Calcium Carbonate

Calcium Carbonate is a medication used to prevent or treat low blood calcium levels in people who do not get enough calcium from their diets. It may be used to treat conditions caused by low calcium levels such as bone loss (osteoporosis), weak bones (osteomalacia/rickets), decreased activity of the parathyroid gland (hypoparathyroidism), and a certain muscle disease (latent tetany). It may also be used in certain patients to make sure that they are getting enough calcium (women who are pregnant, nursing or postmenopausal, people taking certain medications such as phenytoin, phenobarbital, or prednisone).

• Calcium plays a very important role in the body. It is necessary for normal functioning of nerves, cells, muscle, and bone. If there is not enough calcium in the blood, then the body will take calcium from bones, thereby weakening bones. Having the right amount of calcium is important for building and keeping strong bones.
• Calcium Carbonate is available under the following different brand names: Tums, Tums Chewy Delights, Tums Extra, Tums Freshers, Tums Kids, Tums Regular, Tums Smoothies, and Tums Ultra or Children's Pepto.

Dosage of Calcium Carbonate:

Adult and Pediatric Dosages:

Tablet, chewable

• 400 mg (Children's Pepto)
• 500 mg (Tums Regular, Tums Freshers)
• 750 mg (Tums Extra, Tums Kids, Tums Smoothies)
• 1,000 mg (Tums Ultra)
• 1,177 mg (Tums Chewy Delights)

Dosing Considerations – Should be Given as Follows:

Antacid

Adult Dosage:

Take at onset of gastrointestinal distress

• Tums Regular, Tums Freshers (500 mg): Chew 2-4 tablets; not to exceed 15 tablets in 24 hours
• Tums Smoothies (750 mg): Chew 2-4 tablets, not to exceed 10 tablets in 24 hours
• Tums Extra (750 mg): Chew 2-4 tablets; not to exceed 9 tablets in 24 hours
• Tums Ultra (1,000 mg): Chew 2-3 tablets; not to exceed 7 tablets in 24 hours
• Tums Chewy Delights (1,177 mg): Chew and swallow 2-3 chews; not to exceed 10 chews in 24 hours
• Not to exceed 7 grams/day

Pediatric Dosage:

• Children's Pepto
  • Children under 2 years (under 11 kg): Safety and efficacy not established
  • Children 2-5 years (12-21 kg): 400 mg (1 tablet) orally as needed, not to exceed 3 tablets per day
  • Children 6-11 years (22-43 kg): 800 mg (2 tablets) orally as needed, not to exceed 6 tablets per day
• Tums Kids
  • Children under 2 years (under 11 kg): Safety and efficacy not established
  • Children 2-4 years (11-21 kg): 375 mg (1/2 tablet) orally as needed with food
  • Children over 4 years (22-43 kg): 750 mg (1 tablet) orally three times daily with food

Calcium Supplementation

• 1-1.2 grams orally each day or divided each 6-12 hours with meals

Recommended Dietary Allowance

• Adult Dosages:
  • 19-50 years: 1 gram per day orally
• Females:
  • 51 years and older: 1.2 grams per day orally
• Males:
  • 51-70 years: 1 gram per day orally
  • 71 years or older: 1.2 grams per day orally
• Pediatric Dosages:
• Expressed as elemental calcium
  • Infants 0-6 months: 200 mg/day orally
  • Infants 7-12 months: 260 mg/day orally
  • Children 1-3 years: 700 mg/day orally
  • Children 4-8 years: 1,000 mg/day orally
  • Children 9-18 years: 1,300 mg/day orally

Dosing Considerations

Adult and Pediatric Dosage

Calcium carbonate (elemental calcium equivalent)

• 400 mg (161 mg)
• 500 mg (200 mg)
• 750 mg (300 mg)
• 1,000 mg (400 mg)
• 1,177 mg (470 mg)

Common Side effects of Calcium Carbonate include:

• loss of appetite
• constipation
• gas (flatulence)
• nausea
• vomiting
• high calcium levels
• low phosphate levels
• milk-alkali syndrome

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

Severe Interactions of Calcium Carbonate include:

• ceftriaxone

Calcium Carbonate has serious interactions with at least 21 different drugs.

Calcium Carbonate has moderate interactions with at least 127 different drugs.

Calcium Carbonate has minor interactions with at least 66 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

Translation content

This medication contains calcium carbonate. Do not take Tums, Tums Chewy Delights, Tums Extra, Tums Freshers, Tums Kids, Tums Regular, Tums Smoothies, Tums Ultra, or Children's Pepto if you are allergic to calcium carbonate or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity
• High calcium levels in the urine
• Kidney stones (renal calculi)
• Low phosphate levels
• High calcium levels
• Suspected digoxin toxicity

Effects of Drug Abuse

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Calcium Carbonate?"

Long-Term Effects

• High calcium levels and high calcium levels in the urine may result from long-term use.
• See "What Are Side Effects Associated with Using Calcium Carbonate?"

Cautions

• Shake the suspension well; chew tablets thoroughly
• Absorption impaired with the absence of hydrochloric acid in the gastric secretions (achlorhydria)
• High calcium levels and high calcium levels in the urine may result from long-term use
• Advise patients to limit intake of oxalate-rich foods (soy; green, leafy vegetables; animal protein) to avoid reduced absorption through Ca-oxalate formation

Pregnancy and Lactation

• Use calcium carbonate during pregnancy with caution if the benefits outweigh the risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done. Calcium carbonate crosses the placenta.
• Calcium carbonate uses when breastfeeding is safe; it appears in breast milk.