Consists of calcium carbonate, vitamin D3, zinc sulphate
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Calcium carbonate/vitamin D3/zinc sulphate Dosage |
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Consists of calcium carbonate, vitamin D3, zinc sulphate
Applies to the following strength(s): 650 mg; 600 mg; 1250 mg/5 mL; 1250 mg; 1000 mg; 500 mg; 400 mg; base 500 mg; 750 mg; 900 mg; 648 mg; 420 mg; 250 mg; 550 mg; 1177 mg; 850 mg; 400 mg/5 mL; 350 mg; 1.5 g; 1 g; 300 mg; 450 mg
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
2500 to 7500 mg/day orally in 2 to 4 divided doses.
900 to 2500 mg/day orally in 2 to 4 divided doses. This dose may be adjusted as needed to achieve a normal serum calcium level.
300 to 8000 mg/day orally in 2 to 4 divided doses. This dose may be increased as needed and tolerated to decrease symptoms of stomach upset.
Maximum Dose: 5,500 to 7980 mg (depending on product used). Not to exceed maximum daily dosage for a period of greater than 2 weeks unless directed by a physician.
1250 to 3750 mg/day in 2 to 4 divided doses. This dose may be increased as needed and tolerated to decrease the abdominal discomfort. The major limiting factor to the chronic use of calcium carbonate is gastric hypersecretion and acid rebound.
1250 to 3750 mg/day in 2 to 4 divided doses. This dose may be increased as needed and tolerated to decrease the abdominal discomfort. The major limiting factor to the chronic use of calcium carbonate is gastric hypersecretion and acid rebound.
1250 to 3750 mg/day orally in 2 to 4 divided doses. The potential for acid rebound could be detrimental. However, antacids have been frequently used in the management of erosive esophagitis and may be beneficial in decreasing the acidity of gastric contents.
Maximum Dose: 5,500 to 7980 mg (depending on product used). Not to exceed maximum daily dosage for a period of greater than 2 weeks unless directed by a physician.
1250 to 3750 mg/day orally in 2 to 4 divided doses. The potential for acid rebound could be detrimental. However, antacids have been frequently used in the management of erosive esophagitis and may be beneficial in decreasing the acidity of gastric contents.
Maximum Dose: 5,500 to 7980 mg (depending on product used). Not to exceed maximum daily dosage for a period of greater than 2 weeks unless directed by a physician.
Neonatal:
Hypocalcemia (dose depends on clinical condition and serum calcium level): Dose expressed in mg of elemental calcium: 50 to 150 mg/kg/day in 4 to 6 divided doses; not to exceed 1 g/day
Usual
Dosage:
Calcium carbonate:
Children 2 to 5 years: Childrens Pepto, Mylanta (R) Childrens: 1 tablet (400 mg calcium carbonate) as symptoms occur; not to exceed 3 tablets/day
Children 6 to 11 years: Childrens Pepto, Mylanta (R) Childrens: 2 tablets (800 mg calcium carbonate) as symptoms occur; not to exceed 6 tablets/day
Children 11 years and older:
Tums (R), Tums (R) E-X: 2 to 4 tablets chewed as symptoms occur; not to exceed 15 tablets [Tums (R)] or 10 tablets [Tums (R) E-X] per day
Tums (R) Ultra: 2 to 3 tablets chewed as symptoms occur; not to exceed 7 tablets per day
Hypocalcemia (dose depends on clinical condition and serum calcium level): Dose expressed in mg of elemental calcium:
Children: 45 to 65 mg/kg/day in 4 divided doses
Treatment of hyperphosphatemia in end-stage renal failure: Children and Adults: Dose expressed in mg of calcium carbonate: 1 g with each meal; increase as needed; range: 4 to 7 g/day
Hydrofluoric acid (HF) burns (HF concentration less than 20%):
Topical: Various topical calcium preparations have been used anecdotally for treatment of dermal exposure to HF solutions; calcium carbonate at concentrations ranging from 2.5% to 33% has been used; a topical calcium carbonate preparation must be compounded.
Patients with renal dysfunction have an increased risk of hypercalcemia. Periodically checking the serum calcium level, especially if signs or symptoms of hypercalcemia are detected, is recommended.
The use of calcium carbonate is not indicated for the treatment of hyperphosphatemia in patients with calculated or estimated creatinine clearance equal to or greater than 25 mL/min.
Data not available
Calcium is removed by hemodialysis. To ensure a positive net calcium flux into the patient during dialysis, a dialysate calcium concentration of 3 to 3.5 mEq/L is usually required. Mid-dialysis modest hypercalcemia is not uncommon when this concentration is used.
Calcium is removed by peritoneal dialysis. The standard peritoneal dialysate contains 3.5 mEq/L of calcium (in 1.5% dextrose) to maintain a positive calcium balance and to prevent calcium losses. When higher concentrations of dextrose are used, the net calcium balance may be negative because of a greater convective removal of calcium during ultrafiltration. This counterbalances the diffusion of calcium from the dialysate to the patient.
Dietary reference intake: Dosage is in terms of elemental calcium:
0 to 6 months: Adequate intake: 200 mg/day
7 to 12 months: Adequate intake: 260 mg/day
1 to 3 years: RDA: 700 mg/day
4 to 8 years: RDA: 1000 mg/day
9 to 18 years: RDA: 1300 mg/day
Adults, Female/Male: RDA:
19 to 50 years: 1000 mg/day
51 years and older, females: 1200 mg/day
51 to 70 years, males: 1000 mg/day
Female: Pregnancy/Lactating: RDA: Same as for Adults, Female/Male
Calcium carbonate:
Elemental calcium: 400 mg/1 g (20 mEq calcium/gram)
Approximate equivalent dose: 225 mg of calcium salt
Osteoporosis may be associated with increased serum parathyroid hormone, excessive alcohol intake, tobacco use, inactivity, and certain drugs. Additional factors to consider in males with osteoporosis include hypogonadism and/or age related decreases in serum testosterone. Adequate vitamin D intake and weight bearing exercise (if possible) are recommended.
Each 1 g of calcium carbonate contains 400 mg elemental calcium, or 20 mEq calcium.
Before taking Calcium carbonate, tell your doctor if you are taking
You may not be able to take calcium carbonate, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with Calcium carbonate. Talk to your doctor and pharmacist before taking any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. Antacids do interact with or prevent the absorption of many medications. As a general rule it is best to separate Calcium carbonate use and any other medications by at least 1 hour. When antacids are only taken occasionally, this seldom presents a serious problem. Since there are so many good medications to reduce stomach acid, some of them over-the-counter, it is unusual to require frequent Calcium carbonate use during the day and night.
Interactions with this Calcium carbonate may occur with the following:
* flecainide (Tambocor)
* phenytoin type drugs (Dilantin, Mesantoin, Peganone, Cerebyx)
* iron (Feosol, ferrous sulfate, Nu-Iron)
* quinidine (Quinidex, Quinaglute)
* aspirin, salicylates
* tetracycline (Sumycin, Tetracyn)
1 tab daily.
Ask a doctor or pharmacist if it is safe for you to use cholecalciferol if you are also using any of the following drugs:
seizure medication;
cholestyramine, colestipol;
steroids;
digoxin; or
a diuretic or "water pill."
This list is not complete. Other drugs may interact with cholecalciferol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Interactions for vitamin D analogues (Vitamin D2, Vitamin D3, Calcitriol, and Calcidiol)
Cholestyramine
Cholestyramine has been reported to reduce intestinal absorption of fat soluble vitamins; as such it may impair intestinal absorption of any of vitamin D
Phenytoin/Phenobarbital
The coadministration of phenytoin or phenobarbital will not affect plasma concentrations of vitamin D, but may reduce endogenous plasma levels of calcitriol/ergocalcitriol by accelerating metabolism. Since blood level of calcitriol/ergocalcitriol will be reduced, higher doses of Rocaltrol may be necessary if these drugs are administered simultaneously
Thiazides
Thiazides are known to induce hypercalcemia by the reduction of calcium excretion in urine. Some reports have shown that the concomitant administration of thiazides with vitamin D causes hypercalcemia. Therefore, precaution should be taken when coadministration is necessary
Digitalis
Vitamin D dosage must be determined with care in patients undergoing treatment with digitalis, as hypercalcemia in such patients may precipitate cardiac arrhythmias
Ketoconazole
Ketoconazole may inhibit both synthetic and catabolic enzymes of vitamin D. Reductions in serum endogenous vitamin D concentrations have been observed following the administration of 300 mg/day to 1200 mg/day ketoconazole for a week to healthy men. However, in vivo drug interaction studies of ketoconazole with vitamin D have not been investigated
Corticosteroids
A relationship of functional antagonism exists between vitamin D analogues, which promote calcium absorption, and corticosteroids, which inhibit calcium absorption
Phosphate-Binding Agents
Since vitamin D also has an effect on phosphate transport in the intestine, kidneys and bones, the dosage of phosphate-binding agents must be adjusted in accordance with the serum phosphate concentration
Vitamin D
The coadministration of any of the vitamin D analogues should be avoided as this could create possible additive effects and hypercalcemia
Calcium Supplements
Uncontrolled intake of additional calcium-containing preparations should be avoided
Magnesium
Magnesium-containing preparations (eg, antacids) may cause hypermagnesemia and should therefore not be taken during therapy with vitamin D by patients on chronic renal dialysis.
Childn 6 mth-5 yr 5 mL once daily for 10 days. Infant <6 mth 2.5 mL once daily for 10 days. Continue therapy even if diarrhea has stopped.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: penicillamine, quinolone antibiotics (e.g., ciprofloxacin), tetracyclines, phosphorus containing products
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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