Calcium Antacid 750mg Chw Tablets

Manufacturer RUGBY LABORATORIES 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 to help maintain healthy bones.
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How to Use This Medicine

To use this medication correctly, follow your doctor's instructions and read all accompanying information carefully. Take the medication as directed, chewing it thoroughly before swallowing.

To store this medication, keep it at room temperature in a dry location, avoiding storage in a bathroom.

If you miss a dose, remember that this medication is taken as needed. Do not take it more frequently than prescribed by your doctor.
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Lifestyle & Tips

  • Chew tablets thoroughly before swallowing for best results.
  • Do not take the maximum dose for more than 2 weeks, unless directed by a doctor.
  • Avoid foods and drinks that trigger heartburn (e.g., fatty foods, spicy foods, caffeine, alcohol, carbonated beverages).
  • Eat smaller, more frequent meals.
  • Do not lie down immediately after eating.
  • Elevate the head of your bed if heartburn is worse at night.
  • If using as a calcium supplement, take with food to enhance absorption.

Dosing & Administration

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Adult Dosing

Standard Dose: 750 mg to 1500 mg (1 to 2 tablets) as needed, not to exceed 7500 mg (10 tablets) in 24 hours.
Dose Range: 750 - 7500 mg

Condition-Specific Dosing:

heartburn_acid_indigestion: 750 mg to 1500 mg as symptoms occur, typically not more than 2-4 times daily.
calcium_supplementation: Dosage varies widely based on dietary intake and individual needs, typically 500-1000 mg elemental calcium daily in divided doses with meals.
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Pediatric Dosing

Neonatal: Not established
Infant: Not established
Child: For children 2-11 years: Consult a physician. Dosing is typically lower, e.g., 375 mg to 750 mg as needed, not to exceed 2500 mg in 24 hours. For children under 2 years: Not recommended without physician supervision.
Adolescent: For adolescents 12 years and older: Same as adult dosing for antacid use.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor serum calcium.
Moderate: Use with caution; monitor serum calcium closely. Increased risk of hypercalcemia.
Severe: Contraindicated or use with extreme caution; significant risk of hypercalcemia and milk-alkali syndrome. Avoid if possible.
Dialysis: Contraindicated for antacid use due to hypercalcemia risk. May be used as a phosphate binder under strict medical supervision, but other agents are preferred.

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, which can relieve symptoms of heartburn and indigestion. As a calcium supplement, it provides elemental calcium for bone health and various physiological functions.
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Pharmacokinetics

Absorption:

Bioavailability: Approximately 20-30% of elemental calcium is absorbed from the GI tract, depending on gastric pH, dose, and presence of food. Absorption is enhanced in an acidic environment.
Tmax: Antacid effect is rapid (within minutes). Peak serum calcium levels (if absorbed) occur within 2-4 hours.
FoodEffect: Food can enhance calcium absorption by stimulating gastric acid secretion, which aids in the dissolution of calcium carbonate. However, high-fiber foods or those rich in oxalates/phytates can decrease absorption.

Distribution:

Vd: Calcium is widely distributed throughout the body, primarily in bone (99%).
ProteinBinding: Approximately 40-45% of serum calcium is protein-bound (primarily to albumin); 5-10% is complexed with anions (e.g., citrate, phosphate); and 45-50% is ionized (physiologically active).
CnssPenetration: Limited

Elimination:

HalfLife: Not applicable for calcium carbonate as a drug; calcium homeostasis is tightly regulated.
Clearance: Regulated by kidneys and bone turnover.
ExcretionRoute: Unabsorbed calcium is excreted in feces. Absorbed calcium is primarily excreted renally (glomerular filtration and tubular reabsorption).
Unchanged: Not applicable (dissociates)
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Pharmacodynamics

OnsetOfAction: Rapid (within minutes for antacid effect)
PeakEffect: Within 30 minutes for antacid effect
DurationOfAction: Approximately 30-60 minutes when taken on an empty stomach; up to 3 hours when taken with food.

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Help Right Away

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 immediate medical attention:

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
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ 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. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor for advice:

Constipation

Important Note

This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, don't hesitate to reach out to 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:

  • Severe or persistent constipation
  • Loss of appetite, nausea, vomiting
  • Unusual tiredness or muscle weakness
  • Frequent urination or increased thirst
  • Confusion or changes in mental status
  • Abdominal pain that doesn't go away
  • Symptoms of hypercalcemia (see above)
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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.
If you have elevated calcium levels in your blood.

This medication may interact with other health conditions or medications. To ensure safe treatment, provide your doctor and pharmacist with a comprehensive list of:

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

Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe to do so. This will help prevent potential interactions and ensure the best possible treatment outcome.
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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 with your doctor, as some formulations of this drug may contain tartrazine.

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 regimen with your doctor to determine the best schedule.

If you are pregnant, planning to become pregnant, or are currently breast-feeding, it is crucial to discuss the potential benefits and risks of this medication with your doctor. This conversation will help you understand the implications for 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
  • Muscle weakness, fatigue
  • Headache
  • Increased thirst and urination (polyuria, polydipsia)
  • Confusion, stupor
  • Bone pain
  • Kidney stones
  • In severe cases: cardiac arrhythmias, coma, kidney failure (milk-alkali syndrome if combined with high dairy intake)

What to Do:

Discontinue calcium carbonate. Seek immediate medical attention. For severe symptoms, call 911 or Poison Control (1-800-222-1222). Management may include hydration, loop diuretics, and in severe cases, calcitonin or bisphosphonates.

Drug Interactions

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Contraindicated Interactions

  • Cellulose sodium phosphate (risk of hypercalcemia)
  • Thiazide diuretics (increased risk of hypercalcemia, especially with high calcium doses)
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Major Interactions

  • Tetracyclines (e.g., doxycycline, minocycline): Calcium forms insoluble chelates, significantly reducing antibiotic absorption. Separate administration by at least 2-4 hours.
  • Fluoroquinolones (e.g., ciprofloxacin, levofloxacin): Calcium forms insoluble chelates, significantly reducing antibiotic absorption. Separate administration by at least 2-6 hours.
  • Iron supplements (e.g., ferrous sulfate): Calcium can inhibit iron absorption. Separate administration by at least 2 hours.
  • Thyroid hormones (e.g., levothyroxine): Calcium can bind to thyroid hormones, reducing absorption. Separate administration by at least 4 hours.
  • Bisphosphonates (e.g., alendronate, risedronate): Calcium can interfere with absorption. Separate administration by at least 30 minutes to 2 hours.
  • Phosphate binders (e.g., sevelamer, lanthanum): Concurrent use with calcium carbonate as a phosphate binder can lead to excessive calcium absorption and hypercalcemia.
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Moderate Interactions

  • Digoxin: Hypercalcemia can potentiate digoxin toxicity.
  • Calcium channel blockers (e.g., verapamil, diltiazem): High calcium intake may theoretically reduce the effectiveness of calcium channel blockers.
  • Phenytoin: Calcium can reduce phenytoin absorption.
  • Sodium polystyrene sulfonate (Kayexalate): Risk of intestinal necrosis with sorbitol-containing calcium products.
  • Vitamin D analogs (e.g., calcitriol): Increase calcium absorption, increasing hypercalcemia risk.
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Minor Interactions

  • Acid-suppressing agents (e.g., PPIs, H2 blockers): May reduce calcium carbonate dissolution and absorption if used for calcium supplementation, but not relevant for antacid effect.

Monitoring

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Baseline Monitoring

Not typically required for occasional antacid use.

Rationale: OTC product for symptomatic relief.

Timing: N/A

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Routine Monitoring

Serum Calcium

Frequency: Periodically (e.g., every 3-6 months) for chronic, high-dose use or in patients with renal impairment.

Target: 8.5-10.5 mg/dL (2.1-2.6 mmol/L)

Action Threshold: If calcium levels exceed upper limit of normal or patient develops symptoms of hypercalcemia, reduce dose or discontinue.

Renal Function (Creatinine, BUN)

Frequency: Periodically for chronic, high-dose use or in patients with pre-existing renal impairment.

Target: Normal ranges

Action Threshold: Worsening renal function may indicate risk of hypercalcemia or milk-alkali syndrome.

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Symptom Monitoring

  • Constipation
  • Rebound acid secretion (if used excessively)
  • Symptoms of hypercalcemia (nausea, vomiting, constipation, polyuria, polydipsia, muscle weakness, fatigue, confusion)
  • Symptoms of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal impairment)

Special Patient Groups

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Pregnancy

Generally considered safe for use during pregnancy for heartburn relief and calcium supplementation when used at recommended doses. Consult a healthcare provider before use.

Trimester-Specific Risks:

First Trimester: Low risk; commonly used for morning sickness and heartburn.
Second Trimester: Low risk; commonly used for heartburn.
Third Trimester: Low risk; commonly used for heartburn. Ensure adequate hydration to prevent constipation.
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Lactation

Considered safe for use during lactation. Calcium is a natural component of breast milk, and maternal use at recommended doses is unlikely to cause adverse effects in the infant.

Infant Risk: Low risk (L1)
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Pediatric Use

Not recommended for children under 2 years without physician supervision. For children 2-11 years, use only under physician guidance. Dosing must be adjusted for age and weight. Risk of constipation and potential for hypercalcemia with excessive use.

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Geriatric Use

Use with caution in elderly patients, as they may be more susceptible to constipation, hypercalcemia, and drug interactions due to age-related changes in renal function and polypharmacy. Start with lower doses and monitor for adverse effects.

Clinical Information

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Clinical Pearls

  • Calcium carbonate is a fast-acting antacid but can cause rebound acid secretion with prolonged or excessive use.
  • It is also a common calcium supplement; be mindful of total daily calcium intake from all sources (diet, supplements, antacids) to avoid hypercalcemia.
  • Chewable tablets must be chewed thoroughly to ensure proper dissolution and effectiveness.
  • Advise patients to separate calcium carbonate administration from other medications (especially antibiotics, iron, thyroid hormones) by at least 2-4 hours to prevent absorption interference.
  • Constipation is a common side effect; advise adequate fluid intake and dietary fiber.
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Alternative Therapies

  • Other antacids (e.g., aluminum hydroxide, magnesium hydroxide, sodium bicarbonate)
  • H2-receptor antagonists (e.g., famotidine, ranitidine - for longer-lasting acid reduction)
  • Proton pump inhibitors (e.g., omeprazole, esomeprazole - for more potent and prolonged acid suppression)
  • Alginic acid-containing products (e.g., Gaviscon - forms a raft to protect esophagus)
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Cost & Coverage

Average Cost: $5 - $20 per 100 tablets
Generic Available: Yes
Insurance Coverage: OTC (Over-the-Counter) - generally not covered by prescription plans unless prescribed for specific medical conditions (e.g., calcium supplementation for osteoporosis) or through 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 your 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 taken, the amount, and the time it happened.