From the Guidelines
The recommended dosage of calcium carbonate chews for adults is typically 1,000-1,200 mg of elemental calcium daily, divided into 2-3 doses throughout the day, as supported by the study published in the New England Journal of Medicine 1. To determine the correct dosage, it's essential to consider the amount of elemental calcium in each calcium carbonate chew, which is usually around 40% of the total calcium content.
- For optimal absorption, calcium carbonate chews should be taken with meals, as gastric acidity is required for sufficient absorption, as noted in the study 1.
- Each calcium carbonate chew typically contains 500-600 mg of calcium, so 2 chews daily would meet most adults' requirements.
- Children and adolescents generally need 700-1,300 mg daily depending on age, while pregnant or breastfeeding women may require up to 1,300 mg daily.
- It's crucial not to exceed 2,500 mg of calcium from all sources per day to avoid potential side effects like constipation, gas, or kidney stones.
- Additionally, calcium supplements should be taken at least 2 hours apart from certain medications, including tetracycline antibiotics, bisphosphonates, and thyroid medications, as calcium can interfere with their absorption, although this is not explicitly stated in the provided study 1, it is a well-established guideline in clinical practice.
- Calcium carbonate is most effective when vitamin D levels are adequate, so many formulations include vitamin D to enhance calcium absorption in the intestines and promote bone health, which is implied by the importance of dietary sources and balance in the study 1.
From the FDA Drug Label
Directions - Adults and children 12 years and older chew and swallow 1 to 2 chewable tablets every 2-4 hours as needed. Do not exceed 5 chewable tablets in 24 hours. Children under 12 years consult a doctor. 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 recommended dosage and administration guidelines for calcium carbonate (CaCO3) chews are:
- Adults and children 12 years and older: chew and swallow 1 to 2 chewable tablets every 2-4 hours as needed.
- Maximum dosage: do not exceed 5 chewable tablets in 24 hours.
- Children under 12 years: consult a doctor.
- Duration of use: do not use the maximum dosage for more than 2 weeks, except under the advice and supervision of a physician 2 2.
From the Research
Recommended Dosage and Administration Guidelines for Calcium Carbonate Chews
- The recommended dosage of calcium carbonate chews is not explicitly stated in the provided studies, but the studies suggest that the dosage of calcium carbonate can vary depending on the patient's needs and the specific condition being treated 3, 4, 5, 6.
- A study published in 1995 found that administering 3 g of calcium carbonate daily was effective in treating secondary hyperparathyroidism in nondialyzed patients with chronic renal failure 5.
- Another study published in 1999 found that high doses of calcium carbonate (exact dosage not specified) were effective in reducing intact PTH concentrations in hemodialyzed patients with secondary hyperparathyroidism 6.
- A study published in 2014 suggests that calcium supplementation should be tailored to the patient's need, usually 500 mg per day, to achieve a total intake of 1,200 mg or 1,000 mg per day 3.
Administration Guidelines
- Calcium carbonate chews should be taken on an empty stomach, a few minutes before meals, to enhance absorption 4.
- The studies suggest that calcium carbonate can be taken in various forms, including tablets, effervescent tablets, and solutions 4, 7.
- It is essential to monitor serum calcium and phosphate levels, as well as intact parathyroid hormone levels, to adjust the dosage and prevent hypercalcemia or hyperphosphatemia 4, 5, 6.
Absorption and Bioavailability
- The absorption of calcium from calcium carbonate chews can vary, with a study published in 1991 finding that chewable calcium carbonate tablets showed a mean minimum absorption of 25.6% 7.
- Another study published in 1996 found that the intestinal absorption of calcium from calcium carbonate was equivalent to that of calcium acetate, provided that calcium carbonate was taken on an empty stomach a few minutes before meals 4.