Calcium Carbonate

Innovator's Monograph

Indications

Calcium Carbonate 250 mg or 500 mg: This is used for the treatment or prevention of calcium depletion in patients in whom dietary measures are inadequate. Conditions that may be associated with calcium deficiency include hypoparathyroidism, achlorhydria, chronic diarrhea, vitamin D deficiency, steatorrhea, sprue, pregnancy and lactation, menopause, pancreatitis, renal failure, alkalosis, and hyperphosphataemia. Calcium Carbonate is being used increasingly often to treat hyperphosphataemia in chronic renal failure as well as those on continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis.

Many patients are unable to tolerate sufficient doses for complete phosphate control and require additional measures such as stringent dietary phosphate restriction or relatively small doses of aluminium hydroxide. Calcium Carbonate containing preparations can provide short-term relief of dyspeptic systems but are no longer recommended for long-term treatment of peptic ulceration.

Calcium Carbonate 1000 mg: This is indicated for the management of conditions associated with hyperidity and for fast relief of acid indigestion, heartburn, sour stomach and upset stomach.

Therapeutic Class

Minerals in bone formation, Specific mineral preparations

Pharmacology

Calcium carbonate reacts with gastric acid to produce a salt and water. For calcium carbonate the postulated chemical reaction is:

CaCO3 + 2HCl = CaCl2 + H2O + CO2

Two grams of calcium carbonate will readily bring 100 ml of hydrochloric acid to a pH above 6. The increase in gastric pH diminishes the activity of pepsin in the gastric secretion. Up to 30% of the oral calcium load may be absorbed.

Dosage & Administration

Calcium Carbonate is always used orally and when used as an antacid the recommended doses for adults are equivalent to 540-2000 mg Calcium Carbonate per day, doses for children being half of those for adults. As a dietary supplement, such as for the prevention of osteoporosis, 1250-3750 mg Calcium Carbonate (500-1500 mg calcium) daily is recommended in general, but again this will need to be tailored to the individual patient depending on any specific disease such as Calcium deficiency, malabsorption or parathyroid function. In pregnancy and lactation the recommended daily dose of calcium is 1200-1500 mg. In chronic renal failure the doses used vary from 2.5 - 9.0 gm Calcium Carbonate per day and need to be adjusted according to the individual patient. To maximize effective phosphate binding in this context the Calcium Carbonate should be given with meals.

Interaction

Calcium Carbonate may enhance the cardiac effects of digoxin and other cardiac glycosides, if systemic hypercalcaemia occurs. Calcium Carbonate may interfere with the absorption of concomitantly administered tetracycline preparations and in chronic renal failure modification of vitamin D therapy may be required to avoid hypercalcaemia when Calcium Carbonate is used as the primary phosphate binder.

Contraindications

Hypersensitivity to the Calcium Carbonate or any inactive ingredient of the medication. Hypercalcemia (e.g. in hyperparathyroidism, overdosage of vitamin D, demineralizing tumours such as plasmacytomas and bone metastases), severe hypercalcuria, several renal insufficiency.

Side Effects

Orally administered Calcium Carbonate may be irritating to the GI tract. It may also cause constipation. Hypercalcaemia is rarely produced by administration of calcium alone, but may occur when large doses are given to patients with chronic renal failure.

Pregnancy & Lactation

Calcium containing drugs are used widely in pregnancy by way of oral calcium supplementation. Calcium Carbonate can be used in lactating women too.

Precautions & Warnings

In the presence of mild hypercalciuria, excretion levels must be carefully monitored and where necessary the dose of calcium carbonate should be reduced or treatment should be stopped. Patients with a history of stone formation should also be recommended to increase their fluid intake. High dosage of vitamin D should be avoided during Calcium therapy unless specifically indicated.

Use in Special Populations

USE IN CHILDREN: Calcium carbonate has been extensively studied in children and infants with chronic renal failure and is both safe and effective.

USE IN ELDERLY: In case of elderly patients with renal failure when calcium carbonate is taken constipation may be troublesome one for this group. For this reason, monitoring of serum calcium and phosphate is of course indicated for elderly patients.

Storage Conditions

Store in a cool, dry place in controlled room temperature.

Available Brand Names

  • Chewable Tablet A-Cal
    250 mg
    ACME Laboratories Ltd.
    Unit Price : ৳ 1.50
  • Tablet A-Cal
    250 mg
    ACME Laboratories Ltd.
    Unit Price : ৳ 1.00
  • Tablet A-Cal
    500 mg
    ACME Laboratories Ltd.
    Unit Price : ৳ 5.00
  • Tablet Acical
    500 mg
    ACI Limited
    Unit Price : ৳ 4.01
  • Chewable Tablet Acical JR
    250 mg
    ACI Limited
    Unit Price : ৳ 3.01
  • Tablet Ambeecal
    500 mg
    Ambee Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Tablet Aristocal
    500 mg
    Beximco Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Tablet Bonacal
    500 mg
    Marksman Pharmaceuticals Ltd.
    Unit Price : ৳ 2.21
  • Tablet Bpcal
    500 mg
    Bristol Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Cabonate
    500 mg
    Millat Pharmaceuticals Ltd.
    Unit Price : ৳ 2.50
  • Chewable Tablet Cal
    250 mg
    Pacific Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Cal
    500 mg
    Pacific Pharmaceuticals Ltd.
    Unit Price : ৳ 3.50
  • Tablet Cal-aid
    500 mg
    Ethical Drug Ltd.
    Unit Price : ৳ 2.00
  • Tablet Calbo
    500 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 5.00
  • Chewable Tablet Calbo Jr
    250 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 3.01
  • Tablet Calbon
    500 mg
    Aristopharma Ltd.
    Unit Price : ৳ 5.00
  • Tablet Calci-D
    500 mg
    Rephco Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Calcibo
    500 mg
    Astra Biopharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Tablet Calcicar
    500 mg
    Incepta Pharmaceuticals Ltd.
    Unit Price : ৳ 2.50
  • Chewable Tablet Calcid
    1000 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 2.01
  • Tablet Calcifil
    500 mg
    Gaco Pharmaceuticals Ltd.
    Unit Price : ৳ 3.27
  • Tablet Calcin
    500 mg
    Renata Limited
    Unit Price : ৳ 5.00
  • Tablet Calciton
    500 mg
    Chemist Laboratories Ltd.
    Unit Price : ৳ 2.00
  • Tablet Calcium
    500 mg
    Essential Drugs Company Ltd.
    Unit Price : ৳ 1.70
  • Tablet Calcium-A
    500 mg
    Ad-din pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Tablet Calcizen DS
    500 mg
    Zenith Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Caldil
    500 mg
    Drug International Ltd.
    Unit Price : ৳ 4.00
  • Tablet Caletal
    500 mg
    United Chemicals & Pharmaceuticals Ltd.
    Unit Price : ৳ 3.02
  • Tablet Calfeed
    500 mg
    Apollo Pharmaceutical Ltd.
    Unit Price : ৳ 2.00
  • Tablet Calfor
    500 mg
    Asiatic Laboratories Ltd.
    Unit Price : ৳ 1.82
  • Tablet Calium
    500 mg
    Pharmadesh Laboratories Ltd.
    Unit Price : ৳ 2.50
  • Tablet Calmax
    500 mg
    Hudson Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Calmet
    500 mg
    Somatec Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Tablet Calmi
    500 mg
    Alco Pharma Ltd.
    Unit Price : ৳ 4.01
  • Tablet Calos
    500 mg
    Modern Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Tablet Calpo
    500 mg
    Medicon Pharmaceuticals Ltd.
    Unit Price : ৳ 2.84
  • Tablet Calsil
    500 mg
    Silva Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Tablet Calsto
    500 mg
    Monicopharma Ltd.
    Unit Price : ৳ 2.00
  • Tablet Caltonic
    500 mg
    Globex Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Tablet Carben
    500 mg
    Benham Pharmaceuticals Ltd.
    Unit Price : ৳ 3.50
  • Tablet Carbocal
    500 mg
    Globe Pharmaceuticals Ltd.
    Unit Price : ৳ 2.20
  • Tablet Casalt
    500 mg
    Kemiko Pharmaceuticals Ltd.
    Unit Price : ৳ 4.01
  • Tablet Cenet
    500 mg
    Central Pharmaceuticals Ltd.
    Unit Price : ৳ 1.60
  • Tablet Cinet
    500 mg
    Belsen Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Costin
    500 mg
    General Pharmaceuticals Ltd.
    Unit Price : ৳ 3.01
  • Tablet Cpcal
    500 mg
    Cosmo Pharma Laboratories Ltd.
    Unit Price : ৳ 2.00
  • Tablet Edical
    500 mg
    Edruc Ltd.
    Unit Price : ৳ 2.00
  • Tablet Eurocal
    500 mg
    Euro Pharma Ltd.
    Unit Price : ৳ 4.50
  • Tablet Evecal
    500 mg
    Everest Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Forbon
    500 mg
    Social Marketing Company
    Unit Price : ৳ 3.00
  • Tablet Indocal
    500 mg
    Indo Bangla Pharmaceutical
    Unit Price : ৳ 2.00
  • Tablet Ipical
    500 mg
    Ibn-Sina Pharmaceuticals Ltd.
    Unit Price : ৳ 3.50
  • Tablet Isocal
    500 mg
    Doctor’s Chemical Works Ltd.
    Unit Price : ৳ 1.86
  • Tablet Jasocal
    500 mg
    Jayson Pharma Ltd.
    Unit Price : ৳ 2.01
  • Chewable Tablet Jasocal
    250 mg
    Jayson Pharma Ltd.
    Unit Price : ৳ 1.51
  • Chewable Tablet Kidcal
    250 mg
    ACME Laboratories Ltd.
    Unit Price : ৳ 1.51
  • Tablet Maxcal
    500 mg
    Novus Pharmaceuticals Ltd.
    Unit Price : ৳ 3.25
  • Tablet Maxical
    500 mg
    Orion Pharma Ltd.
    Unit Price : ৳ 3.52
  • Tablet Med Cal
    500 mg
    Medimet Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Miracal
    500 mg
    Navana Pharmaceuticals Ltd.
    Unit Price : ৳ 4.50
  • Chewable Tablet Miracal-J
    250 mg
    Navana Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Monocal
    500 mg
    Concord Pharmaceuticals Ltd.
    Unit Price : ৳ 4.01
  • Tablet Mycal
    500 mg
    Organic Health Care
    Unit Price : ৳ 3.01
  • Tablet Myocal
    500 mg
    Nipa Pharmaceuticals Ltd.
    Unit Price : ৳ 2.64
  • Tablet Mystocal
    500 mg
    Mystic Pharmaceuticals Ltd.
    Unit Price : ৳ 2.54
  • Tablet Neocal
    500 mg
    The White Horse Pharma
    Unit Price : ৳ 2.47
  • Tablet Oracal
    500 mg
    Amico Laboratories Ltd.
    Unit Price : ৳ 2.00
  • Tablet Orbical
    500 mg
    Orbit Pharmaceuticals Ltd.
    Unit Price : ৳ 2.10
  • Tablet Orthocal
    500 mg
    Biopharma Laboratories Ltd.
    Unit Price : ৳ 4.00
  • Tablet Orthocal
    250 mg
    Biopharma Laboratories Ltd.
    Unit Price : ৳ 1.80
  • Tablet Oscal
    500 mg
    Unimed Unihealth MFG. Ltd.
    Unit Price : ৳ 3.50
  • Tablet Ossi
    500 mg
    Kumudini Pharma Ltd.
    Unit Price : ৳ 3.00
  • Tablet Ostacid
    500 mg
    Rangs Pharmaceuticals Ltd.
    Unit Price : ৳ 3.51
  • Tablet Ostim
    500 mg
    Hallmark Pharmaceuticals Ltd.
    Unit Price : ৳ 2.52
  • Tablet Ostimet
    500 mg
    Virgo Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Tablet Ostocal
    500 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 4.00
  • Chewable Tablet Ostocal JR
    250 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 3.00
  • Tablet Ostocurb
    500 mg
    Aexim Pharmaceuticals Ltd.
    Unit Price : ৳ 1.60
  • Tablet Ostogen
    500 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 3.26
  • Chewable Tablet Ostogen Jr.
    250 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 2.01
  • Tablet Ostoplus
    500 mg
    Desh Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Tablet Phoenix Calcium
    500 mg
    Phoenix Chemical Laboratory
    Unit Price : ৳ 2.00
  • Tablet Precal
    500 mg
    Premier Pharmaceuticals Ltd.
    Unit Price : ৳ 2.53
  • Tablet Precal
    500 mg
    Premier Pharmaceuticals Ltd.
    30 tablet pot : ৳ 75.90
  • Tablet Procala
    500 mg
    Marker Pharma Ltd.
    Unit Price : ৳ 2.00
  • Tablet Protebon
    500 mg
    Beacon Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Tablet Rejuven
    500 mg
    Novo Healthcare and Pharma Ltd.
    Unit Price : ৳ 3.00
  • Tablet Rocal
    500 mg
    Healthcare Pharmacuticals Ltd.
    Unit Price : ৳ 5.00
  • Tablet Saltonate
    500 mg
    Salton Pharmaceuticals Ltd.
    Unit Price : ৳ 3.01
  • Tablet Sancal
    500 mg
    Prime Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Tablet Sandocal
    500 mg
    SANDOZ (A Novartis Division)
    Unit Price : ৳ 6.00
  • Tablet See-Cal
    500 mg
    Seema Pharmaceuticals Ltd.
    Unit Price : ৳ 3.25
  • Tablet Silcal
    500 mg
    Silco Pharmaceutical Ltd.
    Price not available
  • Tablet Starcal
    500 mg
    NIPRO JMI Pharma Ltd.
    Unit Price : ৳ 5.00
  • Tablet Sucal
    500 mg
    Supreme Pharmaceutical Ltd.
    Unit Price : ৳ 4.00
  • Tablet Suplecal
    500 mg
    Cosmic Pharma Ltd.
    Unit Price : ৳ 3.00
  • Tablet Sycal
    500 mg
    MST Pharma
    Unit Price : ৳ 2.50
  • Tablet Xcid
    1000 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Tablet Xtracal
    500 mg
    Pharmasia Limited
    Unit Price : ৳ 3.50