A Cal 500

Precaution

Renal impairment, hypoparathyroid disease, hypercalcaemia-associated diseases. Calcium absorption is impaired in achlorhydria; use an alternate salt and take with food. Caution when used in patients with a history of kidney stones. Lactation: Safe; crosses the placenta; appears in breast milk

Indication

Heartburn, Indigestion, Calcium deficiency, Hypocalcaemia, Hyperphosphatemia, Calcium supplement, Stomach upset

Adult Dose

Adult: PO Hyperacidity: Take 1-2 tab as needed, up to a max of 16 tab/day. May suck or chew tablets. Hyperphosphataemia in chronic renal failure Initial: 2.5 g/day, up to 17 g/day in divided doses.

Renal Dose

Renal impairment: CrCl (ml/min) <25 Dosage adjustments may be needed depending on serum calcium levels.

Administration

May be taken with or without food. Take w/ meals for better absorption. Avoid taking w/ large amount of fibre-rich food.

Side Effect

Anorexia, nausea, vomiting, constipation, flatulence; hypercalcaemia; metabolic alkalosis; milk-alkali syndrome, tissue-calcification. Gastric hypersecretion and acid rebound (with prolonged use).

Pregnancy Category

Pregnancy category: C Lactation: Safe; crosses the placenta; appears in breast milk

Interaction

Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication.