Amitone Side Effects

Generic Name: calcium carbonate

Note: This page contains information about the side effects of calcium carbonate. Some of the dosage forms included on this document may not apply to the brand name Amitone.

Not all side effects for Amitone may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to calcium carbonate: tablets

Other dosage forms:

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 calcium carbonate (the active ingredient contained in Amitone)

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.

For Healthcare Professionals

Applies to calcium carbonate: compounding powder, oral capsule, oral gum, oral powder, oral suspension, oral tablet, oral tablet chewable

Gastrointestinal

Rebound hyperacidity has been associated with calcium salt antacids. This side effect does not appear to be due to the acid buffering capacity of calcium carbonate (the active ingredient contained in Amitone) but is a consequence of a specific action of calcium on the parietal cell.

Rare cases of calcium carbonate gallstones have been reported in the pediatric literature.[Ref]

Gastrointestinal side effects have included rebound hyperacidity, constipation (6% to 37%) and gallstones (rarely).[Ref]

Metabolic

Prolonged ingestion of large amounts of calcium carbonate (the active ingredient contained in Amitone) and other sources of exogenous calcium can rarely result in the "milk alkali syndrome" and calcinosis. The milk alkali syndrome is characterized by the triad of hypercalcemia, metabolic alkalosis, and renal insufficiency.[Ref]

Metabolic side effects have rarely included hypercalcemia and hypophosphatemia. Hypercalcemia may be more likely and more severe in patients with renal dysfunction. In patients on chronic dialysis, hypercalcemia may also result from excessive calcium in the dialysate, vitamin D intoxication, or severe secondary hyperparathyroidism. Other metabolic side effects have rarely included "mild alkali syndrome", calcinosis, and irreversible renal damage.[Ref]

Renal

Renal side effects have included renal failure, formation of renal calcium and a single case report of a calcium carbonate (the active ingredient contained in Amitone) and calcium phosphate-filled renal cyst.[Ref]

The renal failure that accompanies hypercalcemia and alkalosis in the milk alkali syndrome is usually transient.[Ref]

References

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2. Texter EC Jr, Smart DF, Butler RC "Antacids." Am Fam Physician 11 (1975): 111-8

3. Hercz G, Kraut JA, Andress DA, Howard N, Roberts C, Shinaberger JH, Sherrard DJ, Coburn JW "Use of calcium carbonate as a phosphate binder in dialysis patients." Miner Electrolyte Metab 12 (1986): 314-9

4. Edelson GW, Kleerekoper M "Hypercalcemic crisis." Med Clin North Am 79 (1995): 79-92

5. Beauregard WG, Ferguson WT "Milk of calcium cholecystitis." J Pediatr 96 (1980): 876-7

6. Fordtran JS "Acid rebound." N Engl J Med 279 (1968): 900-5

7. Ullian ME, Linas SL "The milk-alkali syndrome in pregnancy. Case report." Miner Electrolyte Metab 14 (1988): 208-10

8. Clemens JD, Feinstein AR "Calcium carbonate and constipation: a historical review of medical mythopoeia." Gastroenterology 72 (1977): 957-61

9. Powell RW "Pure calcium carbonate gallstones in a two year old in association with prenatal calcium supplementation." J Pediatr Surg 20 (1985): 143-4

10. Malberti F, Surian M, Poggio F, Minoia C, Salvadeo A "Efficacy and safety of long-term treatment with calcium carbonate as a phosphate binder." Am J Kidney Dis 12 (1988): 487-91

11. Drinka PJ, Nolten WE "Hazards of treating osteoporosis and hypertension concurrently with calcium, vitamin D, and distal diuretics." J Am Geriatr Soc 32 (1984): 405-7

12. Abreo K, Adlakha A, Kilpatrick S, Flanagan R, Webb R, Shakamuri S "The milk-alkali syndrome. A reversible form of acute renal failure." Arch Intern Med 153 (1993): 1005-10

13. Kallmeyer JC, Funston MR "The milk-alkali syndrome. A case report." S Afr Med J 64 (1983): 287-8

14. Lewis NM, Marcus MS, Behling AR, Greger JL "Calcium supplements and milk: effects on acid-base balance and on retention of calcium, magnesium, and phosphorus." Am J Clin Nutr 49 (1989): 527-33

15. Campistol JM, Almirall J, Martin E, Torras A, Revert L "Calcium-carbonate-induced calciphylaxis." Nephron 51 (1989): 549-50

16. Cameron AJ, Spence MP "Chronic milk-alkali syndrome after prolonged excessive intake of antacid tablets." Br Med J 3 (1967): 656-7

17. Hakim R, Tolis G, Goltzman D, Meltzer S, Friedman R "Severe hypercalcemia associated with hydrochlorothiazide and calcium carbonate therapy." Can Med Assoc J 121 (1979): 591-4

18. Newmark K, Nugent P "Milk-alkali syndrome. A consequence of chronic antacid abuse." Postgrad Med 93 (1993): 149-50,156

19. Kapsner P, Langsdorf L, Marcus R, Kraemer FB, Hoffman AR "Milk-alkali syndrome in patients treated with calcium carbonate after cardiac transplantation." Arch Intern Med 146 (1986): 1965-8

20. Drivas G, Ward M, Kerr D "Immobilization hypercalcaemia in patients on regular haemodialysis." Br Med J 3 (1975): 468

21. Meric F, Yap P, Bia MJ "Etiology of hypercalcemia in hemodialysis patients on calcium carbonate therapy." Am J Kidney Dis 16 (1990): 459-64

22. Anelli A, Brancaccio D, Damasso R, Padovese P, Gallieni M, Garella S "Substitution of calcium carbonate for aluminum hydroxide in patients on hemodialysis. Effects on acidosis, on parathyroid function, and on calcemia." Nephron 52 (1989): 125-32

23. Caravaca F, Santos I, Cubero JJ, Esparrago JF, Arrobas M, Pizarro JL, Robles R, Sanchez-Casado E "Calcium acetate versus calcium carbonate as phosphate binders in hemodialysis patients." Nephron 60 (1992): 423-7

24. Robson RH, Heading RC "Obsolete but dangerous antacid preparations." Postgrad Med J 54 (1978): 36-7

25. Matsubara M, Unagami H, Totsune K, Sato H, Kikuta Y, Ogawa M, Saito T, Yoshinaga K "Long-term CaCO3 treatment of chronic hemodialysis patients: an attempt to prevent aluminum osteopathy." ASAIO Trans 34 (1988): 168-71

26. Gora ML, Seth SK, Bay WH, Visconti JA "Milk-alkali syndrome associated with use of chlorothiazide and calcium carbonate." Clin Pharm 8 (1989): 227-9

27. Ginsburg DS, Kaplan EL, Katz AI "Hypercalcaemia after oral calcium-carbonate therapy in patients on chronic haemodialysis." Lancet 1 (1973): 1271-4

28. Walan A "Metabolic side-effects and interactions." Scand J Gastroenterol Suppl 75 (1982): 63-8

29. Wooldridge TD, Bower JD, Nelson NC "Rhabdomyolysis: a complication of parathyroidectomy and calcium supplementation." JAMA 239 (1978): 643

30. Kleinman GE, Rodriquez H, Good MC, Caudle MR "Hypercalcemic crisis in pregnancy associated with excessive ingestion of calcium carbonate antacid (milk-alkali syndrome): successful treatment with hemodialysis." Obstet Gynecol 78 (1991): 496-9

31. Muhammedi MA, Piraino B, Rault R, Johnston JR, Puschett JB "Iatrogenic hypercalcemia in hemodialysis patients." Clin Nephrol 36 (1991): 258-61

32. Koide T, Yokogawa K, Takemoto M, Itatani H, Sagawa S, Sonoda T "Pure calcium carbonate urolithiasis in a human." Eur Urol 8 (1982): 319-20

33. Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ "Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women." Ann Intern Med 126 (1997): 497-504

34. Jenkins JK, Best TR, Nicks SA, Murphy FY, Bussell KL, Vesely DL "Milk-alkali syndrome with a serum calcium level of 22 mg/dl and J waves on the ECG." South Med J 80 (1987): 1444-9

35. McCorkell SJ, Hefty TR, Dowling AD "Bilateral milk-of-calcium urine and hydronephrosis." J Urol 133 (1985): 77-8

36. "The kidney and oral calcium therapy." Ann Intern Med 66 (1967): 1021-2

37. Kay C, Armm M, Fleisher P "Milk-of-calcium obstruction of the ureter." J Urol 114 (1975): 940-1

38. Coe FL, Parks JH, Favus MJ "Diet and calcium: the end of an era?" Ann Intern Med 126 (1997): 553-5

39. Piper DW "Calcium carbonate, hypercalcaemia, and peptic ulcer." Br Med J 2 (1971): 774

40. Sevuk M, Turkmen K, Safak M "Milk of calcium hydronephrosis." Eur Urol 14 (1988): 243-4

41. Almen T "Milk-of-calcium in a renal cyst diagnosed by angiography and puncture." J Urol 98 (1967): 175-6

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