Calcium Carbonate

Registered South African indications:

• Dyspepsia
• Heartburn
• Acidity
• Flatulence
• Hypocalcaemia

Contraindications 

• Hypersensitivity to the active ingredient or any of its excipients 
• Hypercalcaemia
• Hyperparathyroidism 
• Hypercalciuria
• Nephrolithiasis
• Zollinger-Ellison Syndrome
• Low phosphate diet
• Coadministration with cardiac glycosides
• Glucose-galactose malabsorption

Cautions

• Severe renal impairment
• Hepatic impairment
• Diabetes mellitus

Forms avail. in SA and covered in this monograph: chu

Dyspepsia
Heartburn
Acidity 
Flatulence

• Oral (chu): 500-1000mg, as needed; Treatment duration: 14 days; Max: 8g/24hrs

Suck slowly or chew

Hypocalcaemia

• Oral (chu): 500-1000mg, 8hrly with meals; Max: 5g/24hrs 

Hyperphosphataemia in chronic kidney disease

• Max: 2000mg/24hrs 

Prevention of pre-eclampsia 

- > 14 weeks gestation

• Oral (chu): 500mg, 12hrly

Paed. forms avail. in SA and covered in this monograph: chu

Dyspepsia
Heartburn
Acidity 
Flatulence
Hypocalcaemia 

Younger than 12 years

• Not established for use

Older than 12 years

• See adult dosage

Pregnancy 

• Safe
• Calcium carbonate has been in wide use for many years without apparent ill consequence. Data on a large number of exposed pregnancies indicate no adverse effects of calcium carbonate tablets on pregnancy or on the health of the foetus/newborn child. To date, no other epidemiological date are available

Breastfeeding 

• Compatible
• No problems are anticipated when using calcium carbonate during breastfeeding

Renal Impairment

• GFR  ≥30ml/min: No dose adjustment recommended
• GFR <29ml/min: Caution; dose adjustment recommended
  Max: 2g/24hrs

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not porphyrinogenic (NP)

Drugs in Sport

• Permitted - No warnings

Gastrointestinal Disorders

• Constipation 
• Flatulence
• Rebound acidity

Endocrine and Metabolic Disorders

• Hypercalcaemia 
• Alkalosis
• Milk-alkali syndrome

• Tetracyclines
• Bisphosphonates
• Thiazide diuretics

None routine

Calcium carbonate reacts chemically to neutralise or buffer existing quantities of stomach acid but has no direct effect on its output. This action results in an increased pH of the stomach contents, thus providing relief of hyperacidity symptoms. It also reduces acid concentrations within the lumen of the oesophagus, thus causing an increase in intra-oesophageal pH and a decrease in pepsin activity, which aids the control of gastro-oesophageal reflux.

Calcium carbonate is available in several formulations. Please note the list below gives examples of products, which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication"

Tablets 500mg

• PC Calcium 500mg (Pharmaceutical contractors)
• Zinplex Calcium 500mg (Zinplex)