Calcium Citrate Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This medication is 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 they are getting enough calcium (such as 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.

How to use Calcium Citrate 200 Mg (950 Mg) Tablet

Take this medication by mouth with food. If your product contains calcium citrate, then it may be taken with or without food. Follow all directions on the product package, or take as directed by your doctor. For best absorption, if your daily dose is more than 600 milligrams, then divide your dose and space it throughout the day. If you have any questions, ask your doctor or pharmacist.

If you are using the chewable product, chew it well before swallowing.

If you are using the effervescent tablet, allow the tablet to fully dissolve in a glass of water before drinking it. Do not chew or swallow the tablet whole.

If you are using the liquid product or powder, measure the medication with a dose-measuring spoon or device to make sure you get the correct dose. Do not use a household spoon. If the liquid product is a suspension, shake the bottle well before each dose.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

If your doctor has recommended that you follow a special diet, it is very important to follow the diet to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.

If you think you may have a serious medical problem, get medical help right away.

Side Effects

Constipation and upset stomach may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: nausea/vomiting, loss of appetite, unusual weight loss, mental/mood changes, bone/muscle pain, headache, increased thirst/urination, weakness, unusual tiredness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking calcium, tell your doctor or pharmacist if you have any allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

If you have any of the following health problems, consult your doctor or pharmacist before using this product: high calcium levels (hypercalcemia), kidney disease (including kidney stones), little or no stomach acid (achlorhydria), heart disease, disease of the pancreas, a certain lung disease (sarcoidosis), difficulty absorbing nutrition from food (malabsorption syndrome).

Some sugar-free formulations of calcium may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist about using this drug safely.

Tell your doctor if you are pregnant before using this medication.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: digoxin, cellulose sodium phosphate, certain phosphate binders (such as calcium acetate).

Calcium can decrease the absorption of other drugs such as bisphosphonates (for example, alendronate), tetracycline antibiotics (such as doxycycline, minocycline), estramustine, levothyroxine, and quinolone antibiotics (such as ciprofloxacin, levofloxacin). Separate your doses of these medications as far as possible from your doses of calcium. Ask your doctor or pharmacist about how long you should wait between doses and for help finding a dosing schedule that will work with all your medications.

Check the labels on all your prescription and nonprescription/herbal products (such as antacids, vitamins) because they may contain calcium. Ask your pharmacist about using those products safely.

Does Calcium Citrate 200 Mg (950 Mg) Tablet interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: nausea/vomiting, loss of appetite, mental/mood changes, headache, weakness, tiredness.

Foods rich in calcium include: dairy products (such as milk, yogurt, cheese, ice cream), dark-green leafy vegetables (such as broccoli, spinach, bok choy), and calcium-fortified foods (such as orange juice).

Vitamin D helps with the absorption of calcium. Foods rich in vitamin D include: fortified dairy products, eggs, sardines, cod liver oil, chicken livers, and fatty fish. Vitamin D is also made by the body as a result of exposure to the sun.

Lab and/or medical tests (such as calcium levels) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

calcium citrate 200 mg (950 mg) tablet

Color: whiteShape: ovalImprint:

This medicine is a white, oval, scored, tablet

calcium citrate 250 mg tablet

Color: whiteShape: oblongImprint:

This medicine is a white, oval, scored, tablet

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Calcium Citrate (Calcitrate) – Side Effects, Interactions, Uses, Dosage, Warnings

Reviewed: June 23, 2020

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance.

Calcium citrate is used to prevent and to treat calcium deficiencies.

Calcium citrate may also be used for purposes not listed in this medication guide.

warnings

What is the most important information I should know about Calcium Citrate (Calcitrate)?

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have ever had:

• kidney disease;
• kidney stones;
• cancer;
• a parathyroid gland disorder; or
• high levels of calcium in your blood.

Ask a doctor before using calcium citrate if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

Side Effects

What are the side effects of Calcium Citrate (Calcitrate)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• little or no urination;
• swelling, rapid weight gain; or
• high levels of calcium in your blood–nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or feeling tired.

Common side effects may include:

• upset stomach; or
• constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Calcium Citrate (Calcitrate) if I’m pregnant or breastfeeding?

C

Risk cannot be ruled out

Based on FDA pregnancy categories

Ask a doctor before using calcium citrate if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

Interactions

What drugs and food should I avoid while taking Calcium Citrate (Calcitrate)?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking calcium citrate.

Dosage Guidelines & Tips

How to take Calcium Citrate (Calcitrate)?

Use Calcium Citrate (Calcitrate) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Calcium Citrate (Calcitrate)?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Overdose Signs

What happens if I overdose on Calcium Citrate (Calcitrate)?

If you think you or someone else may have overdosed on: Calcium Citrate (Calcitrate),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Calcium Citrate (Calcitrate), call 911

911

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Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Cerner Multum™ provides the data within some of the Overview, Uses, Warnings, Side Effects, Pregnancy, Interactions, Dosage, Overdose, and Images sections. The information within all other sections is proprietary to Everyday Health. 

Calcium citrate – clinical and pharmacological activity

In the middle of the twentieth century. a kind of “boom” began: biochemists, physiologists, biophysicists, pharmacologists and clinicians began to show increased interest in studying the role of calcium in regulating the activity of organs and body systems. It has been established that calcium ions take part in the excitation and contraction of muscle cells, regulation of cell membrane permeability, intercellular interactions, blood coagulation, secretion of hormones, mediators, enzymes; perform the function of a converter of signals entering the cell, participate in the regulation of intracellular metabolism, including energy metabolism. There are 1000 times more free calcium ions on the surface of the membrane of cardiomyocytes and vessels than in the cytosol of cells. From the extracellular space, they penetrate into the cytoplasm through special calcium channels, influencing various physiological processes and functions of the cells of all organs, vascular tone, intensity of systole, diastole.

Calcium plays an important role in the formation of bone tissue and maintaining its normal structure and function. Along with special proteins, calcium ions provide bone hardness and elasticity [6, 7].

All this served as a theoretical foundation for the development and introduction into medical practice of calcium preparations based on its salts. Currently, calcium salts such as glycerophosphate, gluconate, carbonate, lactate, citrate, chloride, phosphate and many others are used in medical practice [2, 6].

The pharmacokinetics of calcium citrate has its own characteristics. Calcium is absorbed from the intestine in a soluble ionized form. The dissolution of the drug occurs better in the acidic environment of the stomach. Dissolved ionized calcium penetrates well into all tissues, penetrates the placental barrier, enters breast milk. It is excreted from the body mainly with feces, about 20% – with urine. An important feature of Calcium citrate is its low ability to form kidney stones, which is important with long-term use of this salt. This is because the citrate salt reduces the amount of oxalates in the urine.

Bioavailability is determined by the rate and degree with which the active substance is absorbed from the dosage form, becomes available at the site of the intended therapeutic action.

At night, there is an accelerated release of mineral salts from the body (circadian acceleration of resorptive processes in the bone). Therefore, it is advisable to take calcium supplements after lunch and in the evening, which will prevent an accelerated loss of calcium in the second half of the night, especially with a reduced level (or absence) in the intestine. There is a negative dose-dependent effect of the pharmacotherapeutic activity of calcium: in low doses, this biometal is absorbed better than in high doses. In this regard, it is more rational to take the drug several times a day. For different age groups, there are different physiological norms of calcium intake (table).

Table

Recommended intake of calcium in people of different ages
(according to the Canadian Osteoporosis Society) [8]

Vitamin D, hydrochloric acid, lactose, citric acid, the presence of protein in food, phosphorus, magnesium, as well as some food products: butter, eggs, milk, fish, cod fat, cabbage, etc. contribute to the absorption of calcium ions.

Impair calcium absorption: lack of protein in food, strict adherence to a vegetarian diet, lack of magnesium, phosphorus, foods rich in oxalic acid (sorrel, rhubarb, spinach).

Calcium absorption slows down in diseases of the digestive system (gastritis, enteritis, colitis, peptic ulcer), pancreas (diabetes mellitus, pancreatitis), pathology of other endocrine organs.

It should be emphasized that some drugs, especially glucocorticoids, hormonal contraceptives for systemic use, levothyroxine also impair the absorption of calcium ions.

According to the results of scientific studies (data from the Canadian Osteoporosis Society), there is no convincing evidence on the basis of which it is possible to recommend the additional consumption of other minerals (magnesium, zinc, copper, etc.) in order to prevent or treat osteoporosis [9].

The results of clinical studies conducted in Ukraine and other countries have confirmed the high efficiency of this drug in the treatment of many diseases [2]. Calcium citrate is also used for prophylactic purposes in various diseases.

In osteoporosis in the elderly, osteomalacia [1, 3, 4] Calcium citrate is prescribed 2-6 tablets per day, dividing the daily dose into 3-4 doses. The drug is taken before meals or 1–1.5 hours after meals, in for 3 months. Such patients should also be prescribed vitamin D ₃ at 400–800 IU per day, and also include butter, milk, fish, and eggs in the diet.

Calcium citrate is the optimal dosage form for providing calcium not only to adults, but also to children and adolescents, as it helps to increase bone mineral density, increase bone mass, strengthen dentin and tooth enamel. Children under the age of 6 months are prescribed 1/2 tablet (250 mg) (crushed, dissolved in a small amount of milk), at the age of 6-12 months – also 1/2 tablet 2 times a day, at the age of 1-10 years – 1-2 tablets, 10-18 years – 2-3 tablets per day.

Indications for calcium citrate are:

•? hypocalcemia due to bleeding of various origins, as well as during pregnancy and lactation, in case of injuries – to compensate for the increased need of the body for calcium ions;

•? calcium malabsorption in diseases of the digestive tract and an increased level of calcium excretion through the kidneys and intestines;

•? hypoparathyroidism, dehydration of the body of various origins, allergic diseases and allergic complications when taking medications, increased vascular wall permeability, reduced blood clotting.

Calcium citrate should be prescribed when taking glucocorticoids, oral contraceptives, levothyroxine. In the last three cases, the drug is taken 1 tablet 6 times a day after meals.

Calcium citrate is generally well tolerated, sometimes dyspeptic symptoms (constipation or diarrhea, nausea, vomiting, loss of appetite, abdominal pain), polyuria may occur.

Concomitant use is not recommended Calcium citrate with antacids containing aluminum due to a decrease in their effectiveness. It is undesirable to prescribe it simultaneously with other calcium preparations.

In conclusion, we can note the positive pharmacological properties Calcium citrate:

calcium citrate salt dissolves well and is absorbed in the digestive tract, which leads to good absorption of calcium in the body and, accordingly, the effectiveness of the drug in its preventive or therapeutic use, which is confirmed by the results of many clinical trials. research.

Low risk of kidney stone formation when taking the drug increases the value of Calcium citrate with long-term use.

I.S. Chekman, Head of the Department of Pharmacology with the Course of Clinical Pharmacology of the National Medical University, Corresponding Member of the National Academy of Sciences and the Academy of Medical Sciences of Ukraine, Honored Worker of Science and Technology, Professor

Calcium citrate – a valuable reagent for the food industry and pharmaceuticals

Calcium citrate – an organic compound, salt of citric acid and calcium. It is found in the literature under the names of calcium citrate, tricalcium citrate, food calcium citrate, additive E333. The formula of the substance is Ca3(C6H5O7)2.

The reagent is prepared by organic synthesis from citric acid C6H8O7 and calcium hydroxide Ca(OH)2 or calcium oxide CaO or calcium carbonate CaCO3. The resulting reagent is then thoroughly purified and recrystallized.

Properties

Calcium citrate is a slightly water-soluble powdery substance with colorless crystals, sour taste, brackish aftertaste, odorless. Forms a crystalline hydrate with 4 water molecules Ca3(C6H5O7)2•4h3O. Let’s not dissolve in ethyl alcohol. Not toxic. Does not burn, does not explode.

Biogenic value

3-substituted 4-aqueous calcium citric acid is a valuable source of calcium. This trace element is necessary for a person to form bone tissue. Calcium is excreted from the body daily, so its losses must be replenished. It is most easily absorbed from calcium citrate. The reagent is not deposited in the form of kidney stones and even contributes to their dissolution, does not irritate the gastric mucosa, digestibility does not depend on the acidity of gastric juice. Significantly reduces the destruction of bone tissue and the withdrawal of calcium; promotes the absorption of vitamin C, participates in cellular metabolism.

The World Health Organization has included calcium citrate in the list of safe compounds that do not need regulation when used in food. However, uncontrolled use of calcium citrate preparations is impossible. There are contraindications, in some the substance can cause individual intolerance.

Precautions

Calcium citrate is classified as a human hazard class 3 (low hazard). Its fine dust causes irritation of mucous eyes and respiratory organs. Therefore, production facilities must be equipped with forced mechanical ventilation. Workers must wear protective equipment.

Store and transport the reagent in containers made of materials approved for contact with food. These can be paper, fabric bags with a hermetically sealed liner made of food-grade non-stabilized polyethylene.

Application

• Most of the produced substance is consumed in the food industry as an additive E333 allowed in all countries (regulates acidity, stabilizes food consistency and color, thickener, complexing agent, antioxidant). As a rule, 3-substituted calcium citrate crystal hydrate Ca3(C6H5O7)2•4h3O is used in food products. It is in demand for the manufacture of raw fish, meat and seafood semi-finished products; fats and oils; seasonings and sauces; dairy products; jams and marmalades, compotes, vegetable and fruit preserves; baking; chewing gum, juices, etc. Milk with the addition of E333 tolerates pasteurization better. Allowed for children up to a year.