Calcium Carbonate vs Calcium Lactate

1.      

	Calcium Carbonate	Calcium Lactate
Availability (Prescribing category)	Tablet Calcium Carbonate 500mg (A)	Tablet Calcium Lactate  300mg (B)
Elemental Calcium	40% = 200mg/tablet	13% = 39mg/tablet
Indication	1.     For elemental calcium supplementation 2.     For phosphate binding activity in patients with chronic renal failure	1.     Prophylaxis of calcium deficiency 2.     Treatment of chronic hypocalcaemia
Dosing requirement	1.     500mg to 4g/day od to tds 2.     Total dose of elemental calcium should not exceed 2000mg/day (including dietary sources)	1 – 5g/day in divided doses
Recommended Daily Intake of Calcium	Categories Recommended Daily Intake 19 – 50 years old 1mg/day 50 years old and above (Female), 70 years old and above(Male) 1.2mg/day 50-69 years old (Male) 1mg/day
Absorption Maximum amount of calcium can be absorbed at a time = 500mg of elemental calcium	Not easily absorbed	Easily absorbed
Administration	Need to be taken with food in order to increase the absorption	Take after food
Side Effects	Most constipating form of calcium	Less constipating compared to calcium carbonate
Cost	Cheapest calcium supplement	More expensive

• Calcium carbonate and calcium acetate are 2 calcium formulations that can be used as phosphate binders
• Calcium acetate has a higher specific phosphorus-binding efficacy and causes lower hypercalcemic events compared to calcium carbonate
• Thus calcium carbonate preferred in patients with insufficient dietary calcium intake
•  Choice of calcium mainly based on elemental calcium needed to be given, patient preferences, side effects
• Risk factors that influence magnitude of bone loss:

o   inadequate dietary calcium or Vitamin D

o   concomitant diseases,

o   hormone concentrations,

o   age,

o   body weight

o   physical activity

o   family history

o   alcohol consumption

o   cigarette smoking.

REFERENCEs

1.   Lexicomp

2.  Blue book

3.  Clinical Practice Guideline for Nutrition in Children with CKD:2008 Update, National Kidney Foundation

4. http://www.aafp.org/afp/2000/1015/p1895.html

5. http://www.webmd.com/osteoporosis/living-with-osteoporosis-7/calcium-supplements?page=4

6.  https://www.nlm.nih.gov/medlineplus/ency/article/007477.htm

7.  http://www.emedicinehealth.com/osteoporosis_and_calcium/page8_em.htm

8. www.uptodate.com

9.  MIMS

10.  http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097?pg=2