Calcium Carbonate

Prescribing Information (Research Brand)

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

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 Population

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

  • A Cal Chewable Tablet
    250 mg
    Acme Laboratories Limited.
    Unit Price : ৳ 1.50
  • A Cal Tablet
    250 mg
    Acme Laboratories Limited.
    Unit Price : ৳ 1.00
  • A Cal Tablet
    500 mg
    Acme Laboratories Limited.
    Unit Price : ৳ 6.01
  • Acical Tablet
    500 mg
    ACI Limited.
    Unit Price : ৳ 4.00
  • Acical JR Chewable Tablet
    250 mg
    ACI Limited.
    Unit Price : ৳ 3.01
  • Ambeecal Tablet
    500 mg
    Ambee Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Apocal Tablet
    500 mg
    Apex Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Apocal Chewable Tablet
    250 mg
    Apex Pharmaceuticals Ltd.
    Unit Price : ৳ 1.50
  • Aristocal Tablet
    500 mg
    Beximco Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Bonacal Tablet
    500 mg
    Marksman Pharmaceuticals Ltd.
    Unit Price : ৳ 2.21
  • Boncal Tablet
    500 mg
    Albion Pharmaceuticals Ltd.
    Price not available
  • Boni Tablet
    500 mg
    Delta Pharma Limited
    Unit Price : ৳ 3.00
  • Bpcal Tablet
    500 mg
    Bristol Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Cabonate Tablet
    500 mg
    Millat Pharmaceuticals Limited
    Unit Price : ৳ 3.50
  • Cal Chewable Tablet
    250 mg
    Pacific Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Cal Tablet
    500 mg
    Pacific Pharmaceuticals Ltd.
    Unit Price : ৳ 5.00
  • Cal Aid Tablet
    500 mg
    Ethical Drug Ltd.
    Price not available
  • Cal Up Tablet
    500 mg
    Sonear Laboratories Ltd.
    Price not available
  • Calbo Tablet
    500 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 5.00
  • Calbo Jr Chewable Tablet
    250 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Calbon Tablet
    500 mg
    Aristopharma Ltd.
    Unit Price : ৳ 5.00
  • Calbonat Tablet
    500 mg
    Millat Pharmaceuticals Limited
    Unit Price : ৳ 3.50
  • Calcar Tablet
    500 mg
    Cipla Ltd.
    Price not available
  • Calci D Tablet
    500 mg
    Rephco Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Calcibo Tablet
    500 mg
    Astra Biopharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Calcibost Tablet
    500 mg
    Sharif Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Calcicar Tablet
    250 mg
    Incepta Pharmaceuticals Limited
    Unit Price : ৳ 1.50
  • Calcicar Tablet
    500 mg
    Incepta Pharmaceuticals Limited
    Unit Price : ৳ 2.50
  • Calcifil Tablet
    500 mg
    Gaco Pharmaceuticals Ltd.
    Unit Price : ৳ 3.25
  • Calcin Tablet
    500 mg
    Renata Limited
    Unit Price : ৳ 4.25
  • Calciton Tablet
    500 mg
    Chemist Laboratories Limited.
    Unit Price : ৳ 2.00
  • Calcium Chewable Tablet
    250 mg
    Albion Pharmaceuticals Ltd.
    Price not available
  • Calcium Tablet
    500 mg
    Essential Drugs Company Ltd.
    Unit Price : ৳ 1.70
  • Calcium 500 Tablet
    500 mg
    APC Pharma Ltd.
    Unit Price : ৳ 2.00
  • Calcium A Tablet
    500 mg
    Ad-din pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Calcium DS Tablet
    500 mg
    Albion Pharmaceuticals Ltd.
    Price not available
  • Calcium Sandoz Chewable Tablet
    250 mg
    Sandoz
    Unit Price : ৳ 4.00
  • Calcizen DS Tablet
    500 mg
    Zenith Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Calcon Tablet
    500 mg
    Crystal Pharmaceuticals Ltd.
    Price not available
  • Caldical Tablet
    500 mg
    Ziska Pharmaceuticals Ltd.
    Unit Price : ৳ 2.50
  • Caldil Tablet
    500 mg
    Drug International Ltd.
    Unit Price : ৳ 3.00
  • Caletal Tablet
    500 mg
    United Chemicals & Pharmaceuticals Ltd.
    Price not available
  • Calfeed Tablet
    500 mg
    Apollo Pharmaceutical Laboratories Ltd.
    Unit Price : ৳ 2.00
  • Calfor Tablet
    500 mg
    Asiatic Laboratories Ltd.
    Unit Price : ৳ 2.50
  • Calium Tablet
    500 mg
    Pharmadesh Laboratories Ltd.
    Unit Price : ৳ 2.50
  • Calmax Tablet
    500 mg
    Hudson Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Calmet Tablet
    500 mg
    Somatec Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Calmi Tablet
    500 mg
    Alco Pharma Ltd.
    Unit Price : ৳ 4.00
  • Calos Tablet
    500 mg
    Modern Pharmaceuticals Limited
    Unit Price : ৳ 4.00
  • Calpo Tablet
    500 mg
    Medicon Pharmaceuticals Ltd.
    Unit Price : ৳ 0.95
  • Calsan Tablet
    500 mg
    Novartis (Bangladesh) Ltd.
    Price not available
  • Calsil Tablet
    500 mg
    Silva Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Calsto Tablet
    500 mg
    Monicopharma Limited
    Unit Price : ৳ 2.00
  • Caltonic Tablet
    500 mg
    Globex Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Carben Tablet
    500 mg
    Benham Pharmaceuticals Ltd.
    Unit Price : ৳ 3.50
  • Carbocal Tablet
    500 mg
    Globe Pharmaceuticals Limited.
    Unit Price : ৳ 3.50
  • Casalt Tablet
    500 mg
    Kemiko Pharmaceuticals Ltd.
    Unit Price : ৳ 4.01
  • Cenet Tablet
    500 mg
    Central Pharmaceuticals Ltd (CPL)
    Unit Price : ৳ 1.60
  • Cinet Tablet
    500 mg
    Belsen Pharmaceuticals Ltd.
    Price not available
  • Cium Tablet
    500 mg
    National Laboratories Ltd.
    Price not available
  • Costin Tablet
    250 mg
    General Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Costin Tablet
    500 mg
    General Pharmaceuticals Ltd.
    Unit Price : ৳ 3.01
  • Cpcal Tablet
    500 mg
    Cosmo Pharma Laboratories Ltd.
    Unit Price : ৳ 2.00
  • Edical Tablet
    500 mg
    Edruc Ltd.
    Unit Price : ৳ 2.00
  • Eurocal Tablet
    500 mg
    Euro Pharma Ltd.
    Unit Price : ৳ 5.00
  • Evecal Tablet
    500 mg
    Everest Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Forbon Tablet
    500 mg
    Social Marketing Company
    Unit Price : ৳ 3.00
  • Gravite Tablet
    500 mg
    Bios Pharmaceuticals Ltd.
    Price not available
  • Hical Tablet
    500 mg
    Innova Pharmaceuticals Limited.
    Price not available
  • Indocal Tablet
    500 mg
    Indo Bangla Pharmaceutical
    Unit Price : ৳ 2.00
  • Ipical Tablet
    500 mg
    Ibn-Sina Pharmaceuticals Ltd.
    Unit Price : ৳ 3.50
  • Isocal Tablet
    500 mg
    Doctor’s Chemical Works Ltd.
    Unit Price : ৳ 4.00
  • Jasocal Tablet
    250 mg
    Jayson Pharma Ltd.
    Unit Price : ৳ 1.50
  • Jasocal Tablet
    500 mg
    Jayson Pharma Ltd.
    Unit Price : ৳ 2.00
  • Kidcal Chewable Tablet
    250 mg
    Acme Laboratories Limited.
    Unit Price : ৳ 1.50
  • Maxcal Tablet
    500 mg
    Novus Pharmaceuticals Ltd.
    Unit Price : ৳ 3.25
  • Maxical Tablet
    500 mg
    Orion Pharma Ltd.
    Unit Price : ৳ 3.52
  • Med Cal Tablet
    500 mg
    Medimet Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Miracal Tablet
    500 mg
    Navana Pharmaceuticals Ltd.
    Unit Price : ৳ 4.00
  • Miracal J Chewable Tablet
    250 mg
    Navana Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Monocal Tablet
    500 mg
    Concord Pharmaceuticals Ltd.
    Unit Price : ৳ 4.01
  • Mycal Tablet
    500 mg
    Organic Health Care
    Unit Price : ৳ 4.50
  • Myocal D Tablet
    500 mg
    Nipa Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Mystocal Tablet
    500 mg
    Mystic Pharmaceuticals Ltd.
    Unit Price : ৳ 2.50
  • Naafcal Tablet
    500 mg
    Naafco Pharma Ltd.
    Price not available
  • Neocal Tablet
    500 mg
    The White Horse Pharma
    Unit Price : ৳ 2.50
  • Onecal Tablet
    500 mg
    One Pharma Ltd.
    Price not available
  • Oracal Tablet
    500 mg
    Amico Laboratories Ltd.
    Unit Price : ৳ 2.00
  • Orbical Tablet
    500 mg
    Orbit Pharmaceuticals Ltd
    Unit Price : ৳ 2.10
  • Orthocal Tablet
    500 mg
    Biopharma Laboratories Ltd.
    Unit Price : ৳ 4.00
  • Oscal Tablet
    250 mg
    Unimed Unihealth MFG. Ltd.
    Price not available
  • Oscal Tablet
    500 mg
    Unimed Unihealth MFG. Ltd.
    Unit Price : ৳ 3.50
  • Ossi Tablet
    500 mg
    Kumudini Pharma Ltd.
    Unit Price : ৳ 3.00
  • Ostacid Tablet
    500 mg
    Rangs Pharmaceuticals Ltd.
    Unit Price : ৳ 3.50
  • Ostim Tablet
    500 mg
    Hallmark Pharmaceuticals Ltd.
    Unit Price : ৳ 2.52
  • Ostimet Tablet
    500 mg
    Virgo Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Ostocal Tablet
    500 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 4.00
  • Ostocal JR Chewable Tablet
    250 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 3.00
  • Ostocurb Tablet
    500 mg
    Aexim Pharmaceuticals Ltd.
    Unit Price : ৳ 1.60
  • Ostogen Tablet
    500 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 2.87
  • Ostogen JR Chewable Tablet
    250 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 1.77
  • Ostoplus Tablet
    500 mg
    Desh Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Peocal Tablet
    500 mg
    Peoples Pharma Ltd.
    Price not available
  • Phoenix Calcium Tablet
    500 mg
    Phoenix Chemicals Laboratory (BD) Ltd
    Unit Price : ৳ 2.00
  • Precal Tablet
    500 mg
    Premier Pharmaceuticals Ltd.
    Unit Price : ৳ 2.53
  • Procala Tablet
    500 mg
    Shamsul Al-Amin Pharmaceutical Ltd.
    Unit Price : ৳ 2.00
  • Protebon Tablet
    500 mg
    Beacon Pharmaceuticals Ltd.
    Unit Price : ৳ 2.00
  • Rejuven Tablet
    500 mg
    Novo Healthcare and Pharma Ltd.
    Unit Price : ৳ 3.00
  • Rejuven JR Tablet
    250 mg
    Novo Healthcare and Pharma Ltd.
    Price not available
  • Rocal Tablet
    500 mg
    Healthcare Pharmacuticals Ltd.
    Unit Price : ৳ 5.00
  • Saltonate Tablet
    500 mg
    Salton Pharmaceuticals Ltd.
    Price not available
  • Sancal Tablet
    500 mg
    Prime Pharmaceuticals Ltd.
    Unit Price : ৳ 3.00
  • Sandocal Tablet
    250 mg
    Sandoz
    Price not available
  • Sandocal Tablet
    500 mg
    Sandoz
    Unit Price : ৳ 6.00
  • See-Cal Tablet
    500 mg
    Seema Pharmaceuticals Ltd.
    Unit Price : ৳ 3.25
  • Silcal Tablet
    500 mg
    Silco Pharmaceutical Ltd.
    Price not available
  • Starcal Tablet
    500 mg
    NIPRO JMI Pharma Ltd.
    Unit Price : ৳ 5.00
  • Sucal Tablet
    500 mg
    Supreme Pharmaceutical Ltd.
    Unit Price : ৳ 3.25
  • Suplecal Tablet
    500 mg
    Cosmic Pharma Limited
    Unit Price : ৳ 3.00
  • Sycal Tablet
    500 mg
    MST Pharma
    Unit Price : ৳ 2.50
  • Tumy Chewable Tablet
    240 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 1.50
  • Unate Tablet
    500 mg
    Union Pharmaceuticals Ltd.
    Price not available
  • Xcid Tablet
    1000 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 2.01
  • Xtracal Tablet
    500 mg
    Pharmasia Ltd.
    Unit Price : ৳ 3.50