Lanthanum and Vadadustat: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lanthanum
Vadadustat
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced vadadustat exposure and reduced efficacy of vadadustat
Interaction Deep Dive
Concomitant use of vadadustat with non-iron containing phosphate binders may reduce the exposure of vadadustat, which may reduce the effectiveness of vadadustat. Effect of non-iron containing phosphate binders on pharmacokinetics of vadadustat was studied when coadministered. With sevelamer carbonate both the AUC and Cmax of vadadustat increased by 0.6-fold approximately. When the dose of vadadustat was staggered the result varied. Vadadustat administered 1 hour before sevelamer carbonate or calcium acetate, the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 1.1-fold respectively. The same result was observed when vadadustat was administered 2 hours before sevelamer carbonate, the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 01.1-fold respectively. And when vadadustat was administered 2 hours before sevelamer carbonate the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 0.9-fold respectively. Vadadustat should be administered at least 1 hour before or 2 hours after dosing non-iron-containing phosphate binders1.
Why it happens (mechanism)
Unknown
Literature reports
2 reports — tap to read
a) Effect of non-iron containing phosphate binders on pharmacokinetics of vadadustat was studied when coadministered. With sevelamer carbonate both the AUC and Cmax of vadadustat increased by 0.6-fold approximately. When the dose of vadadustat was staggered the result varied. Vadadustat administered 1 hour before sevelamer carbonate, the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 1.1-fold respectively. And when vadadustat was administered 2 hours before sevelamer carbonate the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 0.9-fold respectively 1.
b) Effect of non-iron containing phosphate binders on pharmacokinetics of vadadustat was studied when coadministered. With calcium acetate both the AUC and Cmax of vadadustat increased by 0.5-fold approximately. When the dose of vadadustat was staggered the result varied. Vadadustat administered 1 hour before calcium acetate, the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 1.1-fold respectively. The same result was observed when vadadustat was administered 2 hours before sevelamer carbonate, the AUC and Cmax of vadadustat increased by approximately 0.8-fold and 01.1-fold respectively 1.
Common questions
Can I take Lanthanum and Vadadustat together?
Reduced vadadustat exposure and reduced efficacy of vadadustat Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lanthanum and Vadadustat interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Lanthanum or Vadadustat need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: VAFSEO(R) oral tablets, vadadustat oral tablets. Akebia Therapeutics (Per Manufacturer), Cambridge, MA, 2024. DailyMed
Keep reading about Lanthanum
Keep reading about Vadadustat
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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