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- What are calcium salts? How do calcium salts work?
- What are calcium salts used for?
- What are the side effects of calcium salts?
- What is the dosage for calcium salts?
- Which drugs or supplements interact with calcium salts?
- Are calcium salts safe to take if you are pregnant or breastfeeding?
- What else should you know about calcium salts?
What are calcium salts? How do calcium salts work?
Calcium is an important mineral required for the proper functioning of many organs and tissues. Calcium is needed for the heart, skeletal muscles, and nervous system to work properly. Additionally, calcium plays an important role in blood coagulation (stops bleeding).
Our bones store calcium which can be released depending on our body's needs. Calcium is naturally found in many of the foods we eat. Calcium supplements are needed when we are unable to get enough calcium from the foods we eat.
Calcium is available in various forms as salts combined with other elements which differ in the amount of calcium they contain. Because of the various forms in which calcium exists, different formulations of calcium supplements are not interchangeable on an mg per mg basis; they do not contain the same amounts of calcium. In order to compare forms of calcium, elemental calcium (i.e., the amount of calcium excluding the other elements with which the calcium is combined) can be expressed in milliequivalents (mEq) or (mg) with 1 mEq equal to approximately 20 mg). Listed below are the commonly used calcium salts and their respective calcium content.
- Calcium acetate: 250 mg (12.5 mEq) per gram
- Calcium carbonate: 400 mg (20 mEq) per gram
- Calcium chloride: 270 mg (13.5 mEq) per gram
- Calcium citrate: 210 mg (10.5 mEq) per gram
- Calcium Glubionate: 64 mg (3.2 mEq) per gram
- Calcium gluconate: 93 mg (4.65 mEq) per gram
- Calcium lactate: 130 mg (6.5 mEq) per gram
Brand names for calcium salts are Cal-Citrate, Cal-Lac, Calcionate, Calciquid, Calcitrate, Calcium Acetate, Calcium Chloride, Calciym Citrate, Calcium Gluceptate, Calcium Gluconate, Calcium Lactate, Calphosan, Calphron, Citracal, Citracal Liquitab, Citrus Calcium, Eliphos, Neo-Calglucon, Phos Cal, PhosLo, Phoslyra, Ridactate, Rolaids, Oysco, and Oyster Shell, Tums.
Calcium salts are available in generic form over the counter (OTC) without a prescription.
What are calcium salts used for?
- Calcium supplements are used in individuals who are unable to get enough calcium from their regular diet. Severe deficiency can result in low levels of calcium in the blood (hypocalcemia).
- Calcium supplements are commonly used to prevent osteoporosis (bone loss).
- Injectable calcium may be used to treat patients in cardiac arrest or those with life threatening cardiac arrhythmias (abnormal heartbeats).
- Injectable calcium may be used to treat severe hyperkalemia (abnormally high levels of blood potassium), or hypermagnesemia (abnormally high levels of blood magnesium).
- Calcium salts also are used as antacids.
What are the side effects of calcium salts?
Common side effects of calcium salts include:
Other side effects include:
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What is the dosage for calcium salts?
Doses of calcium supplements are different for different patients. Dosing depends on age, reason for taking the calcium, formulation used, and other patient specific factors.
General recommendations to prevent calcium deficiency are as follows:
- Adults ≥ 51 years of age 1200 mg by mouth per day (range 1000-1500 mg per day)
- Postmenopausal women 1200 mg by mouth per day
- Adults 19-50 years of age 1000 mg by mouth per day
- Children and adolescents 9-18 years 1300 mg by mouth per day
- Children 4-8 years of age 1000 mg by mouth per day
- Infants 6-12 months of age 200 to 260 mg by mouth per day (from all sources including breast milk, formula, and solid food)
- Neonates and infants < 6 months of age 200 mg by mouth per day (sources of calcium should only include breast milk, formula, or food)
Which drugs or supplements interact with calcium salts?
- Injectable calcium should be avoided in patients taking cardiac glycosides such as digoxin (Lanoxin) because the combination increases the risk for the development of arrhythmias (abnormal heart rhythms).
- Calcium salts may interfere with the absorption of oral phenytoin (Dilantin). Therefore, administration of phenytoin and calcium salts should be separated by at least 2 hours.
- Calcium salts also may interfere with the absorption of some antibiotics. Administration of tetracyclines or quinolone antibiotics and calcium salts should be separated by at least 2 hours.
- Calcium salts may decrease the absorption of thyroid hormones. Levothyroxine (Synthroid) and other thyroid hormones must be taken at least 4 hours before or after calcium supplements.
Are calcium salts safe to take if you are pregnant or breastfeeding?
- Adequate intake of calcium is important to maintain a healthy pregnancy, and for the proper growth and development of the fetus. No evidence of harm has been reported with the normal daily intake of calcium within the recommended dose limits. All pregnant women should seek the advice of their doctor or pharmacists to ensure that their daily intake of calcium is adequate.
- Calcium supplementation is thought to be safe and effective when used during breastfeeding. Breast milk naturally contains calcium, and calcium supplementation does not have any significant effect on the amount of calcium normally found in human milk.
What else should you know about calcium salts?
What preparations of calcium salts are available?
- Calcium acetate oral capsules: 667 mg
- Calcium acetate oral solution: 667 mg/5 ml
- Calcium acetate oral tablets: 667 mg
- Calcium chloride solution for injection 10%
- Calcium citrate oral tablets: 200 and, 950 mg
- Calcium gluconate oral tablets: 50, 500, and 650 mg
- Calcium gluconate solution for injection: 10%
- Calcium carbonate oral tablets: 500, 750, and 1000 mg
How should I keep calcium salts stored?
- Tablets should be stored at room temperature, away from heat, moisture, and direct sunlight. All medications should be kept away from children and pets.
Calcium salts (Cal-Citrate, Tums) are used to supplement calcium in the diet of individuals who cannot get enough calcium from their regular diet; to prevent osteoporosis, and to treat cardiac arrest and hyperkalemia. Side effects, drug interactions, warnings, dosage, and pregnancy and breastfeeding information should be provided prior to using any drug or supplement.
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Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication,prescription medication, and surgery.
Indigestion (Dyspepsia, Upset Stomach Pain)
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some diseases and conditions that do not involve the GI tract. Indigestion can be a chronic condition in which the symptoms fluctuate in frequency and intensity. Signs and symptoms that accompany indigestion include pain in the chest, upper abdominal pain, belching, nausea, bloating, abdominal distention, feeling full after eating only a small portion of food, and rarely, vomiting.
Low Blood Sugar (Hypoglycemia)
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include palpitations, trembling, intense hunger, sweating, nervousness, and weakness. If your blood sugars become too low, use these nearby as a quick treatment table sugar, soda, juice, and glucose tablets.
Intestinal Gas (Belching, Bloating, Flatulence)
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus. Causes of belching or burping include drinking too rapidly, anxiety, carbonated drinks, habit, and swallowing air. Learn about causes of intestinal gas, foods that cause gas and bloating, treatments that reduce excessive gas and soothe gas pain, and much more.
Hyperkalemia (High Blood Potassium)
Hyperkalemia is an abnormally high level of potassium in the blood. Hyperkalemia symptoms include nausea, fatigue, tingling sensations, or muscle weakness. Hyperkalemia may also cause no symptoms. Hyperkalemia treatment may include a low-potassium diet, medications, and intravenous glucose and insulin. Causes of hyperkalemia include kidney dysfunction, certain medications, adrenal gland diseases, and potassium shifts.
GERD (Acid Reflux, Heartburn)
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are: heartburn, regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Heartburn during Pregnancy
Heartburn during pregnancy is quite common. During pregnancy the lower esophageal sphincter muscle becomes weakened , which likely occurs due to the effect of the high levels of the hormones estrogen and progesterone during pregnancy. Fortunately, this resolves after pregnancy. Management of heartburn during pregnancy are generally involves lifestyle changes and avoiding foods that promote heartburn, for example, don't smoke, avoid tight clothing, eat small, frequent meals, chew gum, or sip liquids. The effect of heartburn medications on the fetus is unknown, so it is best to check with your OB/GYN if you feel you need medication to treat heartburn.
Sudden Cardiac Arrest
Sudden cardiac arrest is an unexpected, sudden death caused by sudden cardiac arrest (loss of heart function). Causes and risk factors of sudden cardiac arrest include (not inclusive): abnormal heart rhythms (arrhythmias), previous heart attack, coronary artery disease, smoking, high cholesterol, Wolff-Parkinson-White Syndrome, ventricular tachycardia or ventricular fibrillation after a heart attack, congenital heart defects, history of fainting, heart failure, obesity, diabetes, and drug abuse. Treatment of sudden cardiac arrest is an emergency, and action must be taken immediately.
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