Adult Dosing

Osteoporosis

• 1-1.5 g/day PO divided bid-qid

Hypocalcemia

• 1-2 g/day PO divided bid-qid

Dyspepsia

• 0.3-8 g/day PO divided bid-qid

Duodenal Ulcer

• 1.25-3.75 g/day PO divided bid-qid

Gastric Ulcer

• 1.25-3.75 g/day PO divided bid-qid

Erosive esophagitis

• 1.25-3.75 g/day PO divided bid-qid
• Do not exceed maximum daily dosage for more than 2 wks

GERD

• 1.25-3.75 g/day PO divided bid-qid
• Do not exceed maximum daily dosage for more than 2 wks

Recommended daily intake

• 19-50 yrs: 1g/day elemental calcium PO divided tid-qid
• > 50 yrs: 1.2 g/day elemental calcium PO divided tid-qid
• Note: Dosage is sometimes expressed as elemental calcium. 40% elemental Calcium carbonate; 1 gram CaCO3 is equivalent to 400 mg or 20 mEq elemental calcium

Pediatric Dosing

Chronic Hypocalcemia

• <1 yr: 125-375 mg/kg/day PO divided q4-6 hrs, give milk or formula. Max:1 g/day
• 1 yr: 110-165 mg/kg/day PO divided q6 hrs, with food

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment & prevention of calcium deficiency or hyperphosphatemia (eg, osteoporosis, osteomalacia, mild/moderate renal insufficiency, hypoparathyroidism, rickets)
• Adjunct in prevention of postmenopausal osteoporosis
• Treatment of erosive esophagitis, duodenal ulcer and gastric ulcer
• Treatment of hyperphosphatemia in end-stage renal disease

• Hypersensitivity to any of the ingredients of the product
• Hypercalcemia
• Ventricular fibrillation
• Hypophosphatemia
• Nephrolithiasis

• N/A

Renal Dose Adjustment (Based on CrCl)

• <25 mL/min: Dose reduction recommended; dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

See Supplemental Patient Information

• Calcium carbonate may be irritating to the GI tract; may also cause constipation
• Hypercalcemia may occur when large doses are administered to patients with chronic renal failure. Mild hypercalcemia usually gets controlled by reducing calcium intake (e.g., decreasing the dose of or avoiding supplemental calcium); more severe hypercalcemia may require hemodialysis. Avoid over treatment of hypocalcemia
• In hemodialysis patients adjustments in calcium concentrations in the dialysate may be necessary to reduce the risk of hypercalcemia
• The long-term effect of chronic calcium administration (in patients with chronic renal failure receiving calcium salts to control hyperphosphatemia) on progression of vascular or soft-tissue calcification is not known
• Risk of renal calculi; increase fluid intake and decrease dietary intake of calcium to prevent calculi formation in patients with idiopathic hypocalciuria
• Maintain serum calcium concentrations at 9-10.4 mg/dL (4.5-5.2 mEq/L)
• Monitor calcium frequently if acute hypocalcemia and periodically if long-term treatment

Cautions: Use cautiously in

• Renal impairment
• Cardiac disease
• Concomitant cardiac glycosides
• Cor pulmonale
• Respiratory acidosis
• Respiratory failure
• Achlorhydria (due to impaired absorption)
• GI bleed
• GI obstruction
• Dehydration
• Hypoparathyroid patients
• Concommitant use of thyzide diuretics (can cause hypercalcemia)
• History of Sarcoidosis
• History of renal calculi
• Hypercalciuria

Supplemental Patient Information

• Advise patients to decrease dietary intake of calcium

Pregnancy Category:C

Breastfeeding: Probably safe.

• CNS: Headache
• CV: Arrhythmias, bradycardia
• GI: Nausea, constipation, vomiting
• METABOLIC: Hypercalcemia, hypomagnesemia
• GU: Hypercalciuria, calculi, nephrolithiasis

• Mineral supplement; maintains cell membrane and capillary permeability, assists transmission of nerve impulses and contraction of cardiac, skeletal, and smooth muscle
• Metabolism: Unknown
• Absorbed from the GI tract in the presence of vitamin D
• Excretion: Primarily in feces (80%), minimally in urine (20%)
• Half-life: Unknown

US Trade Name(s)

• Amitone
• Alka-mints
• Alkets
• Alkums
• Calcichew
• Calcium-500
• Caltrate-600
• Os-Cal
• Dicarbosil

US Availability

calcium carbonate (generic)

• OTC TABS: 500, 600, 650, 1250, 1500 mg
• OTC CHEW TABS: 500, 750 mg
• SUSP: 1250 mg/5 mL

Amitone

• TABS: 350mg

Alka-mints

• TABS: 850 mg

Alkets

• TABS: 500 mg, 750 mg

Alkums

• TABS: 500 mg

Calcichew

• TABS: 1.25 g

Caltrate

• TABS: 600 mg

Os-Cal

• TABS: 500 mg

Dicarbosill

• CHEW TABS: 500 mg

Tums

• CHEW TABS: 500 mg

Tums E-X

• CHEW TABS: 750 mg

Tums Ultra

• CHEW TABS: 1000 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• Adcal
• Boots Indigestion Relief Tablets Fruit/peppermint
• Cacit Effervescent Tablet
• Calcichew
• Calcichew Forte
• Remegel
• Remegel Summer Fruit
• Tums Assorted Fruit Antacid Tablets

UK Availability

Adcal

• CHEW TABS: 1500 mg

Boots Indigestion Relief Tablets Fruit/peppermint

• TAB: 500 mg

Cacit Effervescent Tablet

• Effervescent TAB: 1.25 g

Calcichew

• CHEW TABS: 1.25 g

Calcichew Forte

• CHEW TABS: 2.5 g

Remegel

• TAB: 800 mg

Remegel Summer Fruit

• TAB: 800 mg

Tums Assorted Fruit Antacid Tablets

• TABS: 500 mg

Australian Trade Name(s)

• Andrews TUMS Antacid
• CAL-600
• CaL-Sup
• Calci-Tab
• Caltrate

Australian Availability

Andrews TUMS Antacid

• TABS: 500 mg

CAL-600, Calci-Tab

• TABS: 1500 mg

CaL-Sup

• TABS: 1250 mg

Caltrate

• TABS: 600 mg

[Outline]

Gastrointestinal

Antacids

Nutrition/Electrolytes

Minerals & Electrolytes

Pricing data from www.DrugStore.com in U.S.A.

• Calcium Carbonate 1250 MG/5ML SUSP [Bottle] (ROXANE)
  500 5ml = $20.99
  1500 5ml = $40.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.