Usage
Calcium lactate is prescribed for the treatment and prevention of hypocalcemia (low blood calcium levels). It is also used as a calcium supplement for conditions like osteoporosis, osteomalacia, rickets, hypoparathyroidism, and during pregnancy and lactation to meet increased calcium demands. It is classified as a mineral supplement. Its mechanism of action involves providing a source of calcium to maintain calcium homeostasis, support bone health, and facilitate various physiological processes.
Alternate Names
There are no widely used alternate names for Calcium Lactate. Brand names include Cal-Lac and Ridactate.
How It Works
Pharmacodynamics: Calcium is essential for various physiological functions, including bone formation and maintenance, muscle contraction, nerve transmission, blood clotting, and enzyme regulation. Calcium lactate provides a source of calcium to support these functions and prevent deficiencies.
Pharmacokinetics:
- Absorption: Calcium lactate is absorbed primarily in the small intestine through both active transport and passive diffusion. Absorption is enhanced by vitamin D and the presence of food in the stomach.
- Distribution: Absorbed calcium enters the bloodstream and is distributed throughout the body, with approximately 45% bound to plasma proteins. It also crosses the placenta and is present in breast milk.
- Metabolism: Calcium itself is not metabolized but is actively regulated within the body to maintain calcium homeostasis.
- Elimination: Unabsorbed calcium is excreted primarily through feces. A smaller portion is excreted through urine, influenced by factors like vitamin D levels, parathyroid hormone, and dietary intake.
Dosage
Standard Dosage
Adults:
- 325 mg to 650 mg orally two to three times daily, taken with food.
Children:
- Dosage is based on age and the specific condition being treated, and ranges from 45 mg/kg/day to 500 mg/kg/day divided into doses. Pediatric dosing should be carefully monitored by a healthcare professional.
Special Cases:
- Elderly Patients: Similar to adults, but often require closer monitoring for potential side effects.
- Patients with Renal Impairment: Dose adjustment is necessary based on the severity of impairment, with careful monitoring of serum calcium levels.
- Patients with Hepatic Dysfunction: No specific dose adjustment is typically necessary.
- Patients with Comorbid Conditions: Individualized dosing considerations may be required based on specific comorbid conditions.
Clinical Use Cases
Dosage recommendations for intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations are not specifically defined for calcium lactate. Its use in these settings would be directed by the treating physician and based on the individual patient’s calcium levels and clinical needs.
Dosage Adjustments
Dose adjustments are based on serum calcium levels, renal function, and individual patient response.
Side Effects
Common Side Effects:
Constipation, bloating, gas, nausea, vomiting, dry mouth, and increased thirst/urination.
Rare but Serious Side Effects:
Hypercalcemia (high blood calcium) presenting as confusion, fatigue, loss of appetite, excessive thirst or urination, muscle weakness, bone pain, and cardiac arrhythmias.
Long-Term Effects:
Long-term excessive intake may contribute to kidney stones and renal impairment.
Adverse Drug Reactions (ADR):
Severe allergic reactions are rare but can include rash, itching/swelling, dizziness, and difficulty breathing.
Contraindications
Hypercalcemia, hypercalciuria, severe renal failure, hypervitaminosis D, hyperparathyroidism, ventricular fibrillation, digoxin therapy, some types of kidney stones, and sarcoidosis.
Drug Interactions
Calcium lactate can interact with various medications including:
- Digoxin: Calcium can enhance the effects of digoxin, leading to toxicity.
- Thiazide Diuretics: Can increase the risk of hypercalcemia.
- Bisphosphonates, Tetracycline Antibiotics, Quinolone Antibiotics, Levothyroxine: Calcium can reduce the absorption of these drugs.
- Corticosteroids: Reduced calcium absorption.
- Phosphate Binders: Reduced phosphate binding.
Pregnancy and Breastfeeding
Pregnancy Safety Category: C. While generally considered safe, calcium lactate should only be used during pregnancy if the benefits outweigh the risks. It crosses the placenta and can affect fetal calcium levels.
Calcium is present in breast milk. Supplementation is generally considered safe during breastfeeding, but excessive intake should be avoided.
Drug Profile Summary
- Mechanism of Action: Provides supplemental calcium for various physiological functions.
- Side Effects: Constipation, bloating, nausea; rarely, hypercalcemia.
- Contraindications: Hypercalcemia, severe renal failure, digoxin therapy.
- Drug Interactions: Digoxin, thiazide diuretics, various antibiotics, levothyroxine.
- Pregnancy & Breastfeeding: Category C; generally safe if benefits outweigh risks.
- Dosage: Adults: 325-650 mg 2-3 times/day; children: variable based on age/condition.
- Monitoring Parameters: Serum calcium levels, renal function.
Popular Combinations
Calcium is often combined with Vitamin D to enhance calcium absorption.
Precautions
Pre-existing medical conditions like kidney disease, heart problems, sarcoidosis, and malabsorption should be assessed before initiating therapy. Caution should be exercised in patients with a history of kidney stones.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Lactate?
A: Adults: 325-650 mg two to three times daily with food. Children: dose varies based on age/condition, consult pediatric guidelines.
Q2: What are the primary uses of calcium lactate?
A: Treatment and prevention of hypocalcemia, calcium supplementation in conditions like osteoporosis, and meeting increased calcium needs during pregnancy and lactation.
Q3: How does calcium lactate differ from calcium carbonate?
A: Calcium lactate contains less elemental calcium and is generally better tolerated by patients with sensitive stomachs. Calcium carbonate requires stomach acid for optimal absorption.
Q4: Can calcium lactate be taken with other medications?
A: Calcium lactate can interact with certain medications. It’s crucial to inform your doctor about all medications you’re taking to prevent interactions.
Q5: What are the signs of hypercalcemia?
A: Confusion, fatigue, nausea, vomiting, constipation, increased thirst and urination, muscle weakness, and bone pain.
Q6: Is calcium lactate safe during pregnancy and breastfeeding?
A: Generally considered safe but should be used cautiously. Consult with a healthcare professional for guidance.
Q7: How is calcium lactate absorbed?
A: Primarily absorbed in the small intestine, aided by vitamin D and intake with food.
Q8: What are the long-term risks of excessive calcium intake?
A: Increased risk of kidney stones and renal impairment.
Q9: Are there any dietary sources of calcium?
A: Yes, dairy products, leafy greens, nuts, fortified foods, beans, and grains are good sources of calcium.
Q10: What should I do if I miss a dose of Calcium Lactate?
A: Take the missed dose as soon as you remember, unless it’s almost time for the next dose. Do not double the dose to catch up.
