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• Chew Cal indications
• Uses of Chew Cal in details
• Chew Cal description
• Chew Cal dosage
• Chew Cal interactions
• Chew Cal side effects
• Chew Cal contraindications

What is Chew Cal?

Antacids are taken by mouth to relieve heartburn, sour stomach, or acid indigestion. They work by neutralizing excess stomach acid. Some Chew Cal combinations also contain simethicone, which may relieve the symptoms of excess gas. Antacids alone or in combination with simethicone may also be used to treat the symptoms of stomach or duodenal ulcers.

With larger doses than those used for the Chew Cal effect, magnesium hydroxide (magnesia) and magnesium oxide antacids produce a laxative effect. The information that follows applies only to their use as an Chew Cal.

Some antacids, like aluminum carbonate and aluminum hydroxide, may be prescribed with a low-phosphate diet to treat hyperphosphatemia (too much phosphate in the blood). Aluminum carbonate and aluminum hydroxide may also be used with a low-phosphate diet to prevent the formation of some kinds of kidney stones. Aluminum hydroxide may also be used for other conditions as determined by your doctor.

These medicines are available without a prescription. However, your doctor may have special instructions on the proper use and dose of these medicines for your medical problem.

Chew Cal indications

this Chew Cal is useful for the temporary relief of occasional indigestion and heartburn. Frequent, daily or nightly symptoms usually mean a more serious problem. Antacids by themselves do not correct these problems. The medications that are now available to treat acid problems are generally superior to antacids.

The second and more important use of Chew Cal is as a source of calcium, necessary for bones and teeth and to prevent osteoporosis. A quart of milk contains about 1500 mg of calcium which is about what you need. Otherwise this or a similar calcium preparation can be taken.

How should I use Chew Cal?

Use Chew Cal as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Chew Cal by mouth with or without food.
• Take Chew Cal with a full glass of water (8 oz/240 mL).
• Do not take an Chew Cal that has aluminum in it within 1 hour before or 2 hours after you take Chew Cal.
• If you take azole antifungals (eg, ketoconazole), bisphosphonates (eg, etidronate), cation exchange resins (eg, sodium polystyrene sulfonate), cephalosporins (eg, cefdinir), direct thrombin inhibitors (eg, dabigatran), iron, mycophenolate, quinolones (eg, ciprofloxacin), tetracyclines (eg, minocycline), or thyroid hormones (eg, levothyroxine), ask your doctor how to take it with Chew Cal.
• If you miss a dose of Chew Cal, take it as soon as you remember. Continue to take it as directed by your doctor or on the package label.

Ask your health care provider any questions you may have about how to use Chew Cal.

Uses of Chew Cal in details

This medication is used to prevent or treat low blood calcium levels in people who do not get enough calcium from their diets. It may be used to treat conditions caused by low calcium levels such as bone loss (osteoporosis), weak bones (osteomalacia/rickets), decreased activity of the parathyroid gland (hypoparathyroidism), and a certain muscle disease (latent tetany). It may also be used in certain patients to make sure they are getting enough calcium (e.g., women who are pregnant, nursing, or postmenopausal, people taking certain medications such as phenytoin, phenobarbital, or prednisone).

Calcium plays a very important role in the body. It is necessary for normal functioning of nerves, cells, muscle, and bone. If there is not enough calcium in the blood, then the body will take calcium from bones, thereby weakening bones. Having the right amount of calcium is important for building and keeping strong bones.

How to use Chew Cal

Take this medication by mouth with food. If your product contains calcium citrate, then it may be taken with or without food. Follow all directions on the product package, or take as directed by your doctor. For best absorption, if your daily dose is more than 600 milligrams, then divide your dose and space it throughout the day. If you are uncertain about any of the information, consult your doctor or pharmacist.

If you are using the chewable product, chew it well before swallowing.

If you are using the effervescent tablet, allow the tablet to fully dissolve in a glass of water before drinking it. Do not chew or swallow the tablet whole.

If you are using the liquid product or powder, measure the medication with a dose-measuring spoon or device to make sure you get the correct dose. Do not use a household spoon. If the liquid product is a suspension, shake the bottle well before each dose.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

If your doctor has recommended that you follow a special diet, it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.

If you think you may have a serious medical problem, seek immediate medical attention.

Chew Cal description

Each Chew Cal milk powd contains: Energy Density 1 kCal/mL. Energy Distribution: Protein: Fat: CHO 13:37:50, Protein 32.5 g/L, CHO 125.7 g/L, Fat 42 g/L, Na 500 mg/L, K 1,250 mg/L, Mg 200 mg/L, P 500 mg/L, osmolality 300 mOsmol/kg H₂O.

Each Chew Cal oral liqd (ready-to-drink) contains: Energy Density 1 kCal/mL. Energy Distribution: Protein: Fat: CHO 14:32:54, Protein 35 g/L, CHO 135 g/L, Fat 36 g/L, Na 1,000 mg/L, K 1,200 mg/L, Mg 280 mg/L, P 870 mg/L, osmolality 330 mOsmol/kg H₂O.

Chew Cal is specifically formulated for the dietary management of malnutrition and other medical conditions with increased nutritional needs that cannot be met through diet modification alone.

Special Features: Chew Cal is isotonic (low osmolality); 100% complex carbohydrate; 20% of fat as MCT; lactose-free; unflavoured.

Chew Cal dosage

Chew Cal Dosage

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.

Usual Adult Dose for:

• Osteoporosis
• Hypocalcemia
• Dyspepsia
• Duodenal Ulcer
• Gastric Ulcer
• Erosive Esophagitis
• Gastroesophageal Reflux Disease

Usual Pediatric Dose for:

• Hypocalcemia

Additional dosage information:

• Renal Dose Adjustments
• Liver Dose Adjustments
• Dialysis
• Other Comments

Usual Adult Dose for Osteoporosis

2500 to 7500 mg/day orally in 2 to 4 divided doses.

Usual Adult Dose for Hypocalcemia

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.

Usual Adult Dose for Dyspepsia

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.

Usual Adult Dose for Duodenal Ulcer

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 Chew Cal is gastric hypersecretion and acid rebound.

Usual Adult Dose for Gastric Ulcer

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 Chew Cal is gastric hypersecretion and acid rebound.

Usual Adult Dose for Erosive Esophagitis

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.

Usual Adult Dose for Gastroesophageal Reflux Disease

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.

Usual Pediatric Dose for Hypocalcemia

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:

Chew Cal:

Children 2 to 5 years: Childrens Pepto, Mylanta (R) Childrens: 1 tablet (400 mg Chew Cal) as symptoms occur; not to exceed 3 tablets/day

Children 6 to 11 years: Childrens Pepto, Mylanta (R) Childrens: 2 tablets (800 mg Chew Cal) 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 Chew Cal: 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; Chew Cal at concentrations ranging from 2.5% to 33% has been used; a topical Chew Cal preparation must be compounded.

Renal Dose Adjustments

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 Chew Cal is not indicated for the treatment of hyperphosphatemia in patients with calculated or estimated creatinine clearance equal to or greater than 25 mL/min.

Liver Dose Adjustments

Data not available

Dialysis

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.

Other Comments

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

Chew Cal:

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 Chew Cal contains 400 mg elemental calcium, or 20 mEq calcium.

More about Chew Cal

• Side Effects
• During Pregnancy
• Dosage Information
• Drug Images
• Drug Interactions
• Support Group
• Pricing & Coupons
• 13 Reviews - Add your own review/rating

Consumer resources

• Chew Cal
• Chew Cal chewable tablets
• Chew Cal tablets
• Calcium/glycine

• Other brands: Caltrate, Os-Cal, Tums Regular Strength, Oysco 500, More (14) »

Professional resources

• Chew Cal (Wolters Kluwer)

Related treatment guides

• Duodenal Ulcer
• Erosive Esophagitis
• GERD
• Hypocalcemia
• Indigestion
• More (3) »

Chew Cal interactions

See also:
What other drugs will affect Chew Cal?

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 Chew Cal 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 Chew Cal use during the day and night.

Interactions with this Chew Cal 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)

Chew Cal side effects

See also:
What are the possible side effects of Chew Cal?

Applies to Chew Cal: tablets

Other dosage forms:

• chewable tablets

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation.

Seek medical attention right away if any of these SEVERE side effects occur while taking Chew Cal (the active ingredient contained in Chew Cal)

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; increased urination; loss of appetite; mental or mood changes; nausea; severe or persistent constipation or stomach pain; weakness; vomiting.

Chew Cal contraindications

See also:
What is the most important information I should know about Chew Cal?

Known hypersensitivity reaction to any of the ingredients of Chew Cal.

Active ingredient matches for Chew Cal:

Calcium Carbonate in Egypt.

References

1. DailyMed. "CALCIUM CARBONATE; FAMOTIDINE; MAGNESIUM HYDROXIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. DailyMed. "CALCIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
3. PubChem. "Calcium". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology