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Calcium Acetate: Uses, Dosage, and Side Effects for Kidney Health
Summary of Key Points
Calcium acetate is primarily used to manage elevated phosphate levels in individuals with chronic kidney disease. By reducing phosphate absorption, it helps prevent complications such as bone disease. Available in various forms and strengths, it is crucial to consult your healthcare provider before making any changes to your dosage. Consider scheduling a telemedicine appointment with one of our providers for personalized guidance.
Names of Medication
US Brand Name: PhosLo (Calcium acetate)
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, the generic name is listed in parentheses.
Pharmacologic Category
Phosphate Binder: Calcium acetate is classified as a phosphate binder, used to control phosphate levels in patients with kidney disease.
Calcium Acetate Dosage
Calcium acetate is prescribed for various conditions, primarily related to phosphate management and bone health. Below are the recommended dosages for adults. Always consult your doctor before making any adjustments. If you have concerns, consider scheduling a telemedicine visit with one of our providers.
Hyperphosphatemia in Chronic Kidney Disease
Initial Dose: 2 tablets (each 667 mg) with each meal.
Maintenance Dose: Adjust based on serum phosphate levels. Typically, 2-3 tablets with each meal.
Duration: Continue as long as phosphate levels remain elevated or as directed by your healthcare provider.
Renal Osteodystrophy
Initial Dose: 2 tablets (each 667 mg) with each meal.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: Long-term treatment may be required. Follow your doctor’s recommendations.
Osteoporosis
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: Long-term treatment may be necessary. Consult your healthcare provider.
Hypoparathyroidism
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium levels.
Duration: Long-term treatment may be required. Follow your doctor’s recommendations.
Vitamin D Deficiency
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: As directed by your healthcare provider.
Secondary Hyperparathyroidism
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: Long-term treatment may be necessary. Consult your healthcare provider.
Bone Loss
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: As directed by your healthcare provider.
Kidney Stones
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: As directed by your healthcare provider.
Malabsorption Syndromes
Initial Dose: 2 tablets (each 667 mg) with meals.
Maintenance Dose: Adjust based on calcium and phosphate levels.
Duration: Long-term treatment may be required. Consult your healthcare provider.
Dosage Forms and Strengths
Calcium acetate is available in the following forms and strengths:
- Tablets: 667 mg
- Capsules: 667 mg
- Oral solution: 667 mg per 5 mL
Administration Instructions
Take calcium acetate with meals to bind phosphate from food. Swallow tablets or capsules whole with a full glass of water. If using the oral solution, measure the dose carefully with a special device or spoon—avoid household spoons to ensure accuracy. Always follow your healthcare provider’s instructions.
Contraindications for Calcium Acetate
Contraindications are conditions where a medication should not be used due to potential harm. For calcium acetate, the following conditions may pose risks:
- Hypercalcemia (high calcium levels): Calcium acetate raises calcium levels, which can worsen hypercalcemia, leading to complications like kidney stones or heart issues.
- Severe renal impairment: Patients with significantly reduced kidney function may struggle to eliminate calcium, increasing the risk of dangerous calcium buildup.
- Hypophosphatemia (low phosphate levels): Since calcium acetate lowers phosphate, taking it when phosphate levels are already low can cause further imbalances, leading to muscle weakness and bone pain.
- Allergy to calcium acetate: If you are allergic to calcium acetate or any of its ingredients, taking it could trigger an allergic reaction, including rash, swelling, or breathing difficulties.
Always consult your healthcare provider before starting calcium acetate, especially if you have any of the conditions listed above. If you are unsure, one of our telemedicine providers can help assess your situation and recommend the best course of action.
Calcium Acetate Drug Interactions
Calcium acetate can interact with other medications, potentially reducing their effectiveness or increasing the risk of side effects. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal products. Below are some medications that may interact with calcium acetate:
- Levothyroxine (Synthroid): Calcium acetate can reduce the absorption of levothyroxine, making it less effective.
- Fluoroquinolone antibiotics (Cipro, Levaquin): Calcium acetate can bind to these antibiotics in the stomach, reducing their absorption and effectiveness.
- Tetracycline antibiotics (Doxycycline): Calcium acetate can interfere with tetracycline absorption, reducing its effectiveness.
- Bisphosphonates (Fosamax): Calcium acetate can reduce the absorption of bisphosphonates, which are used to treat osteoporosis.
- Digoxin (Lanoxin): Taking calcium acetate with digoxin can increase the risk of digoxin toxicity, leading to irregular heartbeats and other serious side effects.
Your healthcare provider may recommend taking these medications at different times or adjusting your dosage to avoid interactions. If you have concerns, our telemedicine providers can help you manage your medications safely.
Calcium Acetate in Pregnancy
Is it safe to take Calcium acetate during pregnancy? The safety of Calcium acetate during pregnancy has not been fully established. While calcium is essential for both mother and baby, excessive intake can lead to complications such as hypercalcemia, which may affect both. If you are pregnant or planning to become pregnant, it is important to discuss the potential risks and benefits of taking Calcium acetate with your healthcare provider. They can help determine whether this medication is appropriate for you during pregnancy.
Calcium Acetate While Breastfeeding
Is it safe to take Calcium acetate while breastfeeding? Calcium acetate is generally considered safe during breastfeeding, as calcium is a natural component of breast milk. However, elevated calcium levels in the mother’s blood could potentially impact the baby. It is essential to consult your healthcare provider before taking Calcium acetate while breastfeeding to ensure it is safe for both you and your baby.
Estimated Cost of Calcium Acetate Medication
The cost of a 30-day supply of Calcium acetate without insurance can vary depending on the pharmacy and location. With a GoodRx coupon, prices typically range from $15 to $30 for a 30-day supply. Be sure to check with your pharmacy for the most accurate pricing, and consider using a discount card or coupon to help lower your out-of-pocket expenses.
Possible Alternatives to Calcium Acetate
If Calcium acetate is not suitable for you, or if you are exploring other treatment options, there are alternative medications and lifestyle changes that may help manage the conditions it treats. Always consult your healthcare provider or one of our telemedicine providers before making any changes to your treatment plan.
Hyperphosphatemia
Other phosphate binders, such as sevelamer (Renvela) or lanthanum carbonate (Fosrenol), may be considered as alternatives. Additionally, dietary modifications, such as reducing phosphate intake from foods like dairy products, meats, and sodas, can help manage phosphate levels.
Chronic Kidney Disease
In addition to phosphate binders like Calcium acetate, managing chronic kidney disease often involves controlling blood pressure and blood sugar, along with making dietary changes. Medications such as ACE inhibitors or ARBs may be prescribed to help protect kidney function.
Renal Osteodystrophy
Treatment may include vitamin D supplements or medications like calcitriol to support bone health. Phosphate binders and dietary adjustments can also play a role in managing this condition.
Osteoporosis
Medications such as bisphosphonates (Fosamax) or denosumab (Prolia) may be prescribed to strengthen bones. Engaging in weight-bearing exercises, consuming calcium-rich foods, and taking vitamin D supplements can also help improve bone health.
Hypoparathyroidism
Treatment typically involves calcium and vitamin D supplements to maintain normal calcium levels. In some cases, synthetic parathyroid hormone may be prescribed to help regulate calcium levels.
Vitamin D Deficiency
Common treatments for vitamin D deficiency include vitamin D supplements and increased sun exposure. Your healthcare provider may recommend specific dosages based on your blood levels.
Secondary Hyperparathyroidism
In addition to phosphate binders like Calcium acetate, medications such as calcimimetics (Sensipar) may be prescribed to help regulate parathyroid hormone levels.
Bone Loss
Lifestyle changes, such as increasing physical activity and ensuring adequate calcium and vitamin D intake, can help slow bone loss. Medications like bisphosphonates may also be recommended to help preserve bone density.
Kidney Stones
To help prevent kidney stones, reducing calcium intake from supplements (but not from food) and increasing water consumption are often recommended. Medications such as thiazide diuretics may also be prescribed to reduce the risk of stone formation.
Malabsorption Syndromes
Treatment for malabsorption syndromes may involve taking supplements for nutrients that are not being properly absorbed, such as calcium, vitamin D, or other essential vitamins and minerals. Addressing the underlying cause of malabsorption is also crucial for effective management.
Recent Updates on Calcium Acetate Research
Recent studies on Calcium acetate have focused on its effectiveness in managing hyperphosphatemia in patients with chronic kidney disease. Ongoing research is exploring the long-term safety of Calcium acetate, particularly in relation to calcium buildup in blood vessels (vascular calcification). Some studies suggest that non-calcium-based phosphate binders, such as sevelamer, may be safer for certain patients, especially those at higher risk for vascular calcification. However, Calcium acetate remains a widely used and effective treatment for managing high phosphate levels in many patients with kidney disease.
As research continues to evolve, staying informed about the latest findings is important. If you have concerns about your treatment with Calcium acetate, our telemedicine providers are available to discuss your options and make any necessary adjustments to your care plan.
