Calcium carbonate - a Supplement & an Antacid

Calcium carbonate is used as a dietary supplement to maintain calcium homeostasis. It forms insoluble complexes with dietary phosphate and also neutralizes gastric acidity. It is used to treat the following conditions:

  • It is used for the treatment of heartburn, indigestion, sour stomach, and gastrointestinal upset associated with these symptoms.

  • As a dietary supplement in patients with inadequate calcium intake, osteomalacia, osteoporosis, and rickets.

  • It is also used as an off-label medicine to treat hyperphosphatemia in patients with kidney disease and for the treatment of hypoparathyroidism.

Adult dose:

Note: 1 gm of calcium carbonate = 400 mg of elemental calcium.

Calcium carbonate as an Antacid:

    • 1 - 4 tablets to a maximum dose of 8 gms/day orally as calcium carbonate for up to 2 weeks

Use in the treatment of Calcium supplementation (OTC labeling):

Note: For optimal bone health, 1 - 1.2 gms of elemental calcium intake is recommended in adults. Ingestion of high doses of calcium does not improve bone strength.

  • 500 mg to 4 gms/day orally as calcium carbonate in 1 to 3 divided doses.

Off label use in the treatment of Hyperphosphatemia in chronic kidney disease:

    • The total dose of elemental calcium from all sources should not exceed 2 gms per day. (this is equivalent to 4 tablets of 1250 gms of calcium carbonate)

Off label use in the treatment of Hypoparathyroidism:

    • 500 mg to 1 gm of elemental calcium administered orally 2 - 3 times a day.

Dose in children:

Adequate intake (AI):

  • 1 - 6 months:
    • 200 mg/day of elemental calcium orally.
  • 7 - 12 months:
    • 260 mg/day of elemental calcium orally.

Recommended daily allowance (RDA):

  • 1 - 3 years:
    • 700 mg/day of elemental calcium orally.
  • 4 - 8 years:
    • 1,000 mg/day of elemental calcium orally.
  • 9 - 18 years:
    • 1,300 mg/day of elemental calcium orally.

Use as an Antacid (chronic therapy for GERD is not recommended):

  • Children 2 - 5 years, weighing more than 10.9 kg:
    • 375 - 400 mg orally for up to 2 weeks to a maximum daily dose of 1,500 mg/day of calcium carbonate
  • Children 6 - 11 years:
    • 750 - 800 mg orally for up to 2 weeks to a maximum daily dose of 3,000 mg/day of calcium carbonate
  • Children older than 12 years and Adolescents:
    • 500 - 3,000 mg orally for up to 2 weeks to a maximum daily dose of 7,500 mg/day of calcium carbonate

Use in the treatment of Calcium dietary supplementation: 

  • Children 2 - 4 years:
    • 750 mg of calcium carbonate orally twice a day
  • Children older than 4 years and Adolescents:
    • 750 mg of calcium carbonate orally thrice a day

Use in the treatment of Hypocalcemia:

  • Infants and Children:
    • 45 - 65 mg/kg/day of elemental calcium orally in 4 divided doses.

Use in the treatment of Hyperphosphatemia in chronic kidney disease:

  • Infants, Children, and Adolescents:
    • The total calcium intake should not exceed 2 gms per day.
    • Calcium provided from phosphate binders should not exceed 1,500 mg/day of elemental calcium.

Use in the treatment of Rickets due to vitamin D deficiency:

  • Infants and Children:
    • 30 - 75 mg/kg/day of elemental calcium orally in 3 divided doses
    • Initiate treatment at a higher dose and titrate downwards.

 

Pregnancy Risk Factor B

    • Calcium crosses the placental boundary and is necessary for fetal development.
    • The intestinal absorption and urine excretion of calcium increase during pregnancy.
    • Calcium requirements for pregnant and unpregnant women are identical.
    • It can safely be used during pregnancy as an anti-inflammatory agent at the recommended dosage.

Calcium Carbonate use during breastfeeding:

    • Breast milk contains calcium, which is necessary for milk production.
    • The calcium requirements of lactating and nonlactating women are identical.

 

Renal dose:

Dose in renal impairment:

  • Patients with CrCl of less than 25 mL/minute require adjustment in the dose based on the serum calcium levels.

Dose in liver disease:

Dose adjustement in patients with liver disease has not been recommended by the manufacturer.

Side effects:

Common Side Effects of Calcium Carbonate Include:

  • Central nervous system:
    • Headache
    • Laxative effect
  • Endocrine & metabolic:
    • Hypercalcemia
    • Hypophosphatemia
    • Milk-alkali syndrome (manifested by headache, nausea, irritability, and weakness or alkalosis, hypercalcemia, and renal impairment)
  • Gastrointestinal:
    • Abdominal pain
    • Anorexia
    • Constipation
    • Flatulence
    • Hyperacidity (acid rebound)
    • Nausea
    • Vomiting
    • Xerostomia

 

Contraindication to Calcium Carbonate include:

 

 

  • Allergy reactions to calcium carbonate and any component of the formulation

Warnings and Precautions

    • Gastrointestinal effects:
      • It can cause flatulence, constipation, and bloating.
    • Hypercalcemia:
      • Patients who consume excessive amounts of calcium carbonate over a prolonged period of time may experience acute and progressive hypercalcemia, which can lead to seizures and cardiac arrhythmias.
      • A chronic elevation in calcium levels can lead to generalized vascular or soft-tissuecalcification, which may eventually lead to nephrolithiasis.
      • Hypercalcemia has been linked to an increase in mortality among patients with chronic kidney disease.
      • Concomitant medications like thiazide diuretics may increase the risk of hypercalcemia.
    • Achlorhydria:
      • Patients suffering from achlorhydria have lower calcium absorption.
      • You should administer it with food, or use alternative agents.
    • Chronic kidney disease
      • Patients suffering from CKD should be given other phosphate binders such as sevelamer and lanthanum, especially if their serum calcium levels are high or normal.
      • non-calcium based phosphate binders are thought to reduce cardiovascular mortality in patients with CKD compared to calcium acetate and calcium carbonate.
    • Hypoparathyroidism:
      • Hypoparathyroid patients receiving high doses of vitamin D may develop hypercalcemia and hypercalciuria.
    • Kidney stones
      • Calcium supplements should be used with caution for patients with kidney stones.
    • Insufficiency of the renal system:
      • Calcium supplements should be used with caution by patients with renal impairment.

 

Calcium carbonate: Drug Interaction

Risk Factor C (Monitor therapy)

Amphetamines

Antacids may decrease the excretion of Amphetamines.

Antipsychotic Agents (Phenothiazines)

Antacids may decrease the absorption of Antipsychotic Agents (Phenothiazines).

Bromperidol

Antacids may decrease the absorption of Bromperidol.

Calcium Channel Blockers

Calcium Salts may diminish the therapeutic effect of Calcium Channel Blockers.

Captopril

Antacids may decrease the serum concentration of Captopril.

Cardiac Glycosides

Calcium Salts may enhance the arrhythmogenic effect of Cardiac Glycosides.

Cefpodoxime

Antacids may decrease the serum concentration of Cefpodoxime.

Cysteamine (Systemic)

Antacids may diminish the therapeutic effect of Cysteamine (Systemic).

Dexmethylphenidate

Antacids may increase the absorption of Dexmethylphenidate. Specifically, antacids may interfere with the normal release of drug from the extended-release capsules (Focalin XR brand), which could result in both increased absorption (early) and decreased delayed absorption.

Diacerein

Antacids may decrease the absorption of Diacerein.

DOBUTamine

Calcium Salts may diminish the therapeutic effect of DOBUTamine.

Methylphenidate

Antacids may increase the absorption of Methylphenidate. Specifically, antacids may interfere with the normal release of drug from the extended-release capsules (Ritalin LA brand), which could result in both increased absorption (early) and decreased delayed absorption.

QuiNIDine

Antacids may decrease the excretion of QuiNIDine.

Rosuvastatin

Antacids may decrease the serum concentration of Rosuvastatin.

Thiazide and Thiazide-Like Diuretics

May decrease the excretion of Calcium Salts. Continued concomitant use can also result in metabolic alkalosis.

Vitamin D Analogs

Calcium Salts may enhance the adverse/toxic effect of Vitamin D Analogs.

Risk Factor D (Consider therapy modification)

Acalabrutinib

Antacids may decrease the serum concentration of Acalabrutinib. Management: Separate administration of acalabrutinib from the administration of any antacids by at least 2 hours in order to minimize the potential for a significant interaction.

Allopurinol

Antacids may decrease the absorption of Allopurinol.

Alpha-Lipoic Acid

Calcium Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Calcium Salts.

Atazanavir

Antacids may decrease the absorption of Atazanavir.

Bictegravir

Calcium Salts may decrease the serum concentration of Bictegravir. Management: Bictegravir, emtricitabine, and tenofovir alafenamide can be administered with calcium salts under fed conditions, but coadministration with or 2 hours after a caclium salt is not recommended under fasting conditions.

Bisacodyl

Antacids may diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur.

Bismuth Subcitrate

Antacids may diminish the therapeutic effect of Bismuth Subcitrate. Management: Avoid administration of antacids within 30 minutes of bismuth subcitrate (tripotassium bismuth dicitrate) administration.

Bisphosphonate Derivatives

Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid.

Bosutinib

Antacids may decrease the serum concentration of Bosutinib. Management: Administer antacids more than 2 hours before or after bosutinib.

Calcium Polystyrene Sulfonate

Antacids may enhance the adverse/toxic effect of Calcium Polystyrene Sulfonate. The combined use of these two agents may result in metabolic alkalosis and/or loss of efficacy of the cation exchange resin. Management: To minimize this interaction, consider: a)separating doses by 2 or more hours; b)rectal administration of the exchange resin; or c)alternatives to antacids. Monitor for metabolic alkalosis and attenuation of CPS effects. Avoid magnesium hydroxide.

Cefditoren

Antacids may decrease the serum concentration of Cefditoren. Management: Concomitant use of cefditoren with antacids is not recommended. Consider alternative methods to control acid reflux (eg, diet modification) or alternative antimicrobial therapy. If antacid therapy can not be avoided, separate dosing by several hours.

Cefuroxime

Antacids may decrease the serum concentration of Cefuroxime. Management: Administer cefuroxime axetil at least 1 hour before or 2 hours after the administration of shortacting antacids.

Chloroquine

Antacids may decrease the serum concentration of Chloroquine. Management: Separate administration of antacids and chloroquine by at least 4 hours to minimize any potential negative impact of antacids on chloroquine bioavailability.

Corticosteroids (Oral)

Antacids may decrease the bioavailability of Corticosteroids (Oral). Management: Consider separating doses by 2 or more hours. Budesonide enteric coated tablets could dissolve prematurely if given with drugs that lower gastric acid, with unknown impact on budesonide therapeutic effects.

Dabigatran Etexilate

Antacids may decrease the serum concentration of Dabigatran Etexilate. Management: Dabigatran etexilate Canadian product labeling recommends avoiding concomitant use with antacids for 24 hours after surgery. In other situations, administer dabigatran etexilate 2 hours prior to antacids. Monitor clinical response to dabigatran therapy.

Dasatinib

Antacids may decrease the serum concentration of Dasatinib. Management: Simultaneous administration of dasatinib and antacids should be avoided. Administer antacids 2 hours before or 2 hours after dasatinib.

Deferiprone

Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours.

Delavirdine

Antacids may decrease the serum concentration of Delavirdine. Management: Separate doses of delavirdine and antacids by at least 1 hour. Monitor for decreased delavirdine therapeutic effects with this combination.

Dolutegravir

Calcium Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral calcium. Administer dolutegravir/rilpivirine at least 4 hours before or 6 hours after oral calcium salts. Alternatively, dolutegravir and oral calcium can be taken together with food.

Eltrombopag

Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product.

Elvitegravir

Antacids may decrease the serum concentration of Elvitegravir. Management: Separate administration of antacids and elvitegravir-containing products by at least 2 hours in order to minimize the risk for an interaction.

Erlotinib

Antacids may decrease the serum concentration of Erlotinib. Management: Separate the administration of erlotinib and any antacid by several hours in order to minimize the risk of a significant interaction.

Estramustine

Calcium Salts may decrease the absorption of Estramustine.

Fosinopril

Antacids may decrease the serum concentration of Fosinopril. Management: The US and Canadian fosinopril manufacturer labels recommend separating the doses of antacids and fosinopril by 2 hours.

Gefitinib

Antacids may decrease the serum concentration of Gefitinib. Management: Administer gefitinib at least 6 hours before or after administration of an antacid, and closely monitor clinical response to gefitinib.

Hyoscyamine

Antacids may decrease the serum concentration of Hyoscyamine. Management: Administer immediate release hyoscyamine before meals and antacids after meals when these agents are given in combination.

Iron Salts

Antacids may decrease the absorption of Iron Salts. Exceptions: Ferric Carboxymaltose; Ferric Citrate; Ferric Gluconate; Ferric Hydroxide Polymaltose Complex; Ferric Pyrophosphate Citrate; Ferumoxytol; Iron Dextran Complex; Iron Isomaltoside; Iron Sucrose.

Itraconazole

Antacids may increase the serum concentration of Itraconazole. Antacids may decrease the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any antacids. Exposure to Tolsura brand itraconazole may be increased by antacids; consider itraconazole dose reduction.

Ketoconazole (Systemic)

Antacids may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer oral ketoconazole at least 2 hours prior to use of any antacid product. Monitor patients closely for signs of inadequate clinical response to ketoconazole.

Lanthanum

Antacids may diminish the therapeutic effect of Lanthanum.

Ledipasvir

Antacids may decrease the serum concentration of Ledipasvir. Management: Separate the administration of ledipasvir and antacids by 4 hours.

Mesalamine

Antacids may diminish the therapeutic effect of Mesalamine. Antacid-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Avoid concurrent administration of antacids with sustained-release mesalamine products. Separating antacid and mesalamine administration, and/or using lower antacid doses may be adequate means of avoiding this interaction.

Methenamine

Antacids may diminish the therapeutic effect of Methenamine.

Multivitamins/Fluoride (with ADE)

May increase the serum concentration of Calcium Salts. Calcium Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). More specifically, calcium salts may impair the absorption of fluoride. Management: Avoid eating or drinking dairy products or consuming vitamins or supplements with calcium salts one hour before or after of the administration of fluoride.

Multivitamins/Minerals (with ADEK, Folate, Iron)

Antacids may decrease the serum concentration of Multivitamins/Minerals (with ADEK, Folate, Iron). Specifically, antacids may decrease the absorption of orally administered iron. Management: Separate dosing of oral ironcontaining multivitamin preparations and antacids by as much time as possible in order to minimize impact on therapeutic efficacy of the iron preparation.

Mycophenolate

Antacids may decrease the absorption of Mycophenolate. Management: Separate doses of mycophenolate and antacids by at least 2 hours. Monitor for reduced effects of mycophenolate if taken concomitant with antacids.

Neratinib

Antacids may decrease the serum concentration of Neratinib. Specifically, antacids may reduce neratinib absorption. Management: Separate the administration of neratinib and antacids by giving neratinib at least 3 hours after the antacid.

Nilotinib

Antacids may decrease the serum concentration of Nilotinib. Management: Separate the administration of nilotinib and any antacid by at least 2 hours whenever possible in order to minimize the risk of a significant interaction.

PAZOPanib

Antacids may decrease the serum concentration of PAZOPanib. Management: Avoid the use of antacids in combination with pazopanib whenever possible. Separate doses by several hours if antacid treatment is considered necessary. The impact of dose separation has not been investigated.

PenicillAMINE

Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour.

Phosphate Supplements

Antacids may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate administration. Separating administer of oral phosphate supplements from antacid administration by as long as possible may minimize the interaction. Exceptions: Sodium Glycerophosphate Pentahydrate.

Phosphate Supplements

Calcium Salts may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate and calcium administration. Administering oral phosphate supplements as far apart from the administration of an oral calcium salt as possible may be able to minimize the significance of the interaction. Exceptions: Sodium Glycerophosphate Pentahydrate.

Potassium Phosphate

Antacids may decrease the serum concentration of Potassium Phosphate. Management: Consider separating administration of antacids and oral potassium phosphate by at least 2 hours to decrease risk of a significant interaction.

Quinolones

Antacids may decrease the absorption of Quinolones. Of concern only with oral administration of quinolones. Management: Avoid concurrent administration of quinolones and antacids to minimize the impact of this interaction. Recommendations for optimal dose separation vary by specific quinolone. Exceptions: LevoFLOXacin (Oral Inhalation).

Quinolones

Calcium Salts may decrease the absorption of Quinolones. Of concern only with oral administration of both agents. Exceptions: LevoFLOXacin (Oral Inhalation); Moxifloxacin (Systemic).

Raltegravir

Calcium Carbonate may decrease the serum concentration of Raltegravir.

Rilpivirine

Antacids may decrease the serum concentration of Rilpivirine. Management: Administer antacids at least 2 hours before or 4 hours after rilpivirine. Administer antacids at least 6 hours before or 4 hours after the rilpivirine/dolutegravir combination product.

Riociguat

Antacids may decrease the serum concentration of Riociguat. Management: Separate the administration of antacids and riociguat by at least 1 hour in order to minimize any potential interaction.

Sodium Polystyrene Sulfonate

Antacids may enhance the adverse/toxic effect of Sodium Polystyrene Sulfonate. The combined use of these two agents may result in metabolic alkalosis and/or loss of efficacy of the exchange resin. Management: To minimize this interaction, consider: a)separating doses by 2 or more hours; b)rectal administration of the exchange resin; or c)alternatives to antacids. Monitor for metabolic alkalosis and attenuation of SPS effects. Avoid magnesium hydroxide.

Sotalol

Antacids may decrease the serum concentration of Sotalol. Management: Avoid simultaneous administration of sotalol and antacids. Administer antacids 2 hours after sotalol.

Strontium Ranelate

Calcium Salts may decrease the serum concentration of Strontium Ranelate. Management: Separate administration of strontium ranelate and oral calcium salts by at least 2 hours in order to minimize this interaction.

Sulpiride

Antacids may decrease the serum concentration of Sulpiride. Management: Separate administration of antacids and sulpiride by at least 2 hours in order to minimize the impact of antacids on sulpiride absorption.

Tetracyclines

Antacids may decrease the absorption of Tetracyclines. Management: Separate administration of antacids and oral tetracycline derivatives by several hours when possible to minimize the extent of this potential interaction. Exceptions: Eravacycline.

Tetracyclines

Calcium Salts may decrease the serum concentration of Tetracyclines. Management: If coadministration of oral calcium with oral tetracyclines can not be avoided, consider separating administration of each agent by several hours. Exceptions: Eravacycline.

Thyroid Products

Calcium Salts may diminish the therapeutic effect of Thyroid Products. Management: Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours.

Trientine

Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour.

Velpatasvir

Antacids may decrease the serum concentration of Velpatasvir. Management: Separate administration of velpatasvir and antacids by at least 4 hours.

Risk Factor X (Avoid combination)

Baloxavir Marboxil

Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil.

Calcium Acetate

Calcium Salts may enhance the adverse/toxic effect of Calcium Acetate.

Monitoring parameters:

Monitor:

  • Plasma calcium levels (especially if used for the treatment of hypocalcemia and hypoparathyroidism).
  • Phosphate
  • Magnesium
  • Renal function
  • 24-hour urinary calcium and creatinine,
  • Renal imaging every five years in asymptomatic patients with a history of nephrolithiasis or nephrocalcinosis
  • CNS imaging for basal ganglia calcification
  • Ophthalmologic exam
  • Bone mineral density
  • Hyperphosphatemia

CKD stage G3a to G3b:

  • Serum calcium and phosphate:
    • Monitor every 6 - 12 months
  • Parathyroid hormone

CKD stage G4:

  • Serum Calcium and phosphate:
    • Monitor every 3 - 6 months
  • Parathyroid hormone:
    • Monitor every 6 - 12 months

CKD stage G5 and G5D:

  • Serum calcium and phosphate:
    • Monitor every 1 - 3 months
  • Parathyroid hormone:
    • Monitor every 3 - 6 months

 

How to administer Calcium Carbonate?

It is administered orally with food. If more than 600 mg of elemental calcium per day is required, the dose should be administered in divided doses.

Mechanism of action of Calcium Carbonate:

Calcium carbonate can be used as a dietary supplement to maintain osteoporosis's negative calcium balance and prevent or reduce bone loss. It's also important for the optimal function of nerve, muscle and cardiac functions. It can also be used to treat hyperphosphatemia, combining it with phosphate to form insoluble compounds in patients with chronic renal disease.

It can also be used as an anti-antacid to neutralize gastric acidity, inhibit the proteolytic activity by pepsin, and increase the lower esophageal tone. It is only minimally absorbedIf high doses of vitamin D are not given, it is unlikely that the patient will be able to absorb them. The duodenum is the main site of absorption.

Vitamin D levels and patient age are also important factors. Pregnancy doubles the rate of absorption. Calcium isabsorbedIn an ionized and acidic form.AbsorptionPatients with achlorhydria and renal osteodystrophy, Steatorrhea, and Uremia have a decreased risk It isdistributedIt is found mainly in the bones and teeth, and is 40%protein-boundIt is mainly due to albumin. It is excreted primarily from the feces.

 

 

 

Calcium Carbonate international brand names:

  • Antacid Calcium Extra Strength
  • Antacid Calcium
  • Antacid Extra Strength
  • Antacid
  • Cal-Carb Forte
  • Cal-Gest Antacid
  • Cal-Mint
  • Calci-Chew
  • Calcium - 600
  • Calcium Antacid Extra Strength
  • Calcium Antacid Ultra Max St
  • Calcium
  • Antacid
  • Calcium High Potency
  • Caltrate 600
  • Florical
  • Maalox Childrens
  • Maalox
  • Oysco 500
  • Titralac
  • Tums Chewy Bites
  • Tums Chewy Delights
  • Tums E-X 750
  • Tums Extra Strength 750
  • Tums Freshers
  • Tums Kids
  • Tums Lasting Effects
  • Tums Smoothies
  • Tums Ultra 1000
  • Tums
  • Acical
  • Additiva Calcium
  • Andrews TUMS Antacid
  • Apo-Cal
  • Bica
  • Bo-Ne-Ca
  • Bonacal
  • Boncal
  • Bonfit
  • Cal-Sup
  • Calbo
  • Calcanate
  • Calcefor
  • Calci Aid
  • Calcichew
  • Calcifar
  • Calcigamma
  • Calcigran Sine
  • Calcilos
  • Calcimate
  • Calcimate Forte
  • Calcit
  • Calcium
  • Calcium Carbonate
  • Calcium Dago
  • Calcium Genericon
  • Calcium Klopfer
  • Calcium-Carbonat Salmon
  • Pharma
  • Calcium-Phosphatbinder Bichsel
  • Calcium-Sandoz Forte
  • Calciumcarbonat
  • Fresenius
  • Calciumcarbonat-Dial
  • Calcuren
  • Calnat
  • Calos
  • Calperos
  • Calsuba
  • Calsum
  • Calsum Forte
  • Caltab
  • Caltess
  • Caltrate 600
  • Caltrón
  • Cantacid
  • Capool
  • CC-Nefro 500
  • Chooz Antacid Gum 500
  • Cimascal
  • Cipcal
  • Dreisacarb
  • Edee
  • Fixateur phospho-calcique
  • Bichsel
  • Fixical
  • FructiCal
  • Gastrocid
  • Iroviton Calcium
  • Isofem
  • Jasocal
  • Kalcidon
  • Kalcij-karbonat
  • Kalcijev karbonat
  • Kalcitena
  • Kalzonorm
  • Maxi-calc
  • Maxi-Kalz
  • Mubonet
  • N-Zarevet
  • Natecal
  • Noacid
  • Orocal
  • Oscal
  • Osteocal 500
  • Osteomin
  • Pharcal
  • Pluscal
  • Rowarolan
  • Rowarolan Powder
  • Seacal
  • Tetesept
  • Calcium
  • Titralac
  • Tums
  • Tums EX Sugar Free
  • Tums Smoothies EX Peppermint
  • Tums Ultra Spearmint
  • Vicalvit
  • Vitacalcin
  • Weifa-
  • Kalsium

Brands in pakistan:

Calcium Carbonate [Inf 0.48 gm]

MACRIN RS SEARLE PAKISTAN (PVT.) LTD.

Calcium Carbonate [Tabs 50 mg]

CALCIDIN PHARMEDIC (PVT) LTD.

Calcium Carbonate [Tabs 1250 mg]

CALCIBONE GEOFMAN PHARMACEUTICALS
CALTAB CHEWABLE WERRICK PHARMACEUTICALS
OYSTERCAL-500 PHARMAKO PAKISTAN
QALSAN MIXED FRUIT NOVARTIS PHARMA (PAK) LTD

 

Comments

NO Comments Found