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calcium carbonate (Tums, Oscal, Oyst-Cal)

Tradename: Tums. CaCO3 Indications: 1) antacid: 500-1500 mg PO PRN - hiatal hernia, GERD, stress ulcer prophylaxis, pyrosis, dyspepsia, peptic ulcer, gastritis associated with H pylori 2) traveler's diarrhea [10] 2) hypocalcemia: 0.5-1 g PO TID (up to 3 g TID, initially) - renal osteodystrophy 3) osteopenia, osteoporosis: 1-2 g PO QD divided BID/TID 4) hyperphosphatemia in renal failure: 0.5-1 g PO TID Contraindications: 1) renal calculi 2) hypophosphatemia 3) ventricular fibrillation pregnancy_category :value + pregnancy_category :value ? 1st trimester safety_in_lactation :value ? Dosage: Tabs: 500, 750, 1000 mg. Pharmacokinetics: 1) 20% absorbed & eliminated by the kidneys 2) majority is not absorbed & is eliminated in the feces 3) CaCO3 is well absorbed when taken with meals even in patients with achlorhydria Adverse effects: 1) constipation 2) dyspepsia 3) flatulence 4) hypotension 5) arrhythmias 6) lethargy 7) erythema 8) renal dysfunction 9) nausea 10) may increase risk of myocardial infarction in women [6,9] Drug interactions: 1) may antagonize effects of calcium channel blockers 2) may decrease absorption of tetracyclines 3) may increase toxicity of digoxin, precipitating arrhythmias 4) antacids, H2-blockers, proton pump inhibitors inhibit absorption of CaCO3 (use calcium citrate in these patients) [4] 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]

Interactions

drug adverse effects of calclium supplement(s)

Related

Ca+2

General

antacid calcium supplement phosphate binder

Database Correlations

PUBCHEM correlations

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#: 230304 (subscription needed) http://www.prescribersletter.com
  6. Bolland MJ et al, Vascular events in healthy older women receiving calcium supplementation: Randomized controlled trial, BMJ 2008, 336:262 PMID: 18198394 - Prescriber's Letter 15(3): 2008 Calcium Supplementation and Vascular Events Detail-Document#: 240306 (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#: 241008 (subscription needed) http://www.prescribersletter.com
  8. Reid IR et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med 2008 Nov 10; 168:2276. PMID: 19001206
  9. 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: 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: 21505219
  10. Deprecated Reference

Component-of

alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/docosahexaenoate/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/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/thiamine/zinc oxide alpha tocopherol/ascorbate/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/cupric oxide/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 ascorbate/beta carotene/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide ascorbate/biotin/calcium carbonate/cobalamin/dextran/folic acid/iron dextran/nicotinic acid/pantothenate/pyridoxine/riboflavin/thiamine 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/calcium carbonate/cholecalciferol/choline bitartrate/cobalamin/docosahexaenoate/eicosapentaenoate/ferrous fumarate/folic acid/nicotinic acid/potassium iodide/pyridoxine/riboflavin/thiamine/vitamin e/zinc oxide ascorbate/calcium carbonate/cholecalciferol/fatty acid omega 3/folic acid/linoleate/pyridoxine/vitamin e ascorbate/calcium carbonate/cholecalciferol/vitamin e aspirin/calcium carbonate calcium carbonate/calcium gluconate/vitamin d calcium carbonate/cholecalciferol (Caltrate) calcium carbonate/cholecalciferol/co3= calcium carbonate/cholecalciferol/cyanokit/folic acid calcium carbonate/cholecalciferol/ferrous fumarate calcium carbonate/cholecalciferol/magnesium oxide/zinc oxide calcium carbonate/cholecalciferol/vitamin k calcium carbonate/cholecalferol/chondroitin sulfate/glucosamine calcium carbonate/cobalamin/folic acid/pyridoxine calcium carbonate/ergocalciferol calcium carbonate/famotidine/magnesium hydroxide (Pepcid complete) calcium carbonate/folic acid/magnesium carbonate calcium carbonate/gelatin/magnesium oxide calcium carbonate/maalox/simethicone calcium carbonate/magnesium carbonate calcium carbonate/magnesium chloride calcium carbonate/magnesium hydroxide calcium carbonate/magnesium hydroxide/simethicone calcium carbonate/magnesium oxide calcium carbonate/magnesium oxide/zinc oxide calcium carbonate/magnesium oxide/zinc sulfate calcium carbonate/max protein/simethicone calcium carbonate/mylanta calcium carbonate/potassium bicarbonate/sodium bicarbonate calcium carbonate/potassium chloride/sodium chloride calcium carbonate/risedronate calcium carbonate/simethicone calcium carbonate/sodium bicarbonate calcium carbonate/sodium fluoride calcium carbonate/sodium monofluorophosphate calcium carbonate/vitamin D calcium carbonate/vitamin d/vitamin k calcium/magnesium/vitamin D calcium/magnesium/vitamin D/zinc coral calcium Renacidin (Hemiacidrin, citric acid & d-gluconic acid irrigant)