you can buy 5 kilograms of 99.9% pure lanthanum carbonate for about $250, so it is about $50 per kilo or 5 cents per gram. Shire Pharmaceutical, the maker of Fosrenol, charges about $7.50 per gram, so you do the math and see who is profiting.
You are right to be concerned about the long term effect of Fosrenol because not too many long term human studies have been done and you can search this and other forums for the lack of long term data.
The other binder you mentioned, Renvela, has side effects as well, so you may just have to do a trial. If you search this forum, you may find some reports that some patients prefer the older drug Renagel to Renvela for the lesser side effects, mainly stomach problems.
http://ihatedialysis.com/forum/index.php?topic=9497.0You may also find that longer and slower dialysis could effectively remove the phosphorus and that someone on a more complete dialysis may not need binders at all with an average phosphorus limited diet.
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