OTC labeling: Dietary supplement: Oral: One to two tablets or caplets twice daily; also consult specific product information
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule, Oral [preservative free]:
Liquid Calcium with D3: Calcium 600 mg and vitamin D 500 units [gluten free; contains soybean lecithin, soybean oil]
Liquid Calcium/Vitamin D: Calcium 600 mg and vitamin D 200 units [starch free, sugar free]
Generic: Calcium 600 mg and vitamin D 500 units
Liquid, Oral:
Generic: 1000-400 (473 mL)
Packet, Oral:
Generic: Calcium 500 mg and vitamin D 200 units (80 ea)
Tablet, Oral:
Cal-Citrate Plus Vitamin D: Calcium 250 mg and vitamin D 100 units [animal products free, gelatin free, gluten free, lactose free, no artificial color(s), no artificial flavor(s), starch free, sugar free, yeast free]
Calcet Petites: Calcium 200 mg and vitamin D 250 units [gluten free; contains fd&c yellow #5 aluminum lake]
Calcitrate: Calcium 315 mg and vitamin D 250 units [DSC] [scored; lactose free, milk derivatives/products, no artificial color(s), no artificial flavor(s), sodium free, soy free, wheat free, yeast free]
Calcium 600+D: Calcium 600 mg and vitamin D 800 units [contains fd&c yellow #6 (sunset yellow)]
Calcium 600+D: Calcium 600 mg and vitamin D 200 units [contains fd&c yellow #6 aluminum lake, soy polysaccarides]
Calcium Citrate + D3 Maximum: Calcium 315 mg and vitamin D 250 units [gluten free]
Calcium Plus Vitamin D: Calcium 500 mg and vitamin D 200 units [contains fd&c blue #1 aluminum lake, soy polysaccarides]
Calcium+D3: Calcium 600 mg and vitamin D 800 units [contains fd&c yellow #6 (sunset yellow)]
Caltrate 600+D3: Calcium 600 mg and vitamin D 800 units [scored; contains fd&c blue #2 aluminum lake, fd&c red #40 aluminum lake, fd&c yellow #6 aluminum lake]
Citrus Calcium +D: Calcium 315 mg and vitamin D 250 units [DSC] [scored]
Os-Cal Calcium + D3: Calcium 500 mg and vitamin D 200 units [scored; contains fd&c blue #1 aluminum lake, fd&c yellow #5 aluminum lake, methylparaben, propylparaben]
Os-Cal Calcium + D3: Calcium 500 mg and vitamin D 200 units [scored; carbohydrate free, lactose free, sodium free, sugar free; contains fd&c blue #1 aluminum lake, fd&c yellow #5 aluminum lake, methylparaben, propylparaben]
Os-Cal Extra D3: Calcium 500 mg and vitamin D 600 units [scored; contains methylparaben, propylparaben]
Oysco 500+D: Calcium 500 mg and vitamin D 200 units [contains brilliant blue fcf (fd&c blue #1), tartrazine (fd&c yellow #5)]
Oyster Calcium + D: Calcium 250 mg and vitamin D 125 units [DSC], Calcium 500 mg and vitamin D 125 units [DSC]
Oyster Shell Calcium + D: Calcium 500 mg and vitamin D 400 units [gluten free; contains fd&c blue #1 aluminum lake]
Oyster Shell Calcium + D3: Calcium 500 mg and vitamin D 400 units [gluten free; contains fd&c blue #1 aluminum lake]
Oyster Shell Calcium 250+D: Calcium 250 mg and vitamin D 125 units [contains brilliant blue fcf (fd&c blue #1)]
Oyster Shell Calcium Plus D: Calcium 500 mg and vitamin D 200 units [contains fd&c blue #1 aluminum lake, soy polysaccarides]
Oyster Shell Calcium/Vit D: Calcium 500 mg and vitamin D 200 units
Pronutrients Calcium+D3: Calcium 600 mg and vitamin D 800 units
Generic: 500-125 MG-UNIT, Calcium 200 mg and vitamin D 125 units, Calcium 200 mg and vitamin D 250 units, Calcium 250 mg and vitamin D 125 units, Calcium 315 mg and vitamin D 200 units, Calcium 315 mg and vitamin D 250 units, Calcium 500 mg and vitamin D 200 units, Calcium 600 mg and vitamin D 125 units [DSC], Calcium 600 mg and vitamin D 200 units, Calcium 600 mg and vitamin D 400 units
Tablet, Oral [preservative free]:
Calcium 600-D: Calcium 600 mg and vitamin D 400 units [DSC] [scored; animal products free, gluten free, no artificial flavor(s), yeast free; contains fd&c yellow #6 aluminum lake, soy polysaccarides]
Calcium High Potency/Vitamin D: Calcium 600 mg and vitamin D 200 units [sodium free, sugar free; contains fd&c yellow #6 aluminum lake]
Oyster Shell Calcium 500 + D: Calcium 500 mg and vitamin D 125 units [color free, corn free, no artificial flavor(s), starch free, wheat free, yeast free]
Generic: Calcium 250 mg and vitamin D 125 units, Calcium 600 mg and vitamin D 200 units, Calcium 600 mg and vitamin D 400 units
Tablet Chewable, Oral:
Caltrate 600+D3 Soft: Calcium 600 mg and vitamin D 800 units [contains milk (cow), soybean lecithin]
Caltrate Gummy Bites: Calcium 250 mg and vitamin D 400 units
Os-Cal: Calcium 500 mg and vitamin D 600 units [lemon chiffon flavor]
Oysco 500+D: Calcium 500 mg and vitamin D 600 units [DSC] [contains aspartame]
Oyster Shell Calcium 500+D: Calcium 500 mg and vitamin D 400 units [sugar free; contains aspartame]
Generic: Calcium 500 mg and vitamin D 100 units [DSC]
Tablet Chewable, Oral [preservative free]:
Calcium 500/D: Calcium 500 mg and vitamin D 400 units [DSC] [no artificial color(s), starch free]
Generic: Calcium 500 mg and vitamin D 100 units [DSC]
Wafer, Oral:
Vita-Calcium: Calcium 333 mg and vitamin D 133 units (90 ea [DSC], 1000 ea [DSC])
May be product dependent
May administer with or without food; administration with food may increase absorption.
Dietary supplement: Use as a dietary supplement when calcium intake may be inadequate
Os-Cal may be confused with Asacol
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined; also see individual agents
Central nervous system: Headache
Endocrine & metabolic: Hypercalcemia
Gastrointestinal: Gastrointestinal distress
Genitourinary: Hypercalciuria
Concerns related to adverse effects:
• Gastrointestinal effects: Constipation, bloating, and gas are common with calcium supplements (especially carbonate salt).
Disease-related concerns:
• Achlorhydria: Calcium absorption is impaired in achlorhydria; common in elderly, use an alternate salt (eg, citrate) and administer with food.
• Hypoparathyroid disease: Hypercalcemia and hypercalciuria are most likely to occur in hypoparathyroid patients receiving high doses of vitamin D.
• Kidney stones (calcium-containing): Use caution when administering calcium supplements to patients with a history of kidney stones.
• Renal impairment: Use with caution in patients with renal failure to avoid hypercalcemia; frequent monitoring of serum calcium and phosphorus is necessary.
Concurrent drug therapy issues:
• Minerals/other oral drugs: Calcium administration interferes with absorption of some minerals and drugs; use with caution.
Dosage form specific issues:
• Phenylalanine: Some products may contain phenylalanine.
• Shellfish: Some products may be derived from shellfish.
• Soy: Some products may contain soy.
• Tartrazine: Some products may contain tartrazine.
Other warnings/precautions:
• Absorption: Taking calcium (≤500 mg) with food improves absorption.
None known.
Acalabrutinib: Antacids may decrease the serum concentration of Acalabrutinib. Management: Separate administration of acalabrutinib from the administration of any antacids by at least 2 hours in order to minimize the potential for a significant interaction. Risk D: Consider therapy modification
Alpha-Lipoic Acid: Calcium Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Calcium Salts. Management: Separate administration of alpha-lipoic acid from that of any calcium-containing compounds by several hours. If alpha-lipoic acid is given 30 minutes before breakfast, then administer oral calcium-containing products at lunch or dinner. Risk D: Consider therapy modification
Amphetamines: Antacids may decrease the excretion of Amphetamines. Risk C: Monitor therapy
Antipsychotic Agents (Phenothiazines): Antacids may decrease the absorption of Antipsychotic Agents (Phenothiazines). Risk C: Monitor therapy
Atazanavir: Antacids may decrease the absorption of Atazanavir. Management: Administer antacids 1 to 2 hours before or 2 hours after atazanavir to minimize the risk of a clinically significant interaction. Risk D: Consider therapy modification
Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Risk X: Avoid combination
Belumosudil: Antacids may decrease the serum concentration of Belumosudil. Management: Consider separating administration of belumosudil and antacids by 2 hours and monitor for reduced belumosudil efficacy. Risk D: Consider therapy modification
Bictegravir: Calcium Salts may decrease the serum concentration of Bictegravir. Management: Bictegravir, emtricitabine, and tenofovir alafenamide can be administered with calcium salts under fed conditions, but coadministration with or 2 hours after a calcium salt is not recommended under fasting conditions. Risk D: Consider therapy modification
Bisacodyl: Antacids may diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur. Management: Antacids should not be used within 1 hour before bisacodyl administration. Risk D: Consider therapy modification
Bismuth Subcitrate: Antacids may diminish the therapeutic effect of Bismuth Subcitrate. Management: Avoid administration of antacids within 30 minutes of bismuth subcitrate (tripotassium bismuth dicitrate) administration. Risk D: Consider therapy modification
Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Risk D: Consider therapy modification
Bosutinib: Antacids may decrease the serum concentration of Bosutinib. Management: Administer antacids more than 2 hours before or after bosutinib. Risk D: Consider therapy modification
Bromperidol: Antacids may decrease the absorption of Bromperidol. Risk C: Monitor therapy
Cabotegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Cabotegravir. Management: Administer polyvalent cation containing products at least 2 hours before or 4 hours after oral cabotegravir. Risk D: Consider therapy modification
Calcium Acetate: Calcium Salts may enhance the adverse/toxic effect of Calcium Acetate. Risk X: Avoid combination
Calcium Channel Blockers: Calcium Salts may diminish the therapeutic effect of Calcium Channel Blockers. Risk C: Monitor therapy
Calcium Polystyrene Sulfonate: Antacids may enhance the adverse/toxic effect of Calcium Polystyrene Sulfonate. The combined use of these two agents may result in metabolic alkalosis and/or loss of efficacy of the cation exchange resin. Management: To minimize this interaction, consider: a)separating doses by 2 or more hours; b)rectal administration of the exchange resin; or c)alternatives to antacids. Monitor for metabolic alkalosis and attenuation of CPS effects. Avoid magnesium hydroxide. Risk D: Consider therapy modification
Captopril: Antacids may decrease the serum concentration of Captopril. Risk C: Monitor therapy
Cardiac Glycosides: Calcium Salts may enhance the arrhythmogenic effect of Cardiac Glycosides. Risk C: Monitor therapy
Cefditoren: Antacids may decrease the serum concentration of Cefditoren. Management: Concomitant use of cefditoren with antacids is not recommended. Consider alternative methods to control acid reflux (eg, diet modification) or alternative antimicrobial therapy. If antacid therapy can not be avoided, separate dosing by several hours. Risk D: Consider therapy modification
Cefpodoxime: Antacids may decrease the serum concentration of Cefpodoxime. Risk C: Monitor therapy
Cefuroxime: Antacids may decrease the serum concentration of Cefuroxime. Management: Administer cefuroxime axetil at least 1 hour before or 2 hours after the administration of short-acting antacids. Risk D: Consider therapy modification
Chloroquine: Antacids may decrease the serum concentration of Chloroquine. Management: Separate the administration of antacids and chloroquine by at least 4 hours to minimize any potential negative impact of antacids on chloroquine bioavailability. Risk D: Consider therapy modification
Corticosteroids (Oral): Antacids may decrease the bioavailability of Corticosteroids (Oral). Management: Consider separating doses by 2 or more hours. Budesonide enteric coated tablets could dissolve prematurely if given with drugs that lower gastric acid, with unknown impact on budesonide therapeutic effects. Risk D: Consider therapy modification
Cysteamine (Systemic): Antacids may diminish the therapeutic effect of Cysteamine (Systemic). Risk C: Monitor therapy
Dabigatran Etexilate: Antacids may decrease the serum concentration of Dabigatran Etexilate. Management: Dabigatran etexilate Canadian product labeling recommends avoiding concomitant use with antacids for 24 hours after surgery. In other situations, administer dabigatran etexilate 2 hours prior to antacids. Monitor clinical response to dabigatran therapy. Risk D: Consider therapy modification
Dasatinib: Antacids may decrease the serum concentration of Dasatinib. Management: Simultaneous administration of dasatinib and antacids should be avoided. Administer antacids 2 hours before or 2 hours after dasatinib. Risk D: Consider therapy modification
Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider therapy modification
Delavirdine: Antacids may decrease the serum concentration of Delavirdine. Management: Separate doses of delavirdine and antacids by at least 1 hour. Monitor for decreased delavirdine therapeutic effects with this combination. Risk D: Consider therapy modification
Diacerein: Antacids may decrease the absorption of Diacerein. Risk C: Monitor therapy
DOBUTamine: Calcium Salts may diminish the therapeutic effect of DOBUTamine. Risk C: Monitor therapy
Dolutegravir: Calcium Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral calcium. Administer dolutegravir/rilpivirine at least 4 hours before or 6 hours after oral calcium salts. Alternatively, dolutegravir and oral calcium can be taken together with food. Risk D: Consider therapy modification
Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider therapy modification
Elvitegravir: Antacids may decrease the serum concentration of Elvitegravir. Management: Separate administration of aluminum and magnesium containing antacids and elvitegravir-containing products by at least 2 hours in order to minimize the risk for an interaction. Risk D: Consider therapy modification
Erdafitinib: Serum Phosphate Level-Altering Agents may diminish the therapeutic effect of Erdafitinib. Management: Avoid coadministration of serum phosphate level-altering agents with erdafitinib before initial dose increase period based on serum phosphate levels (Days 14 to 21). Risk D: Consider therapy modification
Erlotinib: Antacids may decrease the serum concentration of Erlotinib. Management: Separate the administration of erlotinib and any antacid by several hours in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification
Estramustine: Calcium Salts may decrease the absorption of Estramustine. Management: Administer estramustine on an empty stomach, at least 1 hour before or 2 hours after the dose of an oral calcium supplement. If coadministered with calcium salts, monitor for decreased estramustine therapeutic effects. Risk D: Consider therapy modification
Fosinopril: Antacids may decrease the serum concentration of Fosinopril. Management: The US and Canadian fosinopril manufacturer labels recommend separating the doses of antacids and fosinopril by 2 hours. Risk D: Consider therapy modification
Gefitinib: Antacids may decrease the serum concentration of Gefitinib. Management: Administer gefitinib at least 6 hours before or 6 hours after administration of an antacid, and closely monitor clinical response to gefitinib. Risk D: Consider therapy modification
Hyoscyamine: Antacids may decrease the serum concentration of Hyoscyamine. Management: Administer immediate release hyoscyamine before meals and antacids after meals when these agents are given in combination. Risk D: Consider therapy modification
Infigratinib: Antacids may decrease serum concentrations of the active metabolite(s) of Infigratinib. Antacids may decrease the serum concentration of Infigratinib. Management: Avoid coadministration of infigratinib with antacids or other gastric acid-lowering agents. If antacids cannot be avoided, administer infigratinib 2 hours before or after administration of antacids. Risk D: Consider therapy modification
Iron Preparations: Antacids may decrease the absorption of Iron Preparations. Management: No action is likely necessary for the majority of patients who only use antacids intermittently or occasionally. Consider separating doses of oral iron and antacids in patients who require chronic use of both agents and monitor for reduced iron efficacy. Risk D: Consider therapy modification
Isoniazid: Antacids may decrease the absorption of Isoniazid. Risk C: Monitor therapy
Itraconazole: Antacids may decrease the serum concentration of Itraconazole. Antacids may increase the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any antacids. Exposure to Tolsura brand itraconazole may be increased by antacids; consider itraconazole dose reduction. Risk D: Consider therapy modification
Ketoconazole (Systemic): Antacids may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer oral ketoconazole at least 2 hours prior to use of any antacid product. Monitor patients closely for signs of inadequate clinical response to ketoconazole. Risk D: Consider therapy modification
Lanthanum: Antacids may diminish the therapeutic effect of Lanthanum. Management: Administer antacid products at least 2 hours before or after lanthanum. Risk D: Consider therapy modification
Ledipasvir: Antacids may decrease the serum concentration of Ledipasvir. Management: Separate the administration of ledipasvir and antacids by 4 hours. Risk D: Consider therapy modification
Levoketoconazole: Antacids may decrease the absorption of Levoketoconazole. Management: Advise patients to take antacids at least 2 hours after taking levoketoconazole. Risk D: Consider therapy modification
Mesalamine: Antacids may diminish the therapeutic effect of Mesalamine. Antacid-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Avoid concurrent administration of antacids with the Apriso brand of mesalamine extended-release capsules. The optimal duration of dose separation is unknown. Other mesalamine products do not contain this interaction warning. Risk D: Consider therapy modification
Methenamine: Antacids may diminish the therapeutic effect of Methenamine. Management: Consider avoiding this combination if possible. Antacids may decrease the therapeutic effects of methenamine; sodium bicarbonate is of most concern. If coadministering methenamine and antacids, monitor for decreased methenamine efficacy. Risk D: Consider therapy modification
Multivitamins/Fluoride (with ADE): May increase the serum concentration of Calcium Salts. Calcium Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). More specifically, calcium salts may impair the absorption of fluoride. Management: Avoid eating or drinking dairy products or consuming vitamins or supplements with calcium salts one hour before or after of the administration of fluoride. Risk D: Consider therapy modification
Multivitamins/Minerals (with ADEK, Folate, Iron): Antacids may decrease the serum concentration of Multivitamins/Minerals (with ADEK, Folate, Iron). Specifically, antacids may decrease the absorption of orally administered iron. Management: Separate dosing of oral iron-containing multivitamins and antacids by as much time as possible to minimize impact of this interaction. Monitor for decreased therapeutic efficacy of oral iron preparations during coadministration. Risk D: Consider therapy modification
Naproxen: Antacids may decrease the absorption of Naproxen. Risk X: Avoid combination
Neratinib: Antacids may decrease the serum concentration of Neratinib. Specifically, antacids may reduce neratinib absorption. Management: Separate the administration of neratinib and antacids by giving neratinib at least 3 hours after the antacid. Risk D: Consider therapy modification
Nilotinib: Antacids may decrease the serum concentration of Nilotinib. Management: Separate the administration of nilotinib and any antacid by at least 2 hours whenever possible in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification
Octreotide: Antacids may decrease the serum concentration of Octreotide. Risk C: Monitor therapy
PAZOPanib: Antacids may decrease the serum concentration of PAZOPanib. Management: Avoid the use of antacids in combination with pazopanib whenever possible. Separate doses by several hours if antacid treatment is considered necessary. The impact of dose separation has not been investigated. Risk D: Consider therapy modification
PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider therapy modification
Pexidartinib: Antacids may decrease the serum concentration of Pexidartinib. Management: Administer pexidartinib 2 hours before or after antacids. Risk D: Consider therapy modification
Phosphate Supplements: Antacids may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate administration. Separating administration of oral phosphate supplements from antacid administration by as long as possible may minimize the interaction. Risk D: Consider therapy modification
Phosphate Supplements: Calcium Salts may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate and calcium administration. Administering oral phosphate supplements as far apart from the administration of an oral calcium salt as possible may be able to minimize the significance of the interaction. Risk D: Consider therapy modification
Potassium Phosphate: Antacids may decrease the serum concentration of Potassium Phosphate. Management: Consider separating administration of antacids and oral potassium phosphate by at least 2 hours to decrease risk of a significant interaction. Risk D: Consider therapy modification
QuiNIDine: Antacids may decrease the excretion of QuiNIDine. Risk C: Monitor therapy
Quinolones: Antacids may decrease the absorption of Quinolones. Of concern only with oral administration of quinolones. Management: Avoid concurrent administration of quinolones and antacids to minimize the impact of this interaction. Recommendations for optimal dose separation vary by specific quinolone. Risk D: Consider therapy modification
Quinolones: Calcium Salts may decrease the absorption of Quinolones. Of concern only with oral administration of both agents. Management: Consider administering an oral quinolone at least 2 hours before or 6 hours after the dose of an oral calcium supplement to minimize this interaction. Monitor for decrease therapeutic effects of quinolones during coadministration. Risk D: Consider therapy modification
Raltegravir: Calcium Carbonate may decrease the serum concentration of Raltegravir. Management: Use of once-daily raltegravir with calcium carbonate is not recommended; dose separation does not appear to be adequate to minimize the significance of this interaction. Use of other raltegravir products do not require any dose change. Risk D: Consider therapy modification
Rilpivirine: Antacids may decrease the serum concentration of Rilpivirine. Management: Administer antacids at least 2 hours before or 4 hours after rilpivirine when used with most rilpivirine products. However, administer antacids at least 6 hours before or 4 hours after the rilpivirine/dolutegravir combination product. Risk D: Consider therapy modification
Riociguat: Antacids may decrease the serum concentration of Riociguat. Management: Separate the administration of antacids and riociguat by at least 1 hour in order to minimize any potential interaction. Monitor clinical response to riociguat more closely in patients using this combination. Risk D: Consider therapy modification
Rosuvastatin: Antacids may decrease the serum concentration of Rosuvastatin. Risk C: Monitor therapy
Selpercatinib: Antacids may decrease the serum concentration of Selpercatinib. Management: Coadministration of selpercatinib and antacids should be avoided. If coadministration cannot be avoided, selpercatinib should be administered 2 hours before or 2 hours after antacids. Risk D: Consider therapy modification
Sodium Polystyrene Sulfonate: Antacids may enhance the adverse/toxic effect of Sodium Polystyrene Sulfonate. Specifically, the risk of metabolic alkalosis may be increased. Antacids may diminish the therapeutic effect of Sodium Polystyrene Sulfonate. Risk C: Monitor therapy
Sotalol: Antacids may decrease the serum concentration of Sotalol. Management: Avoid simultaneous administration of sotalol and antacids. Administer antacids 2 hours after sotalol. Risk D: Consider therapy modification
Sotorasib: Antacids may decrease the serum concentration of Sotorasib. Management: Avoid coadministration of sotorasib and antacids. If use of a gastric acid suppressing medication cannot be avoided, administer sotorasib 4 hours before or 10 hours after oral antacid administration. Risk D: Consider therapy modification
Strontium Ranelate: Calcium Salts may decrease the serum concentration of Strontium Ranelate. Management: Separate administration of strontium ranelate and oral calcium salts by at least 2 hours in order to minimize this interaction. Risk D: Consider therapy modification
Sulpiride: Antacids may decrease the serum concentration of Sulpiride. Management: Separate administration of antacids and sulpiride by at least 2 hours in order to minimize the impact of antacids on sulpiride absorption. Risk D: Consider therapy modification
Tetracyclines: Antacids may decrease the absorption of Tetracyclines. Management: Separate administration of antacids and oral tetracycline derivatives by several hours when possible to minimize the extent of this potential interaction. Monitor for decreased therapeutic effects of tetracyclines. Risk D: Consider therapy modification
Tetracyclines: Calcium Salts may decrease the serum concentration of Tetracyclines. Management: If coadministration of oral calcium with oral tetracyclines cannot be avoided, consider separating administration of each agent by several hours. Risk D: Consider therapy modification
Thiazide and Thiazide-Like Diuretics: May decrease the excretion of Calcium Salts. Continued concomitant use can also result in metabolic alkalosis. Risk C: Monitor therapy
Thyroid Products: Calcium Salts may diminish the therapeutic effect of Thyroid Products. Management: Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours. Monitor for decreased therapeutic effects of thyroid products if an oral calcium supplement is initiated/dose increased. Risk D: Consider therapy modification
Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Risk D: Consider therapy modification
Velpatasvir: Antacids may decrease the serum concentration of Velpatasvir. Management: Separate administration of velpatasvir and antacids by at least 4 hours. Risk D: Consider therapy modification
Vitamin D Analogs: Calcium Salts may enhance the adverse/toxic effect of Vitamin D Analogs. Risk C: Monitor therapy
Food may increase calcium absorption. Calcium may decrease iron absorption. Bran, foods high in oxalates, or whole grain cereals may decrease calcium absorption. Management: Administer preferably with food.
Refer to individual monographs.
Refer to individual monographs.
Take (preferably with food) 2 hours before or after other medications to minimize GI upset. Some products may contain phenylalanine.
Dietary reference intake for calcium (IOM 2011):
0 to <6 months: Adequate intake: 200 mg elemental calcium daily
6 to 12 months: Adequate intake: 260 mg elemental calcium daily
1 to 3 years: RDA: 700 mg elemental calcium daily
4 to 8 years: RDA: 1,000 mg elemental calcium daily
9 to 18 years: RDA: 1,300 mg elemental calcium daily
19 to 50 years: RDA: 1,000 mg elemental calcium daily
Females ≥51 years: RDA: 1,200 mg elemental calcium daily
Males: 51 to 70 years: RDA: 1,000 mg elemental calcium daily; >70 years: RDA: 1,200 elemental calcium daily
Pregnancy/lactating: RDA: Requirements are the same as in nonpregnant or nonlactating females
Dietary reference intake for vitamin D (IOM 2011):
0 to 12 months: Adequate intake: 400 units/day
1 to 70 years: RDA: 600 units/day
Males >70 years: RDA: 800 units/day
Pregnancy/lactating: RDA: 600 units/day
Monitor serum calcium (particularly if used in patients with severe renal impairment)
Chewable (Caltrate 600+D3 Soft Oral)
600-800 mg-unit (per each): $0.13
Chewable (Caltrate Gummy Bites Oral)
250-400 mg-unit (per each): $0.14
Chewable (Os-Cal Oral)
500-600 mg-unit (per each): $0.12
Tablets (Calcet Petites Oral)
200-250 mg-unit (per each): $0.10
Tablets (Calcium Carb-Cholecalciferol Oral)
600-400 mg-unit (per each): $0.04
Tablets (Calcium Citrate-Vitamin D Oral)
200-125 mg-unit (per each): $0.05
315-200 mg-unit (per each): $0.07
Tablets (Caltrate 600+D3 Oral)
600-800 mg-unit (per each): $0.11
Tablets (Os-Cal Calcium + D3 Oral)
500-200 mg-unit (per each): $0.07
Tablets (Os-Cal Extra D3 Oral)
500-600 mg-unit (per each): $0.11
Tablets (Oysco 500+D Oral)
500-200 mg-unit (per each): $0.07
Tablets (Pronutrients Calcium+D3 Oral)
600-800 mg-unit (per each): $0.09
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