Cal 500mg Tablet 1 Strip

✔️ Indications

• Relief of heartburn, indigestion, and gastric upset
• Management of calcium deficiency and hypocalcaemia
• Adjunct in the treatment of hyperphosphatemia, especially in chronic kidney disease
• Used as a calcium supplement in dietary insufficiency

✔️ Dosage & Administration

Adults:

• Hyperacidity: 1–2 tablets as needed, up to a maximum of 16 tablets per day. Tablets may be sucked or chewed.

Hyperphosphatemia (chronic renal failure):

• Initial: 2.5 g/day
• Maximum: 17 g/day, administered in divided doses

✔️ Renal Dose Adjustment

In renal impairment (CrCl <25 ml/min):
Dosage may need adjustment based on serum calcium levels. Regular monitoring is advised.

✔️ Administration Guidance:

• Can be taken with or without food.
• For enhanced absorption, it is preferable to take it with meals.
• Avoid concurrent intake with high-fiber foods, as they may reduce calcium absorption.

✔️ Side Effects

• Gastrointestinal: Nausea, vomiting, anorexia, constipation, flatulence
• Metabolic: Hypercalcemia, metabolic alkalosis, milk-alkali syndrome
• Long-term use: Risk of acid rebound, gastric hypersecretion, and tissue calcification

✔️ Drug Interactions

May increase calcium levels when used with:

• Thiazide diuretics
• Vitamin D
• May decrease absorption of:
• Iron, zinc, tetracyclines, quinolones, atenolol, bisphosphonates (e.g., alendronate), sodium fluoride, calcium channel blockers
• May enhance the cardiotoxic effects of digitalis glycosides, increasing the risk of digoxin toxicity
• Reduced efficacy when co-administered with corticosteroids

✔️ Contraindications

• History of or current calcium-containing kidney stones
• Hypercalcemia
• Hypophosphatemia
• Suspected digoxin toxicity

✔️ Precautions

Use with caution in patients with:

• Renal impairment
• Hypoparathyroidism
• Conditions associated with elevated calcium levels
• Achlorhydria (calcium absorption may be reduced—prefer alternative salts and administer with meals)
• A history of nephrolithiasis (kidney stones)
• Pregnancy Category C
• Lactation: Considered safe; crosses the placenta and may be present in breast milk.

✔️ Storage

• Store in a cool, dry place.
• Protect from moisture and heat.