Calcium Carbonate Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

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 calcium carbonate 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 calcium carbonate 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:
Antacid:
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.

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 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.

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

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.

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