Calcium Carbonate
Calcium carbonate contains approximately 40% elemental calcium and is used orally as a supplement or phosphate binder.
Group
Calcium supplement and phosphate binder
Mechanism of Action
Provides calcium, neutralizes gastric acid and binds intestinal phosphate.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Calcium supplementation | 70–185 mg/kg | PO | Every 24 h | Total daily calcium carbonate amount; administer with food. |
| Hypoparathyroidism | Reference only | PO | Calcium carbonate 30–60 mg/kg total per day orally, divided with meals. Number of daily divisions is not specified. | |
| Phosphate binding | Reference only | PO | Calcium carbonate 60–100 mg/kg total per day orally, divided with meals. Number of daily divisions is not specified. | |
| Hypoparathyroidism | 50–75 mg/kg | PO | Every 12 h | Calcium carbonate SALT mass: two equal portions of 100–150 mg/kg total daily. Adjust with serum calcium and the vitamin D regimen. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Calcium supplementation | 70–185 mg/kg | PO | Every 24 h | Total daily calcium carbonate amount; administer with food. |
| Hypoparathyroidism | Reference only | PO | Calcium carbonate 30–60 mg/kg total per day orally, divided with meals. Number of daily divisions is not specified. | |
| Phosphate binding | Reference only | PO | Calcium carbonate 60–100 mg/kg total per day orally, divided with meals. Number of daily divisions is not specified. |
Indications
- Calcium supplementation
- Hypoparathyroidism
- Hyperphosphatemia in chronic kidney disease
- Antacid
Contraindications
- Calcium-containing urinary calculi or hypercalcemia.
- CKD patients require careful calcium monitoring.
- Hypercalcemia; use particular caution with cardiac disease, renal disease or concurrent digitalis glycosides.
Interactions
- Binds fluoroquinolones, tetracyclines, bisphosphonates, zinc and iron.
- Thiazides increase hypercalcemia risk.
- Digitalis glycosides increase sensitivity to calcium-associated arrhythmias.
Adverse effects
- Constipation
- Bloating
- Hypercalcemia
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Calcium Carbonate 500 mg tablet | Tablet | 500 mg / tablet | PO |
| Calcium Carbonate 600 mg tablet | Tablet | 600 mg / tablet | PO |
| Calcium Carbonate 1000 mg tablet | Tablet | 1000 mg / tablet | PO |
| Calcium Carbonate 1250 mg tablet | Tablet | 1250 mg / tablet | PO |
| Calcium Carbonate 1500 mg tablet | Tablet | 1500 mg / tablet | PO |
| Titralac calcium carbonate suspension 1.25 g/5 mL | Oral Liquid | 1250 mg / 5 mL | PO |
| Calci-Mix calcium carbonate 1.25 g capsule | Capsule | 1250 mg / capsule | PO |
Monitoring and Administration
All doses here are calcium carbonate salt mass, not elemental calcium. Give with meals and adjust to calcium and phosphate results.
Pronefra is a multi-ingredient phosphate binder; the described doses are 1 mL/4.4 kg twice daily for cats and 1 mL/5 kg twice daily for dogs, with food. Its complete active composition and strengths are not supplied, so no preparation conversion is encoded.
When indicated, monitor magnesium, phosphorus, potassium, renal function and urinary calcium as well as serum calcium. Do not infer compatibility of an admixture from compatibility with a different diluent or concentration.