Calcium Carbonate
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Trade Name
Classification
Antacid; calcium supplement; electrolyte
Dosage/Route
- * Dosage:
- – Chewable tablets: 500 mg, 750 mg, 1000 mg (elemental calcium varies; e.g., 500 mg tablet = 200 mg Ca)
- – Tablets: 600 mg, 1250 mg
- – Suspension: 1250 mg/5 mL
- * Route: Oral (PO)
Usual Dosage
- * Antacid (Adults): 500-1000 mg PO PRN (every 2-4 hours); max 6-8 g/day short-term
- * Calcium Supplement: 500-1500 mg elemental calcium/day (1-3 g CaCO₃) divided BID-TID
- * Children: 45-65 mg/kg/day elemental Ca, divided doses
- * With meals (supplement) or PRN (antacid)
Mechanism of Action
- * Antacid: Neutralizes gastric acid (HCl) in the stomach, raising pH to relieve heartburn/indigestion
- * Supplement: Provides elemental calcium for absorption in the small intestine, supporting bone health and correcting hypocalcemia; binds phosphate in CKD (less effective than calcium acetate)
Side Effects & Adverse Effects
- * Side Effects: Constipation, bloating, gas, chalky taste
- * Adverse Effects:
- – Hypercalcemia (rare, chronic overuse; thirst, confusion, kidney stones)
- – Milk-alkali syndrome (high doses with milk; nausea, alkalosis)
- – Rebound acid hypersecretion (after antacid effect wears off)
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor calcium levels (normal 8.5-10.2 mg/dL) if supplement; GI symptoms (constipation)
- – Assess for hypercalcemia (EKG changes, lethargy) with prolonged use
- – Avoid with iron, tetracyclines (binds, reduces absorption—space 2 hr)
- – Chew tablets fully; shake suspension
- * Teachings:
- – Antacid: Take PRN after meals or at symptom onset
- – Supplement: Take with meals (enhances absorption)
- – Report severe constipation, confusion, or flank pain
- – Increase fluids/fiber; limit if on dialysis (per MD)
Indication for This Patient
- * Antacid: Heartburn, indigestion, acid reflux (GERD)
- * Calcium supplement: Hypocalcemia, osteoporosis prevention/treatment, CKD phosphate binding (less common)
Time
- * Timing:
- – Antacid: PRN, every 2-4 hr.
- – Supplement: BID-TID with meals.
- * Onset: Antacid: minutes; Supplement: days-weeks for bone effect.
- * Duration: Antacid: 1-3 hr; Supplement: ongoing
