From the Guidelines
The recommended dose of Tums (calcium carbonate) is 2-4 tablets as needed, with a maximum of 7 times per day (or 15 tablets total daily), for relief of acid indigestion, heartburn, or upset stomach, with each tablet containing 500 mg of calcium carbonate for regular strength, 750 mg for Extra Strength, and 1000 mg for Ultra Strength 1.
Tums Dosage and Administration
To achieve the best results, it is essential to chew the tablets thoroughly before swallowing, and take them preferably 1 hour after meals. The calcium carbonate in Tums acts as an antacid by raising the pH in your stomach, effectively reducing acidity.
Important Considerations
If symptoms persist for more than two weeks, or if you need to take Tums regularly, consult a healthcare provider as this may indicate a more serious condition requiring different treatment. It is also crucial to consider the elemental calcium content in Tums, which is 40% of the calcium carbonate content, as seen in the provided table from the study 1.
Elemental Calcium Content
For example, TUMS EX (extra strength) contains 750 mg of calcium carbonate, which corresponds to 300 mg of elemental calcium, and TUMS Ultra contains 1,000 mg of calcium carbonate, corresponding to 400 mg of elemental calcium. This information is vital for patients who require specific amounts of calcium intake, especially those with kidney disease or other conditions that affect calcium absorption.
Bioavailability and Dietary Considerations
The bioavailability of calcium from Tums is generally high, comparable to milk and dairy products, but it is essential to consider the high phosphorus content of these products, especially in children who require dietary phosphorus restriction 1. Additionally, some foods high in phytates, such as bran cereal, may have poor bioavailability of calcium, and fortified products seem to provide calcium bioavailability comparable to milk.
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. Active ingredient (in each chewable tablet) Calcium carbonate 750 mg The recommended dose of Tums is not to exceed 5 chewable tablets (containing 750 mg of calcium carbonate each) in a 24-hour period 2.
From the Research
Tums Dose Information
- The typical dose of Tums, which contains calcium carbonate, is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, it is mentioned that large amounts of calcium carbonate salts can cause hypercalcemia, metabolic alkalosis, and renal failure, as seen in the calcium-alkali syndrome 4.
- The study on the calcium-alkali syndrome 4 describes a case where a 78-year-old woman presented with weakness, malaise, and confusion after taking large amounts of calcium carbonate tablets to treat heartburn symptoms.
- Another study 5 found that concomitant use of acid-reducing medications, such as proton pump inhibitors and histamine H2 receptor antagonists, with calcium carbonate may attenuate the hypophosphatemic effect of calcium carbonate in patients undergoing hemodialysis.
Interactions with Other Medications
- Long-term use of proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) may lead to malabsorption of vitamin B12 6.
- A study found that both PPIs and H2RAs were associated with an increased risk of vitamin B12 deficiency, with higher doses of PPIs having a stronger association 6.
- Treatment with PPIs may also induce tolerance to H2RAs in Helicobacter pylori-negative patients, reducing the effect of H2RAs on gastric pH 7.