From the Guidelines
Calcium salts in medications are compounds containing calcium that are used for various therapeutic purposes, with calcium carbonate and calcium citrate being the most widely prescribed, and their use should be guided by the most recent evidence to minimize risks and maximize benefits in terms of morbidity, mortality, and quality of life. The most common calcium salts include calcium carbonate, calcium citrate, calcium gluconate, calcium lactate, and calcium phosphate. These are primarily used as calcium supplements to prevent or treat calcium deficiency, with typical dosing for calcium supplements ranging from 500-1200 mg of elemental calcium daily, often divided into smaller doses for better absorption 1. Calcium salts are also used as antacids (calcium carbonate), as phosphate binders in kidney disease patients (calcium acetate, brand name PhosLo), and in emergency medicine as calcium chloride or calcium gluconate for treating conditions like hypocalcemia, hyperkalemia, or calcium channel blocker overdose. Key considerations in the choice of calcium salt formulation include bioavailability, cost, and patient acceptability, with calcium carbonate being likely the most cost-effective choice in most settings 1. The effectiveness and safety of different calcium salts can vary, and their use should be tailored to individual patient needs and medical conditions, taking into account potential side effects such as constipation, gas, and bloating, and avoiding high doses in those with kidney stones or certain medical conditions 2, 3, 4, 5. In clinical practice, the selection of a calcium salt should prioritize the patient's specific health requirements, the presence of any comorbid conditions, and the potential for drug interactions, to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life. Given the variability in patient responses and the potential for adverse effects, the choice of calcium salt and dosing regimen should be individualized and guided by the most recent clinical evidence and guidelines. Ultimately, the goal of calcium salt therapy is to maintain optimal calcium levels, support bone health, and prevent or treat conditions associated with calcium deficiency, while minimizing risks and maximizing benefits for the patient.
From the FDA Drug Label
Active ingredient (in each chewable tablet) Calcium carbonate 750 mg The calcium salt in this pharmaceutical is calcium carbonate, which is used as an active ingredient in the drug 6.
- Calcium carbonate is the specific calcium salt used in this formulation.
From the Research
Definition and Types of Calcium Salts
- Calcium salts are compounds that contain calcium and are used in various pharmaceutical applications, including the treatment and prevention of osteoporosis, osteopenia, and hypocalcemia states 7, 8, 9.
- The most commonly used calcium salts include carbonate, citrate, pidolate, dobesilate, gluconate, phosphate, and lactate, each with different bioavailability and clinical uses 7.
Therapeutic Applications
- Calcium salts are used to treat and prevent osteoporosis, with calcium citrate and calcium carbonate being the most frequently used forms 8, 9.
- Calcium salts are also used to treat other conditions, such as achloridria, chronic hypoparathyroidism, and hypocitraturic subjects with moderate/high risk of nephrolithiasis 8.
- Calcium phosphate and calcium carbonate have been shown to support robust bone building in osteoporosis treatment 10.
Bioavailability and Formulation
- The bioavailability of calcium salts varies depending on the salt used, with pidolate and calcium citrate being more efficiently absorbed in patients with achlorhydria or low gastric secretion 9.
- The formulation of calcium salts can also affect their bioavailability, with nanoscale calcium salt-based formulations showing potential as therapeutics for osteoporosis 11.
Clinical Significance
- The choice of calcium salt can have significant clinical implications, particularly in patients with restricted phosphorus intakes, where phosphate salt may be preferable 10.
- Calcium salts can also interact with other medications and substances, such as vitamin D, to enhance their therapeutic effects 11.