Calcium Acetate
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Trade Name
PhosLo (primary brand name); generic calcium acetate
Classification
Phosphate binder; electrolyte supplement (calcium source)
Dosage/Route
- * Dosage:
- – Capsules/Tablets: 667 mg (169 mg elemental calcium)
- – Gelcaps: 667 mg
- * Route: Oral (PO)
Usual Dosage
- * Adults (Hyperphosphatemia): 2-4 tablets (1,334-2,668 mg) PO with each meal; typical 3-6 g/day divided TID
- * Titration: Adjust based on serum phosphate levels; max ~12 g/day
- * Take with meals to bind dietary phosphate
Mechanism of Action
Binds dietary phosphate in the GI tract, forming insoluble calcium phosphate complexes excreted in feces. Reduces serum phosphate levels in chronic kidney disease (CKD); also provides supplemental calcium to prevent hypocalcemia
Side Effects & Adverse Effects
- * Side Effects: Nausea, constipation, flatulence
- * Adverse Effects:
- – Hypercalcemia (rare; thirst, confusion, arrhythmias)
- – GI upset (severe constipation, obstruction if not chewed/swallowed properly)
- – Rare: Calcium deposits (vascular calcification, long-term high doses)
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor serum calcium, phosphate (goal: Ca 8.4-9.5 mg/dL, P 3.5-5.5 mg/dL)
- – Assess GI function (constipation); EKG if hypercalcemia suspected
- – Avoid with calcium-based antacids or high Ca intake (increases risk)
- – Ensure taken with meals (ineffective otherwise)
- * Teachings:
- – Take with meals/snacks; swallow whole (don’t crush unless specified)
- – Report severe constipation, confusion, or irregular heartbeat
- – Increase fluids/fiber to prevent constipation
- – Avoid extra calcium (milk, supplements) unless prescribed
Indication for This Patient
- * Hyperphosphatemia in chronic kidney disease (CKD), especially on dialysis
- * Secondary hypocalcemia (adjunct in CKD if calcium low)
Time
- * Timing: With each meal (TID typically)
- * Onset: Phosphate binding immediate with meal; serum effect in days
- * Duration: Continuous with meals while on therapy
