Calcium carbonate

Calcium carbonate is an active ingredient used to treat heartburn and acid regurgitation (reflux). It is also used as a phosphate binder for high phosphate levels and for the prevention and treatment of calcium deficiency and osteoporosis. Calcium carbonate is the calcium salt of carbonic acid and is found all over the world in the form of limestone or marble. Calcium carbonate is also found in mussel shells, pearls, crustaceans, snails, corals, bones and teeth.

Calcium carbonate is a white, colorless and odorless solid. It decomposes at approx. 600°C into carbon dioxide and calcium oxide.

Calcium carbonate is an inorganic salt that is used as an antacid, i.e. as a medicine to neutralize stomach acid. By increasing the pH value in the stomach, it inhibits the enzyme pepsin, which is responsible for the formation of stomach acid. Calcium carbonate also increases bicarbonate and prostaglandins, which also has a small protective effect on our cells.

The bioavailability - i.e. the percentage of the active ingredient available in the blood - varies depending on the pH value or filling level of the stomach and the dosage.

99% of the calcium in the body is found in the bones. Calcium carbonate is mainly excreted via the faeces, only a very small proportion is excreted via the sweat glands.

Always take calcium carbonate exactly as described in the package leaflet or as advised by your doctor.

The usual recommended dose for adults is between 500-1500 mg per day.

The maximum dose for adults and children weighing 43 kg or more is 7500 mg per day.

The maximum dose for children between 22 kg and 43 kg is 2400 mg per day.

The maximum dose for children between 11 kg and 22 kg is 1200 mg per day.

Calcium carbonate should not be used forchildren under 11 kg.

Caution, calcium carbonate should not be overdosed as it can lead to severe hypercalcemia.

The following side effects may occur:

Rarely:

• allergic reactions
• itching
• skin rash (urticaria)
• Diarrhea and constipation
• Flatulence
• nausea
• Stomach complaints

Very rare:

• Hypercalcemia (excessive blood calcium concentration)
• Hypercalciuria (too high urine calcium concentration)

Frequency not known:

• Milk-alkali syndrome, which is associated with a very high calcium concentration (hypercalcemia), an increase in pH (alkalosis) and renal dysfunction

Interactions may occur if the following medicines are taken at the same time:

• Drugs for heart failure (digitalis glycosides) - the effect of these may be increased
• Levothyroxine (T4) (treatment of the thyroid gland) - the effect of levothyroxine may be reduced, so there should be an interval of at least 4 hours between them
• High-dose calcium carbonate and vitamin D with verapamil (for cardiac arrhythmias) -verapamil may be weakened
• with diuretic medication (thiazide diuretics) may lead to reduced excretion of calcium
• it can inhibit the absorption of fluoride preparations (dental hygiene), bisphosphonates(osteoporosis), tetracyclines (infections), estramustine(prostate cancer) or iron preparations
• Medications to block stomach acid that contain aluminum can increase the aluminum level in the body
• Cortisone-containing medications can reduce calcium absorption
• foods that contain oxalic acid or phytic acid, such as spinach, rhubarb, bran or wholegrain products
• large amounts of milk or dairy products can lead to milk-alkali syndrome

Calcium carbonate must NOT be taken in the following cases

• if you are allergic to calcium ions
• with an elevated calcium content in the blood
• in case of severe kidney dysfunction
• with a tendency to kidney stones
• chronic urinary tract infections
• for soft tissue calcifications

Calcium carbonate is approved from a weight of 11 kg (which corresponds to a 2-3 year old child).

Calcium carbonate can be taken during pregnancy and breastfeeding, but the maximum daily dose should not exceed 1500 mg. This must be particularly taken into account if your child is receiving additional calcium.