calcium acetate

Contraindicated in:

Hypercalcemia;
Renal calculi;
Ventricular fibrillation;
Concurrent use of calcium supplements.

Use Cautiously in:

Severe respiratory insufficiency;
Renal disease;
Cardiac disease;
OB: Hypercalcemia may ↑ risk of maternal and fetal complications;
Lactation: Breastfeeding not expected to harm infant provided that serum calcium levels monitored.

Adv. Reactions/Side Effects ⬆ ⬇

CV: arrhythmias, bradycardia

F and E: hypercalcemia

GI: constipation, nausea, vomiting

GU: calculi, hypercalciuria

Neuro: headache, tingling

Interactions ⬆ ⬇

Drug-drug:

Hypercalcemia ↑ risk of digoxin toxicity.
Chronic use with antacids in renal impairment may lead to milk-alkali syndrome.
Calcium supplements, including calcium-containing antacids, may ↑ risk of hypercalcemia; avoid concurrent use.
May ↓ absorption of orally administered phenytoin and iron salts; take 1 hr before or 3 hr after calcium acetate.
May ↓ absorption of orally administered tetracyclines; take ≥1 hr before calcium acetate
May ↓ absorption of orally administered fluoroquinolones; take ≥2 hr before or 6 hr after calcium acetate
May ↓ absorption of orally administered levothyroxine; take ≥4 hr before or 4 hr after calcium acetate
Excessive amounts may ↓ effects of calcium channel blockers.
↓absorption of risedronate; take ≥2 hr before or after calcium acetate).
May ↓ effectiveness of atenolol.
Concurrent use with thiazide diuretics may ↑ risk of hypercalcemia.
May ↓ ability of sodium polystyrene sulfonate to ↓ serum potassium.

Drug-Food:

Cereals, spinach, or rhubarb may ↓ absorption.

Availability ⬆ ⬇

(Generic available)

Gelcaps: 667 mg (169 mg elemental Ca)
Tablets: 667 mg (169 mg elemental Ca)

Route/Dosage ⬆ ⬇

1 gram of calcium acetate contains 250 mg elemental calcium (12.7 mEq calcium). Doses are expressed in mg calcium acetate
PO (Adults ): Hyperphosphatemia in end-stage renal disease: 1334 mg with each meal; may ↑ gradually (in absence of hypercalcemia) to achieve target serum phosphate levels (usual dose = 2001–2668 mg with each meal).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Binds to dietary phosphate to form an insoluble calcium phosphate complex, which is excreted in the feces, resulting in decreased serum phosphorus concentrations.

Therapeutic effects:

Control of hyperphosphatemia in end-stage renal disease without promoting aluminum absorption.

Classifications ⬆ ⬇

Therapeutic Classification: mineral and electrolyte replacements/supplements

Pharmacokinetics ⬆ ⬇

Absorption: 30–40% absorbed following oral administration; absorption from the GI tract requires vitamin D.

Distribution: Readily enters extracellular fluid.

Metabolism/Excretion: Excreted mostly in the feces; 20% eliminated by the kidneys.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(effects on serum calcium)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Advise patient to avoid taking calcium-containing supplements, including calcium-based antacids, during therapy.
Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Instruct patients on taking calcium acetate on a regular schedule to take missed doses as soon as possible; then go back to regular schedule.
Instruct patient in foods to avoid on a low-calcium diet. See Food Sources for Specific Nutrients.
Advise patient to notify health care professional promptly if signs and symptoms of hypercalcemia (constipation, anorexia, nausea, vomiting, confusion, stupor) occur.

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇