When calcium intake may be insufficient or if requirements are high, calcium lactate, an OTC (over the counter) medication, is used as a dietary supplement to treat calcium shortage.
Calcium lactate Dose in Adults
OTC labeling as a dietary supplement:
- 252 mg of elemental calcium orally daily
Calcium lactate Dose in Childrens
Note: 1,000 mg of calcium lactate is equivalent to 130 mg of elemental calcium or 6.5 mEq calcium.
Adequate intake (AI) of calcium:
- Dosage expressed as elemental calcium:
- 1 - 6 months:
- 200 mg/day orally.
- 7 - 12 months:
- 260 mg/day orally.
- 1 - 6 months:
RDA of Calcium:
- Dose is expressed as elemental calcium:
- 1 - 3 years:
- 700 mg/day orally.
- 4 - 8 years:
- 1,000 mg/day orally.
- 9 - 18 years:
- 1,300 mg/day orally.
- 1 - 3 years:
Calcium lactate in the treatment of Hypocalcemia:
- Infants and Children:
-
Oral administration of 45–65 mg/kg/day of elemental calcium in 4 separate doses. Based on the clinical situation and the patient's serum calcium levels, the dose should be modified.
-
Pregnancy Risk Factor B
Calcium lactate during pregnancy:
- Calcium crosses the placental boundary
- Pregnancy increases calcium absorption from the digestive tract.
- Calcium requirements for pregnant and unpregnant women are identical.
Calcium lactate use during breastfeeding:
- Breastmilk contains calcium and it can be used during lactation.
Calcium lactate Dose in Renal Disease:
- Dose adjustment is based on the patients’ serum calcium levels.
- Patients with renal illness require the concurrent dose of activated vitamin D (alfaclcidol or calcitriol)
Dose of Calcium lactate for Liver Disease:
- No dose adjustement is required in patients with liver disease.
Common Side Effects Of Calcium Lactate Include:
- Mild hypercalcemia (calcium levels of more than 10.5 mg/dL)
- Constipation
- Anorexia
- Vomiting.
- Nausea
- More severe hypercalcemia (calcium levels of more than 12 mg/dL)
- Confusion
- Stupor.
- Delirium
- Coma
- Central nervous system:
- Headache
- Endocrine & metabolic:
- Hypophosphatemia
- Hypercalcemia
- Increased thirst
- Gastrointestinal:
- Anorexia
- Abdominal pain
- Constipation
- Vomiting
- Nausea
Contraindication to Calcium lactate include:
- Conditions that cause hypercalcemia should be avoided.
- These include primary hyperparathyroidism and sarcoidosis.
Warnings and Precautions
- Gastrointestinal effects:
- Calcium supplements can cause gastrointestinal upset. These include gas, constipation, and bloating.
- Achlorhydria:
- Patients suffering from achlorhydria may have reduced calcium absorption. You should take it with food or use an alternate salt.
- Calcium-containing Kidney stones:
- Calcium supplements should be used with caution for patients with kidney stones.
- Renal impairment
- Patients with impaired renal function should have their calcium, phosphorus and renal functions regularly checked.
Calcium lactate: Drug Interaction
Note: Drug Interaction Categories:
- Risk Factor C: Monitor When Using Combination
- Risk Factor D: Consider Treatment Modification
- Risk Factor X: Avoid Concomitant Use
Risk Factor C (Monitor therapy). |
|
| Calcium Channel Blockers | Calcium salts can lessen calcium channel blockers' therapeutic effects. |
| Cardiac Glycosides | Cardiac glycosides may have an impact that causes arrhythmias, which calcium salts can amplify. |
| DOBUTamine | Calcium salts may have an impact on dabobutamine. |
| Multivitamins/Minerals (with ADEK, Folate, Iron) | It could elevate serum calcium salt levels. |
| Thiazide and Thiazide - Like Diuretics |
Could reduce the excretion of calcium salts. Metabolic alkalosis may result from concurrent, ongoing usage. |
| Vitamin D Analogs | Calcium salts can make vitamin D analogues more poisonous or have negative consequences. |
| Risk Factor D (Still a possibility of therapy modification) | |
| Alpha-Lipoic acid |
The absorption of alpha-lipoic acid can be decreased by calcium salts. Calcium salts may not be absorbed as well when alpha-lipoic acid is present. |
| Bictegravir |
Calcium salts have the potential to lower bictegravir serum levels. Treatment: In fed settings, bictegravir and emtricitabine can be administered with calcium salts. However, it is not advised for fasting to coadminister a calcium sodium salt with or two hours after it. |
| Bisphosphonate Derivatives |
Polyvalent cation-containing items have the potential to reduce the serum concentration of bisphosphonate derivatives. The following oral drugs should not be used within the following time frames: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. There are two exceptions: pamidoate and zoledronic acid. |
| Deferiprone |
Products containing polyvalent cations may lower the level of deferiprone in the serum. Administration: Deferiprone must be taken at least four hours apart from any oral medications or dietary supplements containing polyvalent cations. |
| Dolutegravir |
Calcium salts may lower the content of dolutegravir in the blood. Dolutegravir needs to be taken at least two or six hours before calcium supplements. Dolutegravir/rilpivirine should be administered at least 4 hours before or 6 hours after taking oral calcium salts. Dolutegravir and oral calcium can both be taken with meals. |
| Eltrombopag | The serum concentration of Eltrombopag may be decreased by products containing polyvalent cations. Administration: Take eltrombopag 2 hours or more before you take any polyvalent product. |
| Estramustine | The absorption of estramustine might be decreased by calcium salts. |
| Multivitamins/Fluoride (with ADE) |
Serum concentrations may rise as a result of calcium salts. Fluoride and multivitamin serum concentrations may be lowered by calcium salts (with ADE). Fluoride absorption may be impaired by calcium salts. Management: Avoid dairy products one hour before or two hours after fluoride administration. You should also avoid calcium-salt supplements and vitamins. |
| PenicillAMINE |
Utilizing goods that include polyvalent cations can lower the serum levels of penicillAMINE. Treatment: Give oral polyvalent cation-containing products and penicillamines each at least an hour to work. |
| Phosphate Supplements | Calcium salts can decrease the absorption rate of phosphate supplements. Management: This only applies to oral phosphate or calcium administration. The interaction may be minimized by administering oral phosphate supplement as well as oral calcium salts as close as possible. Sodium Glycerophosphate pentahydrate is an exception. |
| Quinolones | Calcium salts can decrease Quinolones' absorption. This concern is only for oral administrations of Quinolones. Exceptions: LevoFLOXacin (Oral Inhalation) |
| Strontium Ranelate |
Calcium salts may lower the serum levels of strontium ranelate. Treatment: To prevent any interactions, it is crucial to give strontium ranelate and oral calcium salts at least two hours apart. |
| Tetracyclines |
Tetracycline levels in the serum can be lowered by calcium salts. Management: It is worth thinking about separating the administration of oral calcium and oral tetracyclines by a few hours if they cannot be avoided. The exception is eravacylin. |
| Thyroid Products | Thyroid Products may be affected by calcium salts. Management: Keep the oral calcium supplement and thyroid product separated for at least four hours. |
| Trientine |
Products with polyvalent cations may lower the serum concentration of trientine. Avoid taking trientine or other oral medications containing polyvalent cations at the same time. If required, give oral iron supplements a two-hour gap between each dose. It is necessary to administer oral polyvalent cations separately. |
Risk Factor X (Avoid Combination) |
|
| BaloxavirMarboxil | BaloxavirMarboxil serum concentration may be decreased by products that contain polyvalent Cation. |
| Calcium Acetate | Calcium Salts can increase the toxic/adverse effects of Calcium Acetate. |
Monitor:
- Serum total calcium levels or ionized calcium (preferred)
- Serum Phosphate levels
- Serum Magnesium
- Parathyroid hormone levels, 25 OH vitamin D, and Bone density (in specific patients)
- Renal imaging & CNS imaging for nephrocalcinosis, nephrolithiasis, and basal ganglia calcifications (in specific patients).
How to administer Calcium lactate?
It may be taken with or without food, however, absorption increases when taken with food.
Mechanism of action of Calcium lactate:
- Calcium lactate can be used as a dietary addition.
- By raising blood calcium levels, calcium outflow from the bones is reduced and parathyroid hormone is suppressed.
- It is necessary for optimal nerve and muscle performance via regulation of the activity potential.
- It is also necessary for normal cardiac function.
25%-35% of the drug can be resoldabsorbedFrom the gastrointestinal tract and isVitamin D is essential. Patients with achlorhydria, kidney disease and a diarrheal condition have impaired absorption 45 percent of the drug is Protein-bound, and is excreted primarily through the feces.
Calcium lactate international brands:
- Agocal
- Biocalcium
- Calax
- Calcium natural
- Emlactate
- Lakalsik
- Prokalk
- United Home Calactate
Calcium lactate Brands in Pakistan:
|
Tabs 300 Mg |
|
| CalciumLactate | Ideal Pharmaceutical Industries |
| CalciumLactate | Irza Pharma (Pvt) Ltd. |
| CalciumLactate | Karachi Pharmaceutical Laboratory |
| CalciumLactate | Karachi Pharmaceutical Laboratory |
| CalciumLactate | Mian Brothers Laboratories (Pvt) Ltd. |
| CalciumLactate | Ardin Pharmaceuticals |
|
Powder 500 Mg/Sachet |
|
| Citocal | Don Valley Pharmaceuticals (Pvt) Ltd. |
