From the Guidelines
Tums (calcium carbonate) is generally considered safe to use during pregnancy for occasional heartburn or indigestion, as supported by the WHO's strong recommendation for calcium supplementation to prevent preeclampsia 1. The recommended dosage is typically 500-1000 mg as needed, not exceeding 7 tablets (3500 mg) in 24 hours. Key points to consider when taking Tums during pregnancy include:
- Take Tums by chewing the tablets thoroughly before swallowing, and follow with a glass of water.
- You can take them as symptoms occur, ideally between meals and at bedtime when heartburn is often worst.
- Tums works by neutralizing stomach acid and providing quick, temporary relief.
- It's also a source of supplemental calcium, which is beneficial during pregnancy, as calcium supplementation has been shown to prevent preeclampsia, a leading cause of maternal mortality globally 1. However, if you find yourself needing Tums frequently (more than twice a week), consult your healthcare provider as this might indicate a condition requiring different treatment. Also, be aware that Tums can cause constipation, a common pregnancy complaint already, so ensure adequate fluid intake and discuss with your provider if constipation becomes problematic. For severe or persistent heartburn, your doctor might recommend other pregnancy-safe medications. According to the most recent and highest quality study, prudent practice would entail daily administration as calcium carbonate administered in divided doses of not >500 mg elemental calcium per dose 1.
From the FDA Drug Label
If pregnant or breast-feeding, ask a health professional before use. The FDA drug label does not answer the question.
From the Research
Safety of Tums (Calcium Carbonate) During Pregnancy
- There is limited direct evidence on the safety of Tums (calcium carbonate) during pregnancy 2, 3, 4, 5, 6.
- A case study reported a pregnant woman who was taking calcium carbonate (Tums) and ranitidine (Zantac) for heartburn, and was able to stop using these medications after receiving chiropractic care 2.
- A review article on the management of heartburn during pregnancy and lactation mentions that antacids, including calcium carbonate, are first-line therapeutic agents, but notes that not all drug agents have been extensively evaluated in pregnant women or during breastfeeding 3.
- Studies on the effects of calcium carbonate on esophageal and gastric pH in subjects with heartburn suggest that it can increase esophageal pH and provide relief from heartburn symptoms 4, 5, 6.
- However, these studies do not specifically address the safety of calcium carbonate during pregnancy.
- It is essential to consult with a healthcare provider before taking any medication, including Tums, during pregnancy to discuss the potential risks and benefits 3.
Mechanism of Action of Calcium Carbonate
- Calcium carbonate can rapidly neutralize esophageal acid and may prevent reflux, suggesting a mechanism of action independent of acid neutralization 6.
- The calcium released from chewed antacids may improve esophageal motor function in heartburn sufferers by increasing proximal esophageal contractile amplitude and acid clearance 6.
- However, the effects of calcium carbonate on esophageal motility and acid clearance may not be directly relevant to its safety during pregnancy.
Potential Interactions and Side Effects
- Calcium carbonate can interact with other medications and may have side effects, such as constipation or acid rebound 5.
- However, there is limited evidence on the potential interactions and side effects of calcium carbonate during pregnancy.