Usage
Calcium lactobionate is primarily used to treat and prevent hypocalcemia (low blood calcium levels). It’s prescribed for conditions caused by calcium deficiency, such as:
- Hypoparathyroidism (underactive parathyroid gland).
- Osteomalacia/rickets (softening of the bones due to vitamin D deficiency, often associated with calcium deficiency).
- Latent tetany (muscle spasms or cramps due to low calcium).
- Osteoporosis (bone loss).
It is also given to patients who may not get enough calcium from their diet, such as pregnant or breastfeeding women, postmenopausal women, and individuals taking certain medications like phenytoin, phenobarbital, or prednisone. Additionally, it’s used in cases of hyperkalemia and hypermagnesemia.
Pharmacological Classification: Calcium Supplement, Electrolyte replenisher
Mechanism of Action: Calcium is essential for various physiological functions, including nerve and muscle function, blood clotting, and bone health. Calcium lactobionate provides a source of calcium to replenish depleted stores, restoring normal calcium levels and supporting these critical processes.
Alternate Names
No widely recognized alternate names exist for calcium lactobionate. However, “calcium lactobionate,” with or without variations in spelling, is how it’s often referred to in medical texts.
Brand Names: Brand names containing calcium lactobionate can vary depending on the manufacturer. They may appear in multivitamin formulations or combined with other minerals. It is important to check the ingredients for accurate identification.
How It Works
Pharmacodynamics: Calcium lactobionate dissociates into calcium and lactobionate ions. Calcium ions exert their effects by binding to cell surface receptors and influencing intracellular signaling pathways. They are crucial for muscle contraction, nerve impulse transmission, and blood coagulation. Lactobionate ions have minimal pharmacological activity.
Pharmacokinetics:
- Absorption: Calcium absorption from the gut is influenced by factors such as vitamin D levels, dietary components, and the presence of other minerals. Calcium lactobionate is generally well-absorbed.
- Distribution: Calcium is distributed throughout the body, primarily in bones and teeth. A small fraction circulates in the bloodstream, where it plays a crucial role in various physiological functions.
- Metabolism: Calcium is not metabolized in the body.
- Elimination: Calcium is excreted primarily through the kidneys. Small amounts are also lost through feces and sweat.
Mode of Action: Calcium ions influence numerous cellular processes, including:
- Muscle contraction: Calcium binds to troponin-C, initiating the interaction of actin and myosin, leading to muscle fiber shortening.
- Nerve impulse transmission: Calcium influx at nerve terminals triggers neurotransmitter release.
- Blood coagulation: Calcium is a cofactor for several clotting factors, essential for blood clot formation.
Elimination Pathways: Predominantly renal excretion.
Dosage
Standard Dosage
Adults: The typical dosage range for adults is 1–2 grams of calcium lactobionate per day, divided into two doses. The dosage can be adjusted based on individual needs and the severity of the deficiency.
Children: Dosage should be determined by a healthcare provider based on the child’s age, weight, and specific health needs.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary in elderly patients, particularly those with renal impairment. Close monitoring of calcium levels is recommended.
- Patients with Renal Impairment: Reduced dosage is often required. Careful monitoring of calcium levels is essential.
- Patients with Hepatic Dysfunction: No specific dosage adjustment is typically needed.
- Patients with Comorbid Conditions: Dose adjustments may be necessary depending on the specific comorbidity.
Clinical Use Cases
The clinical use of calcium lactobionate primarily focuses on hypocalcemia management across various settings, including:
- Intubation: Supplemental calcium may be given before or during intubation.
- Surgical Procedures: To maintain calcium homeostasis.
- Mechanical Ventilation: Calcium supplementation may be needed in patients undergoing prolonged mechanical ventilation.
- Intensive Care Unit (ICU) Use: For patients with critical illnesses.
- Emergency Situations (e.g., status epilepticus, cardiac arrest): IV calcium gluconate is preferred in emergency situations requiring rapid calcium repletion.
Dosage Adjustments
Dosage adjustments should be individualized based on factors such as serum calcium levels, renal function, and the presence of other medical conditions.
Side Effects
Common Side Effects:
- Constipation
- Nausea
- Upset Stomach
- Dry mouth
- Increased thirst
Rare but Serious Side Effects:
- Hypercalcemia (high blood calcium levels)
- Allergic reactions (rash, itching, hives, swelling)
- Cardiac arrhythmias
Long-Term Effects: With careful dosage management and monitoring, calcium lactobionate is generally considered safe for long-term use. However, monitoring calcium levels and adjusting dosage as needed are essential.
Contraindications
- Hypercalcemia
- Hyperparathyroidism
- Severe renal impairment
- Hypersensitivity to calcium lactobionate or any of its components
Drug Interactions
- Thiazide diuretics (can increase calcium levels)
- Antacids (may affect calcium absorption)
- Tetracycline antibiotics
- Digoxin (calcium can increase the risk of digoxin toxicity)
- Bisphosphonates (calcium can decrease their absorption)
- Levothyroxine (calcium can decrease its absorption)
- Quinolone antibiotics (calcium can decrease their absorption)
Pregnancy and Breastfeeding
Calcium lactobionate is generally considered safe during pregnancy and breastfeeding when taken at recommended doses. Adequate calcium intake is important during these periods for both maternal and fetal/infant health. However, it’s always advisable to consult a physician before taking any medication during pregnancy or while breastfeeding. FDA category C
Drug Profile Summary
- Mechanism of Action: Replenishes calcium levels in the body
- Side Effects: Constipation, nausea, upset stomach, hypercalcemia (rare)
- Contraindications: Hypercalcemia, severe renal impairment
- Drug Interactions: Thiazide diuretics, antacids, tetracycline antibiotics, digoxin
- Pregnancy & Breastfeeding: Generally safe
- Dosage: 1–2 grams daily, divided into 1–2 doses
- Monitoring Parameters: Serum calcium levels, renal function tests
Popular Combinations
Calcium lactobionate may be combined with vitamin D to enhance calcium absorption and utilization. Other combinations may depend on the specific clinical need.
Precautions
- Monitor calcium levels regularly, especially during long-term use.
- Use cautiously in patients with renal impairment.
- Adjust the dosage based on individual needs and the severity of calcium deficiency.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Lactobionate?
A: The standard adult dosage is 1–2 grams daily, divided into 1-2 doses. Pediatric doses should be determined by a healthcare provider.
Q2: What are the common side effects of Calcium Lactobionate?
A: Common side effects include constipation, nausea, upset stomach, dry mouth, and increased thirst.
Q3: Who should not take Calcium Lactobionate?
A: Patients with hypercalcemia, hyperparathyroidism, or severe renal impairment should not take this medication.
Q4: How does Calcium Lactobionate interact with other medications?
A: It can interact with drugs like thiazide diuretics, antacids, tetracyclines, digoxin, and certain antibiotics.
Q5: Can pregnant or breastfeeding women take Calcium Lactobionate?
A: It is generally considered safe during pregnancy and breastfeeding when taken at recommended dosages. Consult with a healthcare provider for personalized advice.
Q6: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember, unless it’s close to the next scheduled dose. Do not double the dose.
Q7: How is Calcium Lactobionate administered?
A: It is typically administered orally.
Q8: What should I monitor while taking Calcium Lactobionate?
A: Monitor serum calcium levels and renal function during treatment.
Q9: Is calcium lactobionate safe for long-term use?
A: It can be used long-term under appropriate monitoring. Regularly check serum calcium levels and adjust the dosage as needed.
Q10: What is the role of calcium in the body?
A: Calcium plays vital roles in nerve and muscle function, blood clotting, enzyme activity, and bone formation.
