Calcium carbonate

Calcium Carbonate is part of the drug class:

• CALCIUM

Serious side effects have been reported with calcium carbonate including the following:  

• Hypercalcemia (blood calcium levels that are too high). Tell your healthcare provider right away if you have some or all of the following symptoms
  • ​nausea
  • headache
  • vomiting
  • confusion
  • weakness

Do not take calcium carbonate if you are allergic to calcium carbonate or to any of its ingredients.

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance. Calcium can also bind to other minerals (such as phosphate) and aid in their removal from the body.

Calcium carbonate is used to prevent and to treat calcium deficiencies.

Calcium carbonate may also be used for purposes not listed in this medication guide.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• little or no urinating;

• swelling, rapid weight gain; or

• high levels of calcium in the blood--nausea, vomiting, stomach pain, loss of appetite, constipation, increased thirst or urination, muscle pain or weakness, joint pain, confusion, and feeling tired or restless.

Common side effects may include:

• nausea or vomiting;

• constipation.

• decreased appetite;

• dry mouth or increased thirst; or

• urinating more than usual.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Hypocalcemia:

Recommended dose: 1250 mg orally 2 to 3 times a day with meals

Use: Prevention of calcium deficiency

Usual Adult Dose for Dyspepsia:

Chewable Tablets:
-Recommended dose: 1000 to 3531 mg orally up to 4 times a day as needed
-Maximum dose: 6750 to 7500 mg/day
-Duration of therapy: Up to 2 weeks

Gum:
Recommended dose: 500 mg (1 piece) orally every 2 to 4 hours as needed
Maximum dose: 6000 mg/day (12 pieces/day)
Duration of therapy: Up to 2 weeks

Liquid:
Recommended dose: 1250 mg orally as needed for symptoms
Maximum dose: 7500 mg/day
Duration of therapy: Up to 2 weeks

Powder Packets:
Recommended dose: 1000 mg (1 packet) orally as needed for symptoms
Maximum dose: 8000 mg/day (8 packets/day)
Duration of therapy: Up to 2 week

Comment:
-This drug should only be used for 2 weeks except under the supervision of a healthcare provider.

Use: Relief of upset stomach due to heartburn, acid indigestion, and/or sour stomach

Usual Pediatric Dose for Dyspepsia:

Chewable Tablets:
2 to 5 years OR 24 to 47 pounds:
-Recommended dose: 400 mg orally up to 3 times a day as needed
-Maximum dose: 1200 mg/day
-Duration of therapy: Up to 2 weeks

6 to 11 years OR 48 to 95 pounds:
-Recommended dose: 800 mg orally up to 3 times a day as needed
-Maximum dose: 2400 mg/day
-Duration of therapy: Up to 2 weeks

12 years and older:
-Recommended dose: 1000 to 2000 mg orally up to 3 times a day as needed
-Maximum dose: 7500 mg/day
-Duration of therapy: Up to 2 weeks

Granule Formulations:
2 to 5 years OR 24 to 47 pounds:
-Recommended dose: 375 mg orally up to 2 times a day as needed

6 to 11 years OR 48 to 95 pounds:
-Recommended dose :750 mg orally once a day as needed
-Duration of therapy: Up to 2 weeks

Gum:
12 years and older:
-Recommended dose: 500 mg (1 piece) orally every 2 to 4 hours as needed
-Maximum dose: 6000 mg/day (12 pieces/day)
-Duration of therapy: Up to 2 weeks

Comments:
-Weight-based dosing is preferred for pediatric patients.
-This drug should only be used for 2 weeks except under the supervision of a healthcare provider.
-Once opened, granule packets should be used within 2 weeks.

Use: Relief of upset stomach due to heartburn, acid indigestion, sour stomach, and/or overindulgence in food/drink

• Oscal

• Alcalak [OTC] [DSC]
• Antacid Calcium Extra Strength [OTC]
• Antacid Calcium [OTC]
• Antacid Extra Strength [OTC]
• Antacid [OTC]
• Cal-Carb Forte [OTC]
• Cal-Gest Antacid [OTC]
• Cal-Mint [OTC]
• Calcarb 600 [OTC] [DSC]
• Calci-Chew [OTC]
• Calci-Mix [OTC] [DSC]
• Calcium 600 [OTC]
• Calcium Antacid Extra Strength [OTC]
• Calcium Antacid Ultra Max St [OTC]
• Calcium Antacid [OTC]
• Calcium High Potency [OTC]
• Caltrate 600 [OTC]
• Florical [OTC]
• Maalox Childrens [OTC]
• Maalox [OTC]
• Os-Cal [OTC] [DSC]
• Oysco 500 [OTC]
• Titralac [OTC]
• Tums Chewy Bites [OTC]
• Tums Chewy Delights [OTC]
• Tums E-X 750 [OTC]
• Tums Freshers [OTC]
• Tums Kids [OTC]
• Tums Lasting Effects [OTC]
• Tums Smoothies [OTC]
• Tums Ultra 1000 [OTC]
• Tums [OTC]

Store between 15°C to 30°C (59°F to 86°F). Protect oral suspension from freezing.

Concerns related to adverse effects:

• Gastrointestinal effects: Constipation, bloating, and gas are common with calcium supplements (especially carbonate salt) (IOM, 2011).

• Hypercalcemia: Chronic hypercalcemia may result in vascular calcification and other soft-tissue calcification (IOM, 2011).

Disease-related concerns:

• Achlorhydria: Calcium absorption is impaired in achlorhydria; administration is followed by increased gastric acid secretion within 2 hours of administration especially with high doses. Common in the elderly, use an alternate salt (eg, citrate) and administer with food (IOM, 2011; Recker, 1985).

• Hypoparathyroid disease: Hypercalcemia and hypercalciuria are most likely to occur in hypoparathyroid patients receiving high doses of vitamin D.

• Kidney stones (calcium-containing): Use caution when administering calcium supplements to patients with a history of kidney stones (IOM, 2011).

• Renal insufficiency: Use with caution as these patients are more sensitive or susceptible to the effects of excess calcium (IOM, 2011).

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

• Vitamin D: It is recommended to concomitantly administer vitamin D for optimal calcium absorption when used for the treatment or prevention of conditions related to bone health (eg, osteoporosis).

Other warnings/precautions:

• Appropriate product selection: Multiple salt forms of calcium exist; close attention must be paid to the salt form when ordering and administering calcium; incorrect selection or substitution of one salt for another without proper dosage adjustment may result in serious over or under dosing.

Applies to calcium carbonate: oral suspension, oral tablet, oral tablet chewable