Calcium Carbonate
Indications
250 mg or 500 mg tablet:
This is used for the treatment or prevention of calcium depletion in
patients in whom dietary measures are inadequate. Conditions that may be
associated with calcium deficiency include hypoparathyroidism,
achlorhydria, chronic diarrhea, vitamin D deficiency, steatorrhea,
sprue, pregnancy and lactation, menopause, pancreatitis, renal failure,
alkalosis, and hyperphosphataemia. Calcium Carbonate is being used
increasingly often to treat hyperphosphataemia in chronic renal failure
as well as those on continuous ambulatory peritoneal dialysis (CAPD) and
haemodialysis. Many patients are unable to tolerate sufficient doses
for complete phosphate control and require additional measures such as
stringent dietary phosphate restriction or relatively small doses of
aluminium hydroxide. Calcium Carbonate containing preparations can
provide short-term relief of dyspeptic systems but are no longer
recommended for long-term treatment of peptic ulceration.
1000 mg tablet: This is indicated for the management of conditions associated with hyperidity and for fast relief of acid indigestion, heartburn, sour stomach and upset stomach.
1000 mg tablet: This is indicated for the management of conditions associated with hyperidity and for fast relief of acid indigestion, heartburn, sour stomach and upset stomach.
Pharmacology
Calcium carbonate reacts with gastric acid
to produce a salt and water. For calcium carbonate the postulated
chemical reaction is: CaCO3 + 2HCl = CaCl2 + H2O + CO2
Two grams of calcium carbonate will readily bring 100 ml of hydrochloric acid to a pH above 6. The increase in gastric pH diminishes the activity of pepsin in the gastric secretion. Up to 30% of the oral calcium load may be absorbed.
Two grams of calcium carbonate will readily bring 100 ml of hydrochloric acid to a pH above 6. The increase in gastric pH diminishes the activity of pepsin in the gastric secretion. Up to 30% of the oral calcium load may be absorbed.
Dosage & Administration
250 mg or 500 mg tablet:
Calcium Carbonate is always used orally and when used as an antacid the
recommended doses for adults are equivalent to 540-2000 mg Calcium
Carbonate per day, doses for children being half of those for adults. As
a dietary supplement, such as for the prevention of osteoporosis,
1250-3750 mg Calcium Carbonate (500-1500 mg calcium) daily is
recommended in general, but again this will need to be tailored to the
individual patient depending on any specific disease such as Calcium
deficiency, malabsorption or parathyroid function. In pregnancy and
lactation the recommended daily dose of calcium is 1200-1500 mg. In
chronic renal failure the doses used vary from 2.5-9.0 gm Calcium
Carbonate per day and need to be adjusted according to the individual
patient. To maximize effective phosphate binding in this context the
Calcium Carbonate should be given with meals.
1000 mg tablet: 2000-3000 mg tablet when symptoms occur; may be repeated hourly if needed or as directed by the physician.
1000 mg tablet: 2000-3000 mg tablet when symptoms occur; may be repeated hourly if needed or as directed by the physician.
Interaction
Calcium Carbonate may enhance the cardiac
effects of digoxin and other cardiac glycosides, if systemic
hypercalcaemia occurs. Calcium Carbonate may interfere with the
absorption of concomitantly administered tetracycline preparations and
in chronic renal failure modification of vitamin D therapy may be
required to avoid hypercalcaemia when Calcium Carbonate is used as the
primary phosphate binder.
Contraindications
- Hypercalcaemia and hyperparathyroidism
- Hypercalciuria and nephrolithiasis
- Zollinger-Ellison syndrome
- Concomitant digoxin therapy (requires careful monitoring of serum calcium level)
Side Effects
Orally administered Calcium Carbonate may
be irritating to the GI tract. It may also cause constipation.
Hypercalcaemia is rarely produced by administration of calcium alone,
but may occur when large doses are given to patients with chronic renal
failure.
Pregnancy & Lactation
Calcium containing drugs have been widely
used in pregnancy by way of oral calcium supplementation or antacid
therapy. Calcium Carbonate can be used in lactating women too.
Use in Special Populations
Use in children: Calcium
carbonate has been extensively studied in children and infants with
chronic renal failure and is both safe and effective.
Use in elderly: In case of elderly patients with renal failure when calcium carbonate is taken constipation may be troublesome one for this group. For this reason, monitoring of serum calcium and phosphate is of course indicated for elderly patients.
Use in elderly: In case of elderly patients with renal failure when calcium carbonate is taken constipation may be troublesome one for this group. For this reason, monitoring of serum calcium and phosphate is of course indicated for elderly patients.
Therapeutic Class
Minerals in bone formation, Specific mineral preparations
Storage Conditions
Store in a cool, dry place in controlled room temperature.