Calcium Antacid 500mg Chw Tablets

Manufacturer MAJOR PHARMACEUTICALS Active Ingredient Calcium Carbonate Chewable Tablets (Antacid)(KAL see um KAR bun ate) Pronunciation KAL-see-um KAR-bun-ate
It is used to treat heartburn and upset stomach.It may be given to you for other reasons. Talk with the doctor.
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Drug Class
Antacid, Mineral Supplement
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Pharmacologic Class
Antacid (neutralizing agent), Calcium salt
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Pregnancy Category
Category B
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

Calcium carbonate is an antacid that works by neutralizing stomach acid to relieve heartburn, sour stomach, acid indigestion, and upset stomach. It can also be used as a calcium supplement.
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How to Use This Medicine

Taking Your Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. It's essential to follow the instructions carefully. Before swallowing, make sure to chew the medication thoroughly.

Storing and Disposing of Your Medication

Keep your medication at room temperature in a dry location. Avoid storing it in a bathroom. This will help maintain its effectiveness and safety.

Missing a Dose

Since this medication is taken as needed, do not take it more frequently than your doctor advises. If you have any questions or concerns about missed doses, consult your doctor for guidance.
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Lifestyle & Tips

  • Chew tablets thoroughly before swallowing for best results.
  • Drink a full glass of water after taking, if desired.
  • Do not take more than the recommended dose.
  • Avoid foods and drinks that trigger heartburn (e.g., spicy foods, fatty foods, caffeine, alcohol, carbonated beverages).
  • Eat smaller, more frequent meals.
  • Avoid lying down immediately after eating.
  • Elevate the head of your bed if nighttime heartburn is an issue.

Dosing & Administration

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Adult Dosing

Standard Dose: 500-1000 mg (1-2 tablets) as needed, not to exceed 7500 mg (15 tablets) in 24 hours.
Dose Range: 500 - 7500 mg

Condition-Specific Dosing:

heartburn: Chew 1-2 tablets as symptoms occur.
acidIndigestion: Chew 1-2 tablets as symptoms occur.
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Pediatric Dosing

Neonatal: Not established
Infant: Not established
Child: For children 2-11 years: Consult a doctor. Typical dose is 250-500 mg as needed, not to exceed 2500 mg in 24 hours.
Adolescent: For adolescents 12 years and older: Same as adult dosing.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor for hypercalcemia.
Moderate: Use with caution; monitor for hypercalcemia. Avoid chronic high doses.
Severe: Contraindicated due to risk of hypercalcemia and metabolic alkalosis.
Dialysis: Contraindicated for antacid use; may be used as a phosphate binder under strict medical supervision.

Hepatic Impairment:

Mild: No specific adjustment needed.
Moderate: No specific adjustment needed.
Severe: No specific adjustment needed.

Pharmacology

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Mechanism of Action

Calcium carbonate acts as an antacid by neutralizing hydrochloric acid in the stomach to form calcium chloride, water, and carbon dioxide. This increases gastric pH, reducing heartburn and indigestion symptoms. As a calcium supplement, it provides elemental calcium for bone health and other physiological functions.
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Pharmacokinetics

Absorption:

Bioavailability: Variable (15-30% for calcium absorption, immediate for antacid effect)
Tmax: Not applicable for antacid effect (immediate). For systemic calcium absorption, variable (1-4 hours).
FoodEffect: Food can enhance calcium absorption. For antacid effect, can be taken with or without food.

Distribution:

Vd: Not applicable for antacid effect. Systemic calcium is distributed throughout the body, primarily in bone.
ProteinBinding: Approximately 45% bound to plasma proteins (primarily albumin).
CnssPenetration: Limited

Elimination:

HalfLife: Not applicable for antacid effect. Systemic calcium half-life is complex and regulated by homeostatic mechanisms.
Clearance: Not applicable for antacid effect. Systemic calcium is primarily excreted renally.
ExcretionRoute: Fecal (unabsorbed calcium), Renal (absorbed calcium)
Unchanged: Most of the ingested calcium carbonate is excreted unchanged in feces if not absorbed.
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Pharmacodynamics

OnsetOfAction: Immediate (for antacid effect)
PeakEffect: Immediate (for antacid effect)
DurationOfAction: 1-3 hours (for antacid effect)

Safety & Warnings

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Side Effects

Serious Side Effects: Seek Medical Help Immediately
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical attention right away:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.

Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience:
- Constipation
or any other side effects that bother you or do not go away.

Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Symptoms worsen or do not improve after 2 weeks of use.
  • Severe stomach pain or cramping.
  • Black, tarry stools (may indicate gastrointestinal bleeding).
  • Signs of hypercalcemia: severe constipation, nausea/vomiting, unusual tiredness, increased thirst/urination, muscle weakness, confusion.
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Before Using This Medicine

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have elevated calcium levels in your blood.

This medication may interact with other health conditions or medications. To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:

All prescription and over-the-counter (OTC) medications you are currently taking
Any natural products or vitamins you are using
* Your existing health problems

Before starting, stopping, or adjusting the dose of any medication, including this one, consult with your doctor to confirm that it is safe to do so. This will help prevent potential interactions and ensure the safe use of this medication.
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Precautions & Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. If you have a known allergy to tartrazine (also referred to as FD&C Yellow No. 5), consult your doctor, as some formulations of this drug may contain this ingredient.

When taking this medication, be aware that it may interfere with the absorption of other oral medications. To minimize potential interactions, your doctor may advise you to take other oral drugs at a different time than this medication. Discuss your medication schedule with your doctor to ensure safe and effective treatment.

If you are pregnant, planning to become pregnant, or are currently breastfeeding, notify your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby, allowing you to make an informed decision about your treatment.
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Overdose Information

Overdose Symptoms:

  • Severe constipation
  • Nausea
  • Vomiting
  • Loss of appetite
  • Unusual weight loss
  • Muscle pain
  • Bone pain
  • Increased thirst
  • Increased urination
  • Mental/mood changes (e.g., confusion, lethargy)
  • Fatigue
  • Headache
  • Kidney stones (with chronic overdose)

What to Do:

If overdose is suspected, contact a poison control center immediately. In the US, call 1-800-222-1222. Seek emergency medical attention if symptoms are severe.

Drug Interactions

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Contraindicated Interactions

  • Thiazide diuretics (increased risk of hypercalcemia)
  • Digoxin (hypercalcemia can potentiate digoxin toxicity)
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Major Interactions

  • Tetracyclines (e.g., doxycycline, minocycline): Decreased absorption of tetracyclines.
  • Fluoroquinolones (e.g., ciprofloxacin, levofloxacin): Decreased absorption of fluoroquinolones.
  • Iron supplements (e.g., ferrous sulfate): Decreased absorption of iron.
  • Thyroid hormones (e.g., levothyroxine): Decreased absorption of thyroid hormones.
  • Bisphosphonates (e.g., alendronate): Decreased absorption of bisphosphonates.
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Moderate Interactions

  • Phenytoin: Decreased absorption of phenytoin.
  • Ketoconazole, Itraconazole (pH-dependent absorption): Decreased absorption due to increased gastric pH.
  • Mycophenolate mofetil: Decreased absorption.
  • Sodium polystyrene sulfonate (Kayexalate): Risk of metabolic alkalosis and intestinal necrosis.
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Minor Interactions

  • Non-steroidal anti-inflammatory drugs (NSAIDs): May reduce NSAID-induced gastric irritation, but no direct interaction.

Monitoring

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Routine Monitoring

Symptoms of heartburn/indigestion

Frequency: As needed

Target: Relief of symptoms

Action Threshold: If symptoms persist or worsen after 2 weeks of use, consult a doctor.

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Symptom Monitoring

  • Constipation
  • Nausea
  • Stomach upset
  • Loss of appetite
  • Unusual weight loss
  • Muscle pain
  • Bone pain
  • Increased thirst
  • Increased urination
  • Mental/mood changes (e.g., confusion, lethargy)
  • Fatigue
  • Headache

Special Patient Groups

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Pregnancy

Generally considered safe for use as an antacid during pregnancy when used as directed. It is also a common source of calcium supplementation during pregnancy. Consult a healthcare provider before use.

Trimester-Specific Risks:

First Trimester: Low risk, commonly used.
Second Trimester: Low risk, commonly used.
Third Trimester: Low risk, commonly used.
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Lactation

Considered safe for use during breastfeeding. Calcium is a natural component of breast milk, and calcium carbonate is unlikely to cause adverse effects in the infant.

Infant Risk: Low risk
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Pediatric Use

Use in children under 12 years should be under the guidance of a healthcare professional. Dosing is age and weight-dependent. Risk of milk-alkali syndrome with excessive intake.

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Geriatric Use

Use with caution in elderly patients, especially those with pre-existing renal impairment, as they may be more susceptible to hypercalcemia and milk-alkali syndrome. Consider potential drug interactions due to polypharmacy.

Clinical Information

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Clinical Pearls

  • Chew tablets thoroughly for optimal antacid effect.
  • Separate administration of calcium carbonate from other medications by at least 2 hours before or 4-6 hours after to minimize drug interactions, especially with antibiotics (tetracyclines, fluoroquinolones), thyroid hormones, and bisphosphonates.
  • While effective for immediate relief, calcium carbonate's antacid effect is relatively short-lived compared to H2 blockers or PPIs.
  • Chronic high doses can lead to hypercalcemia and milk-alkali syndrome, especially in individuals with renal impairment.
  • Can cause constipation; increasing fluid and fiber intake may help.
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Alternative Therapies

  • Magnesium hydroxide (Milk of Magnesia)
  • Aluminum hydroxide (e.g., Amphojel)
  • Sodium bicarbonate (e.g., Alka-Seltzer)
  • H2 receptor blockers (e.g., famotidine, ranitidine)
  • Proton pump inhibitors (e.g., omeprazole, lansoprazole)
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Cost & Coverage

Average Cost: $5 - $20 per 60-150 chewable tablets
Generic Available: Yes
Insurance Coverage: OTC (Over-The-Counter), generally not covered by insurance unless prescribed or part of an FSA/HSA.
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General Drug Facts

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.