Thursday, January 14, 2016

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




















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