Calcium carbonate

Calcium carbonate

[tablets 5 cents]

ADMINISTRATION ROUTES:

  • PO

ALTERNATIVE NAMES:

  • Calci-Tab, Caltrate, Calcium-Sandoz

ICU INDICATIONS:

  1. calcium supplementation

PRESENTATION AND ADMINISTRATION:

  • PO:
    Calci-Tab 500 (500mg elemental calcium), Calci-Tab 600 (600mg elemental calcium), Caltrate tablets (600mg elemental calcium), Calci-Tab Effervescent (1gm elemental calcium), Calcium Sandoz (5.23gm of calcium lactate-gluconate, 0.8gm of calcium carbonate)

DOSAGE:

  • PO:
    500mg-1800mg of elemental calcium per day

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • Not applicable

CLINICAL PHARMACOLOGY:

  • Calcium.

CONTRAINDICATIONS:

  1. Hypercalcaemia
  2. Digitalis toxicity
  3. hyperphosphataemia (do not administer calcium if the Calcium + Phosphate is >5.5; this is an indication for dialysis)

WARNINGS

  • Nil

PRECAUTIONS

  • General:
    Elderly, fluid restriction, decreased GI motility, GI obstruction, dehydration.
  • Laboratory Tests:
    No tests in addition to standard ICU tests are required.
  • Drug/Laboratory Test Interactions:
    False Increase: Chloride, benzodiazepine (false positive). False Decrease: Magnesium, lipase.

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Calcium channel blockers:
    Calcium administration may inhibit calcium channel blocker activity.
  • Doxycycline, tetracycline:
    Co-therapy with a tetracycline and calcium carbonate can reduce the serum concentrations and efficacy of tetracyclines.
  • Quinolones:
    Reduced bioavailability of quinolone antibiotics.
  • Thiazides:
    Large doses of calcium with thiazides may lead to milk-alkali syndrome.

ADVERSE REACTIONS

  • Cardiovascular:
    Bradycardia, cardiac arrest, dysrhythmias, heart block, hemorrhage, hypotension, rebound hypertension, shortened QT interval.
  • Gastrointestinal:
    Anorexia, constipation, diarrhoea, flatulence, nausea, obstruction, rebound hyperacidity, vomiting.
  • Genitourinary:
    Renal dysfunction, renal failure, renal stones.
  • Metabolic:
    Hypercalcaemia (drowsiness, lethargy, muscle weakness, headache, constipation, coma, anorexia, nausea, vomiting, polyuria, thirst); metabolic alkalosis; milk-alkali syndrome (nausea, vomiting, disorientation, headache).

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