calcium supplement

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Indications

* clinical significance vs statistical significance; 1-2% increase in bone mineral density not clinically significant[20]

Contraindications

pregnancy_category :value +

pregnancy_category :value ? 1st trimester

safety_in_lactation :value ?

Dosage

* 1 dietary calcium serving is = 300 mg of calcium[18]

Pharmacokinetics

  • 20% absorbed & eliminated by the kidneys
  • majority is not absorbed & is eliminated in the feces

Adverse effects

Drug interactions

Mechanism of action

More general terms

More specific terms

Additional terms

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, 496
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. Greendale G, In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 25-28, 2002
  5. Prescriber's Letter 14(3): 2007 Calcium and Vitamin D Supplementation: Who Needs It? Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230304&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. 6.0 6.1 Bolland MJ et al, Vascular events in healthy older women receiving calcium supplementation: Randomized controlled trial, BMJ 2008, 336:262 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18198394
    Prescriber's Letter 15(3): 2008 Calcium Supplementation and Vascular Events Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240306&pb=PRL (subscription needed) http://www.prescribersletter.com
  7. Prescriber's Letter 15(10): 2008 CHART: Comparison of Oral Calcium Salts GUIDELINES: NAMS Position Statement on the Management of Osteoporosis in Postmenopausal Women GUIDELINES: Diagnosis and Management of Osteoporosis in Canada Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241008&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. 8.0 8.1 Reid IR et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med 2008 Nov 10; 168:2276. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19001206
  9. 9.0 9.1 Bolland MJ et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: Meta-analysis. BMJ 2010 Jul 29; 341:c3691 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20671013
  10. 10.0 10.1 Bolland MJ et al Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis BMJ 2011; 342:d2040 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21505219 <Internet> http://www.bmj.com/content/342/bmj.d2040.full
    Abrahamsen B and Sahota O Do calcium plus vitamin D supplements increase cardiovascular risk? BMJ 2011; 342:d2080 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21505220 <Internet> http://www.bmj.com/content/342/bmj.d2080
  11. 11.0 11.1 11.2 Li K, Kaaks R et al Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg) Heart 2012;98:920-925 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22626900 <Internet> http://heart.bmj.com/content/98/12/920.full
    Reid IR and Bolland MJ Calcium supplements: bad for the heart? Heart 2012;98:895-896 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22626897 <Internet> http://heart.bmj.com/content/98/12/895.extract
  12. 12.0 12.1 Anderson JJB et al Calcium intakes and femoral and lumbar bone density of elderly U.S. men and women: National Health and Nutrition Examination Survey 2005-2006 analysis. J Clin Endocrinol Metab 2012 Dec; 97:4531 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23071160
  13. 13.0 13.1 Michaelsson K et al Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23403980 BMJ 2013;346:f228 http://www.bmj.com/content/346/bmj.f228
  14. 14.0 14.1 14.2 Moyer VA et al Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 26 February 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440163 <Internet> http://annals.org/article.aspx?articleid=1655858
    Nestle M and Nesheim MC To Supplement or Not to Supplement: The U.S. Preventive Services Task Force Recommendations on Calcium and Vitamin D Ann Intern Med. 26 February 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440174 <Internet> http://annals.org/article.aspx?articleid=1655860
  15. 15.0 15.1 15.2 15.3 Xiao Q et al. Dietary and supplemental calcium intake and cardiovascular disease mortality: The National Institutes of Health-AARP Diet and Health study. JAMA Intern Med. Feb 4, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23381719 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1568523
    Larsson SC. Are calcium supplements harmful to cardiovascular disease? JAMA Intern Med. Feb 4, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23380757 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1568524
  16. Prescriber's Letter 20(4): 2013 COMMENTARY: Calcium and Cardiovascular Risk PATIENT EDUCATION HANDOUT: Calcium and Vitamin D Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=290409&pb=PRL (subscription needed) http://www.prescribersletter.com
  17. Deprecated Reference
  18. 18.0 18.1 18.2 18.3 18.4 18.5 18.6 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
    Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
    Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  19. 19.0 19.1 Gallagher JC et al Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women. Menopause. June 16, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24937025 <Internet> http://journals.lww.com/menopausejournal/Abstract/publishahead/Incidence_of_hypercalciuria_and_hypercalcemia.98368.aspx
  20. 20.0 20.1 20.2 Tai V et al Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ 2015;351:h4183 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26420598 <Internet> http://www.bmj.com/content/351/bmj.h4183
    Bolland MJ et al Calcium intake and risk of fracture: systematic review. BMJ 2015;351:h4580 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26420387 <Internet> http://www.bmj.com/content/351/bmj.h4580
    Michaelsson K Calcium supplements do not prevent fractures. BMJ 2015;351:h4825 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26420735 <Internet> http://www.bmj.com/content/351/bmj.h4825
  21. Heaney RP, Kopecky S, Maki KC et al A review of calcium supplements and cardiovascular disease risk. Adv Nutr. 2012 Nov 1;3(6):763-71. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23153730 Free PMC Article
  22. Prentice RL, Pettinger MB, Jackson RD et al Health risks and benefits from calcium and vitamin D supplementation: Women's Health Initiative clinical trial and cohort study. Osteoporos Int. 2013 Feb;24(2):567-80. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23208074 Free PMC Article
  23. Reid IR, Bolland MJ, Avenell A, Grey A. Cardiovascular effects of calcium supplementation. Osteoporos Int. 2011 Jun;22(6):1649-58. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21409434
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  25. 25.0 25.1 Kopecky SL, Bauer DC, Gulati M et al Lack of Evidence Linking Calcium With or Without Vitamin D Supplementation to Cardiovascular Disease in Generally Healthy Adults: A Clinical Guideline From the National Osteoporosis Foundation and the American Society for Preventive Cardiology. Annals of Internal Medicine. Oct 25, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27776362 <Internet> http://annals.org/aim/article/2571714/lack-evidence-linking-calcium-without-vitamin-d-supplementation-cardiovascular-disease
    Chung M, Tang AM, Fu Z, Wang D, Newberry SJ Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis. Annals of Internal Medicine. Oct 25, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27776363 <Internet> http://annals.org/aim/article/2571713/calcium-intake-cardiovascular-disease-risk-updated-systematic-review-meta-analysis
    Margolis KL, Manson JE Calcium Supplements and Cardiovascular Disease Risk: What Do Clinicians and Patients Need to Know? Annals of Internal Medicine. Oct 25, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27776361 <Internet> http://annals.org/aim/article/2571715/calcium-supplements-cardiovascular-disease-risk-what-do-clinicians-patients-need
  26. 26.0 26.1 Zhao JG, Zeng XT, Wang J et al Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults. A Systematic Review and Meta-analysis. JAMA. 2017;318(24):2466-2482 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29279934 https://jamanetwork.com/journals/jama/article-abstract/2667071
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