calcium carbonate (Tums, Oscal, Oyst-Cal)
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Introduction
Tradename: Tums. CaCO3
Indications
- antacid: 500-1500 mg PO PRN
- hiatal hernia, GERD, stress ulcer prophylaxis, pyrosis, dyspepsia, peptic ulcer, gastritis associated with H pylori
- traveler's diarrhea[10]
- hypocalcemia: 0.5-1 g PO TID (up to 3 g TID, initially)
- osteopenia, osteoporosis: 1-2 g PO QD divided BID/TID
- hyperphosphatemia in renal failure: 0.5-1 g PO TID
Contraindications
pregnancy_category :value +
pregnancy_category :value ? 1st trimester
safety_in_lactation :value ?
Dosage
Tabs: 500, 750, 1000 mg
Pharmacokinetics
- 20% absorbed & eliminated by the kidneys
- majority is not absorbed & is eliminated in the feces
- CaCO3 is well absorbed when taken with meals even in patients with achlorhydria
Adverse effects
- constipation
- dyspepsia
- flatulence
- hypotension
- arrhythmias
- lethargy
- erythema
- renal dysfunction
- nausea
- may increase risk of myocardial infarction in women[6][9]
Drug interactions
- may antagonize effects of calcium channel blockers
- may decrease absorption of tetracyclines
- may increase toxicity of digoxin, precipitating arrhythmias
- antacids, H2-blockers, proton pump inhibitors inhibit absorption of CaCO3 (use calcium citrate in these patients)[4]
- drug interaction(s) of iron supplements in combination with antacids
- drug interaction(s) of beta-adrenergic receptor antagonists with calcium salts
- drug interaction(s) of bisphosphonate with Ca+2
Mechanism of action
- metabolic agent with diverse functions
- 1200 mg/day improves bone mineral density in elderly men but does not reduce risk of fracture[8]
More general terms
Additional terms
Component of
- Renacidin (Hemiacidrin, citric acid & d-gluconic acid irrigant)
- coral calcium
- calcium carbonate/magnesium oxide/zinc gluconate
- calcium carbonate/cholecalciferol/phytonadione
- calcium carbonate/cholecalciferol/cobalamin/folic acid/magnesium oxide/pyridoxine
- ascorbate/biotin/calcium carbonate/cobalamin/folic acid/iron dextran/nicotinic acid/pantothenate/pyridoxine/riboflavin/succinate/thiamine
- alpha tocopheryl acetate/ascorbate/calcium carbonate/cholecalciferol/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/potassium iodide/pyridoxine/retinol/riboflavin/thiamine/zinc sulfate
- calcium carbonate/cholecalferol/chondroitin sulfate/glucosamine
- calcium carbonate/vitamin d/vitamin k
- calcium carbonate/sodium bicarbonate
- calcium carbonate/risedronate
- calcium/magnesium/vitamin D/zinc
- calcium/magnesium/vitamin D
- calcium carbonate/magnesium oxide/zinc sulfate
- calcium carbonate/magnesium oxide
- calcium carbonate/folic acid/magnesium carbonate
- calcium carbonate/ergocalciferol
- calcium carbonate/cobalamin/folic acid/pyridoxine
- calcium carbonate/cholecalciferol/magnesium oxide/zinc oxide
- calcium carbonate/cholecalciferol/cyanokit/folic acid
- calcium carbonate/calcium gluconate/vitamin d
- ascorbate/calcium carbonate/cholecalciferol/vitamin e
- ascorbate/calcium carbonate/cholecalciferol/fatty acid omega 3/folic acid/linoleate/pyridoxine/vitamin e
- ascorbate/calcium carbonate/cholecalciferol/choline bitartrate/cobalamin/docosahexaenoate/eicosapentaenoate/ferrous fumarate/folic acid/nicotinic acid/potassium iodide/pyridoxine/riboflavin/thiamine/vitamin e/zinc oxide
- ascorbate/biotin/calcium carbonate/cobalamin/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/vitamin a/vitamin e/zinc oxide
- ascorbate/biotin/calcium carbonate/cobalamin/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/vitamin a/vitamin e/zinc/zinc oxide
- ascorbate/biotin/calcium carbonate/cobalamin/dextran/folic acid/iron dextran/nicotinic acid/pantothenate/pyridoxine/riboflavin/thiamine
- ascorbate/beta carotene/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
- alpha tocopheryl acetate/ascorbate/calcium carbonate/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium oxide/nicotinamide/potassium iodide/pyridoxine/retinol/riboflavin/thiamine/vitamin d/zinc sulfate
- alpha tocopherol/ascorbate/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/cupric oxide/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
- alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/thiamine/zinc oxide
- alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/ferrous fumarate/folic acid/nicotinamide/pantothenate/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
- alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/docosahexaenoate/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/thiamine/zinc oxide
- calcium carbonate/sodium fluoride
- calcium carbonate/magnesium chloride
- calcium carbonate/magnesium carbonate
- calcium carbonate/cholecalciferol/ferrous fumarate
- calcium carbonate/famotidine/magnesium hydroxide (Pepcid complete)
- calcium carbonate/mylanta
- calcium carbonate/magnesium hydroxide
- calcium carbonate/maalox/simethicone
- calcium carbonate/cholecalciferol/vitamin k
- calcium carbonate/magnesium hydroxide/simethicone
- calcium carbonate/cholecalciferol/co3=
- calcium carbonate/cholecalciferol (Caltrate)
- calcium carbonate/vitamin D
- calcium carbonate/simethicone
- calcium carbonate/max protein/simethicone
- aspirin/calcium carbonate
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, 496
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ 4.0 4.1 Greendale G, In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 25-28, 2002
- ↑ 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
- ↑ 6.0 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 - ↑ 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
- ↑ 8.0 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
- ↑ 9.0 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
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 Apr 19; 342:d2040 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21505219 - ↑ 10.0 10.1 Deprecated Reference