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Calcium Carbonate

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Calcium Carbonate, Tums, Caltrate, Os-Cal, Viactiv, Rolaids

  • See Also
  1. Antacid
  2. Peptic Ulcer Disease
  3. Calcium Supplementation
  4. Osteoporosis Prevention
  • Indications
  1. Osteoporosis Prevention
    1. See Calcium Supplementation
  2. Peptic Ulcer Disease
    1. See Antacid
  • Dosing
  • Calcium Carbonate
  1. Background
    1. Calcium Carbonate is 40% elemental Calcium (20 meq elemental Ca++ per Calcium Carbonate gram)
  2. Formulations
    1. Tums: 200 mg/tab elemental Calcium (extra strength 400 mg/tab)
    2. Viactiv: 500 mg/chew elemental Calcium (also contains Vitamin D 500 mg, Vitamin K 40 mcg)
    3. Os-Cal: 500 mg/tab elemental Calcium (also contains Vitamin D, from 200 mg to 800 mg depending on preparation)
    4. Caltrate: 600 mg/tab elemental Calcium (also contains Vitamin D 200 mg)
  3. Administration
    1. Take with meals or citrus juice
    2. Absorption reduced with Fasting or achlorhydria
  4. Dose
    1. Osteoporosis Prevention
      1. See Calcium Supplementation
  • Dosing
  • Combination Agents
  1. Calcium Carbonate and Magnesium Hydroxide (Tablets contain 700 mg/300 mg)
    1. Adults: 2 to 4 tabs four times daily as needed for use as Antacid
    2. Unknown safety in pregnancy and Lactation
  1. Advantages
    1. Calcium Carbonate has the most elemental Calcium (40%) of the Calcium supplements
    2. Calcium Carbonate Tablet 650 mg contains 250 mg elemental Calcium
    3. Calcium Carbonate is the least expensive Calcium preparation
  2. Disadvantages
    1. Only 35% of Calcium supplements are absorbed (contrast with much better Dietary Calcium absorption)
    2. Constipation
  • Adverse Effects
  1. Constipation
  2. Metabolic Alkalosis (longterm use)
  3. Hypercalcemia
  4. Milk-Alkali Syndrome
    1. Rare complication of combining chronic use of Calcium Supplementation with milk or bicarbonate
  • Drug Interactions
  1. Calcium Carbonate decreases absorption of drugs better absorbed at lower gastric pH
    1. Levothyroxine
    2. Tetracycline
    3. Fluoroquinolones
  • Resources
  1. Calcium Carbonate Chewable Antacid
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=27d9b505-08bd-4261-a59d-6ddc4031be32
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 90
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia