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Side Effects
Serious

Serious side effects are associated with excessively high doses (see Overdose).
Common

No common side effects with recommended doses of calcium.
Less Common

Constipation, diarrhea, drowsiness, loss of appetite, dry mouth, and muscle weakness are some of the symptoms that could result if blood levels of calcium are too high (hypercalcemia).
Calcium


Drug Class:
Antihypocalcemic; dietary supplement; antacid

Available OTC?: Yes

Available Generic?: Yes

Caltrate 600
600 mg (Lederle)
Available In
Why Prescribed
How It Works
Range and Frequency
Onset of Effect
Duration of Action
Dietary Advice
Storage
Missed Dose
Stopping the Drug
Prolonged Use
Over 60
Driving and Hazardous Work
Alcohol
Pregnancy
Breast Feeding
Infants and Children
Overdose Symptoms
What to Do
Drug Interactions
Food Interactions
Disease Interactions


Available In
Capsules, oral suspension, tablets, chewable tablets, liquid

Why Prescribed
To ensure adequate calcium intake in those who do not get sufficient amounts by diet alone. Calcium is essential to many body functions, including the transmission of nerve impulses, the regulation of muscle contraction and relaxation (including of the heart), blood clotting, and various metabolic activities. Calcium is also necessary for maintaining strong bones and is commonly prescribed to prevent and treat postmenopausal osteoporosis (bone thinning). Vitamin D, which aids in the absorption of calcium from the intestine, is often prescribed along with calcium supplements to prevent or treat osteoporosis. (Indeed, some calcium supplement tablets contain vitamin D.) Calcium is also prescribed for individuals with persistently low blood calcium levels (hypocalcemia) caused, for example, by low levels of parathyroid hormone (hypoparathyroidism).

How It Works
Calcium supplements compensate for inadequate dietary intake of this essential mineral. Forms of supplements available include calcium carbonate (the most common and inexpensive), calcium citrate (the best absorbed, but relatively expensive), calcium phosphate, calcium lactate, and calcium gluconate. Because calcium carbonate and phosphate supplements are difficult to absorb, other calcium products are preferable for individuals with low gastric (stomach) acid secretion.

Range and Frequency
Optimal daily calcium intakes— Ages 0 to 6 months: 210 mg. Ages 6 months to 1 year: 270 mg. Ages 1 to 3 years: 500 mg. Ages 4 to 8 years: 800 mg. Ages 9 to 18 years: 1,300 mg. Ages 19 to 50 years: 1,000 mg. Age 51 and older: 1,200. For pregnant or breast-feeding women, under 19 years: 1,300 mg; ages 19 to 50 years: 1,000 mg. Be sure to include dietary calcium as well as the supplements in your total daily intake.

Onset of Effect
Unknown.

Duration of Action
For as long as the supplement is taken.

Dietary Advice
Calcium carbonate and calcium phosphate supplements are best absorbed if taken 60 to 90 minutes after meals. Take with 1 full glass (8 oz) of water or juice. Follow all special dietary guidelines as recommended by your doctor.

Storage
Store in a tightly sealed container away from heat, moisture, and direct light.

Missed Dose
If you are taking calcium supplements on a regular basis and miss a dose, take it as soon as you remember, then resume your regular dosage schedule.

Stopping the Drug
The decision to stop taking calcium supplements should be made in consultation with your doctor.

Prolonged Use
Adverse effects are more likely to occur if supplements are taken in doses greater than 2,000 to 2,500 mg a day for a long period of time. Your doctor should regularly check your blood calcium levels if you are taking calcium supplements to treat low blood calcium (hypocalcemia).

Over 60
No special problems are expected.

Driving and Hazardous Work
Calcium supplements should have no effect on your ability to perform such tasks safely.

Alcohol
To ensure proper absorption of calcium, consume alcohol in moderation only (no more than 2 drinks per day).

Pregnancy
It is crucial to receive enough calcium during pregnancy and to maintain those levels throughout pregnancy, preferably through diet alone. However, excessive calcium intake during pregnancy may be harmful to the mother or fetus and should be avoided.

Breast Feeding
Excessive amounts of this supplement taken while nursing may be harmful to the mother or infant and should be avoided.

Infants and Children
No special problems expected.

Overdose Symptoms
Early symptoms: Constipation (especially in children), diarrhea, dry mouth, increased thirst and frequency of urination, persistent headache, loss of appetite, metallic taste, nausea and vomiting, unusual fatigue. Advanced symptoms: Bone and muscle pain, irregular heartbeat, persistent itching, extreme drowsiness, mental changes. Severe calcium toxicity may be fatal.

What to Do
Call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.

Drug Interactions
Consult your doctor for specific advice if you are taking other calcium-containing preparations, cellulose sodium phosphate, digitalis drugs, etidronate, gallium nitrate, phenytoin, or tetracycline antibiotics. Combined use of calcium supplements with thiazide diuretics or vitamin D may lead to excessively high calcium levels.

Food Interactions
Excessive protein consumption can increase the excretion of calcium in the urine. In meals preceding calcium consumption, avoid spinach and rhubarb (high in oxalic acid), and bran and whole cereals (high in phytic acid), since these substances may interfere with calcium absorption.

Disease Interactions
Consult your doctor if you have frequent episodes of diarrhea, any stomach or intestinal problems, heart disease, sarcoidosis, kidney disease, or kidney stones.

Date Published: 04/13/2005
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