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.
Pharmacology
Calcium carbonate reacts with gastric acid to produce a salt and water. For calcium carbonate the postulated
chemical reaction is: CaCO +2HCl = CaCl +H O+CO . 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.
* চি কি ৎসকে র পরা মর্শ মোর্শমো তা বে ক ঔষধ সে বন করুন’
3 2 2 2
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)
When hypercalcaemia occurs, discontinuation of the drug is usually sufficient to return serum calcium concentrations
to normal. Calcium salts should be used cautiously in patients with sarcoidosis, renal or cardiac disease, and in
patients receiving cardiac glycosides.
SideEffects
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.
TherapeuticClass
Minerals in bone formation, Specific mineral preparations
StorageConditions
Store in a cool, dry place in controlled room temperature.