Calcium Carbonate

Indications
Oral
Hyperacidity
Adult: Per tablet contains 500 mg calcium carbonate: Take 1-2 tablets as needed, up to a max of 16 tablets/day. May suck or chew tablets. Pregnant women: 1-2 tablets as needed, up to a max of 7 tablets in 24 hr.
CrCl (ml/min)Dosage Recommendation
<25Dosage adjustments may be needed depending on serum calcium levels.

Oral
Hyperphosphataemia in patients with chronic renal failure
Adult: Initially, 2.5 g daily, given in divided doses, may increase up to 17 g daily in divided doses if needed.
CrCl (ml/min)Dosage Recommendation
<25Dosage adjustments may be needed depending on serum calcium levels.
Contraindications
Patients with Ca renal calculi or history of renal calculi; hypercalcaemia; hypophosphataemia. Patients with suspected digoxin toxicity.
Warnings / Precautions
Renal impairment, hypoparathyroid disease, hypercalcaemia-associated diseases. Calcium absorption is impaired in achlorhydria; use an alternate salt and take with food. Caution when used in patients with a history of kidney stones.
Adverse Reactions
Constipation, flatulence; hypercalcaemia; metabolic alkalosis; milk-alkali syndrome, tissue-calcification. Gastric hypersecretion and acid rebound (with prolonged use).
Drug Interactions
Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication.
See Below for More calcium carbonate Drug Interactions
Food Interactions
Absorption may be increased with food. Decreased absorption with bran, foods high in oxalates and whole grain cereals. Calcium may reduce iron absorption.
Mechanism of Actions
Calcium carbonate can neutralise gastric acid rapidly and effectively. However, it may adversely activate Ca dependent processes, leading to secretion of gastric and hydrochloric acid. It can induce rebound acid secretion and, prolonged high doses may cause hypercalcemia, alkalosis and milk-alkali syndrome.
Absorption: Converted to calcium chloride by gastric acid. Some of the calcium is absorbed in the intestines. Calcium is absorbed in soluble, ionized form; solubility of calcium is increased in an acidic environment.
Distribution: Crosses placenta, enters breast milk.
Excretion: Mainly in the faeces as unabsorbed calcium; urine (20%).
Administration
May be taken with or without food. (Take w/ meals for better absorption. Avoid taking w/ large amt of fibre-rich food.)
ATC Classification
A12AA04 - calcium carbonate ; Belongs to the class of calcium-containing preparations. Used as dietary supplements.
A02AC01 - calcium carbonate ; Belongs to the class of calcium-containing antacids.
Available As
  • Calcium Carbonate 0.375 gm
  • Calcium Carbonate 0.59 mg
  • Calcium Carbonate 0.593 gm
  • Calcium Carbonate 0.625 gm
  • Calcium Carbonate 1.25 gm
  • Calcium Carbonate 1.25 mg
  • Calcium Carbonate 10 mg
  • Calcium Carbonate 100 mg
  • Calcium Carbonate 1000 mg
  • Calcium Carbonate 105 mg
  • Calcium Carbonate 1107 mg
  • Calcium Carbonate 1125 mg
  • Calcium Carbonate 125 mg
  • Calcium Carbonate 1250 mg
  • Calcium Carbonate 130 mg
  • Calcium Carbonate 150 mg
  • Calcium Carbonate 162 mg
  • Calcium Carbonate 165 mg
  • Calcium Carbonate 187.3 mg
  • Calcium Carbonate 195 mg
  • Calcium Carbonate 2 mg
  • Calcium Carbonate 2.5 mg
  • Calcium Carbonate 200 mg
  • Calcium Carbonate 225 mg
  • Calcium Carbonate 250 mg
  • Calcium Carbonate 2500 mg
  • Calcium Carbonate 2500 mg (2 tab)
  • Calcium Carbonate 30 mg
  • Calcium Carbonate 300 mg
  • Calcium Carbonate 312.5 mg
  • Calcium Carbonate 370 mg
  • Calcium Carbonate 375 mg
  • Calcium Carbonate 400 mg
  • Calcium Carbonate 425 mg
  • Calcium Carbonate 5.75% w/w
  • Calcium Carbonate 50 mg
  • Calcium Carbonate 500 mcg
  • Calcium Carbonate 500 mg
  • Calcium Carbonate 59 mg
  • Calcium Carbonate 625 mg
  • Calcium Carbonate 650 mg
  • Calcium Carbonate 680 mg
  • Calcium Carbonate 740 mg
  • Calcium Carbonate 75 mg
  • Calcium Carbonate 750 mg
  • Calcium Carbonate 97.5 mg
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