What is the appropriate dosage and usage of Tums (calcium carbonate) for relief of heartburn and indigestion?

From the Guidelines

For heartburn and indigestion relief, adults and children 12 years and older should take 2-4 Tums tablets as symptoms occur, up to a maximum of 7 tablets in 24 hours, with the Extra Strength formulation containing 750mg of calcium carbonate per tablet being a suitable option 1. The dosage and usage of Tums (calcium carbonate) can vary depending on the specific product and individual needs.

• Tums contains calcium carbonate, which works by neutralizing stomach acid on contact, providing quick relief from heartburn and indigestion symptoms.
• The standard strength tablets contain 500mg of calcium carbonate, while Extra Strength provides 750mg, and Ultra contains 1000mg per tablet, with the Extra Strength formulation being a suitable option for relief 1.
• It is recommended to chew the tablets thoroughly before swallowing for fastest relief, and to take Tums when symptoms occur, preferably after meals and at bedtime.
• Tums should be taken at least 2 hours apart from certain medications like antibiotics or iron supplements, as it may interfere with their absorption, and should not be used for more than two weeks continuously without consulting a healthcare provider.
• If symptoms persist or worsen, or if you experience severe chest pain, seek medical attention as these could indicate a more serious condition, and if you're pregnant, Tums is generally considered safe for occasional heartburn relief, but always consult your doctor first 1.

From the FDA Drug Label

Do not take more than 5 chewable tablets in a 24-hour period, or use the maximum dosage for more than 2 weeks, except under the advice and supervision of a physician. The appropriate dosage and usage of Tums (calcium carbonate) for relief of heartburn and indigestion is:

• Do not exceed 5 chewable tablets in a 24-hour period
• Do not use the maximum dosage for more than 2 weeks, except under the advice and supervision of a physician 2

From the Research

Dosage and Usage of Tums

• The appropriate dosage and usage of Tums (calcium carbonate) for relief of heartburn and indigestion is not explicitly stated in the provided studies, but it is mentioned that calcium carbonate antacid tablets (Tums, 1000 mg) were used in a study to compare the effects of over-the-counter famotidine and calcium carbonate antacid on postprandial gastric acid 3.
• In the study, calcium carbonate had a rapid onset of action, neutralizing 6.7 mmol of acid in the first 30 minutes, but its duration of effect was only 60 minutes 3.
• Another study compared the efficacy of effervescent ranitidine to as-needed calcium carbonate antacids in subjects who self-treat heartburn, and found that ranitidine was more effective than antacids in reducing heartburn, healing erosive oesophagitis, alleviating pain, and improving quality of life 4.
• The study used calcium carbonate 750 mg as-needed, but did not provide information on the optimal dosage and usage of Tums for relief of heartburn and indigestion.

Comparison with Other Treatments

• A review of over-the-counter heartburn drugs found that antacids can transiently neutralize acid in the esophagus, but do not significantly affect gastric pH or prevent subsequent heartburn episodes 5.
• The review recommended that antacids and H2 RAs are not recommended for treatment of frequent heartburn, while OTC PPIs are both indicated for, and effective for, treatment of frequent heartburn 5.
• A study compared an omeprazole treatment strategy with an antacid-alginate/ranitidine treatment strategy for dyspepsia symptom relief, and found that the omeprazole treatment strategy was superior in providing relief of acid-related dyspepsia symptoms 6.
• Another study found that omeprazole provides rapid relief of heartburn in patients without endoscopic oesophagitis 7.

Limitations

• The provided studies do not provide direct evidence on the optimal dosage and usage of Tums for relief of heartburn and indigestion.
• The studies suggest that other treatments, such as ranitidine and omeprazole, may be more effective than antacids in reducing heartburn and improving quality of life 4, 6, 7.