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CALCIUM SUPPLEMENTS (Systemic)
Some commonly used brand names are:
In the U.S.—
Calcium supplements are taken by individuals who are unable to get enough calcium in their regular diet or who have a need for more calcium. They are used to prevent or treat several conditions that may cause hypocalcemia (not enough calcium in the blood). The body needs calcium to make strong bones. Calcium is also needed for the heart, muscles, and nervous system to work properly.
The bones serve as a storage site for the body"s calcium. They are continuously giving up calcium to the bloodstream and then replacing it as the body"s need for calcium changes from day to day. When there is not enough calcium in the blood to be used by the heart and other organs, your body will take the needed calcium from the bones. When you eat foods rich in calcium, the calcium will be restored to the bones and the balance between your blood and bones will be maintained.
Pregnant women, nursing mothers, children, and adolescents may need more calcium than they normally get from eating calcium-rich foods. Adult women may take calcium supplements to help prevent a bone disease called osteoporosis. Osteoporosis, which causes thin, porous, easily broken bones, may occur in women after menopause, but may sometimes occur in elderly men also. Osteoporosis in women past menopause is thought to be caused by a reduced amount of ovarian estrogen (a female hormone). However, a diet low in calcium for many years, especially in the younger adult years, may add to the risk of developing it. Other bone diseases in children and adults are also treated with calcium supplements.
Calcium supplements may also be used for other conditions as determined by your health care professional.
Injectable calcium is administered only by or under the supervision of your health care professional. Other forms of calcium are available without a prescription.
Calcium supplements are available in the following dosage forms:
A calcium ``salt"" contains calcium along with another substance, such as carbonate or gluconate. Some calcium salts have more calcium (elemental calcium) than others. For example, the amount of calcium in calcium carbonate is greater than that in calcium gluconate. To give you an idea of how different calcium supplements vary in calcium content, the following chart explains how many tablets of each type of supplement will provide 1000 milligrams of elemental calcium. When you look for a calcium supplement, be sure the number of milligrams on the label refers to the amount of elemental calcium, and not to the strength of each tablet.
Importance of DietFor good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods. If you think that you are not getting enough vitamins and/or minerals in your diet, you may choose to take a dietary supplement.
The daily amount of calcium needed is defined in several different ways.
Normal daily recommended intakes in milligrams (mg) for calcium are generally defined as follows:
Getting the proper amount of calcium in the diet every day and participating in weight-bearing exercise (walking, dancing, bicycling, aerobics, jogging), especially during the early years of life (up to about 35 years of age) is most important in helping to build and maintain bones as dense as possible to prevent the development of osteoporosis in later life.
The following table includes some calcium-rich foods. The calcium content of these foods can supply the daily RDA or RNI for calcium if the foods are eaten regularly in sufficient amounts.
Vitamin D helps prevent calcium loss from your bones. It is sometimes called ``the sunshine vitamin"" because it is made in your skin when you are exposed to sunlight. If you get outside in the sunlight every day for 15 to 30 minutes, you should get all the vitamin D you need. However, in northern locations in winter, the sunlight may be too weak to make vitamin D in the skin. Vitamin D may also be obtained from your diet or from multivitamin preparations. Most milk is fortified with vitamin D.
Do not use bonemeal or dolomite as a source of calcium . The Food and Drug Administration has issued warnings that bonemeal and dolomite could be dangerous because these products may contain lead.
Before Using This Dietary Supplement
If you are taking this dietary supplement without a prescription, carefully read and follow any precautions on the label. For calcium supplements, the following should be considered:
Pregnancy—It is especially important that you are receiving enough calcium when you become pregnant and that you continue to receive the right amount of calcium throughout your pregnancy. The healthy growth and development of the fetus depend on a steady supply of nutrients from the mother. However, taking large amounts of a dietary supplement during pregnancy may be harmful to the mother and/or fetus and should be avoided.
Breast-feeding—It is especially important that you receive the right amount of calcium so that your baby will also get the calcium needed to grow properly. However, taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or baby and should be avoided.
Children—Problems in children have not been reported with intake of normal daily recommended amounts. Injectable forms of calcium should not be given to children because of the risk of irritating the injection site.
Older adults—Problems in older adults have not been reported with intake of normal daily recommended amounts. It is important that older people continue to receive enough calcium in their daily diets. However, some older people may need to take extra calcium or larger doses because they do not absorb calcium as well as younger people. Check with your health care professional if you have any questions about the amount of calcium you should be taking in each day.
Medicines or other dietary supplements—Although certain medicines or dietary supplements should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your health care professional may want to change the dose, or other precautions may be necessary. When you are taking calcium supplements, it is especially important that your health care professional know if you are taking any of the following:
Other medical problems—The presence of other medical problems may affect the use of calcium supplements. Make sure you tell your health care professional if you have any other medical problems, especially:
Proper Use of This Dietary Supplement
Dosing—The amount of calcium needed to meet normal daily recommended intakes will be different for different individuals. The following information includes only the average amounts of calcium.
Drink a full glass (8 ounces) of water or juice when taking a calcium supplement. However, if you are taking calcium carbonate as a phosphate binder in kidney dialysis, it is not necessary to drink a glass of water.
This dietary supplement is best taken 1 to 11/2 hours after meals , unless otherwise directed by your health care professional. However, patients with a condition known as achlorhydria may not absorb calcium supplements on an empty stomach and should take them with meals.
For individuals taking the chewable tablet form of this dietary supplement:
For individuals taking the syrup form of this dietary supplement:
Take this dietary supplement only as directed. Do not take more of it and do not take it more often than recommended on the label. To do so may increase the chance of side effects.
Missed dose—If you are taking this dietary supplement on a regular schedule and you miss a dose, take it as soon as possible, then go back to your regular dosing schedule.
Storage—To store this dietary supplement:
Precautions While Using This Dietary Supplement
If this dietary supplement has been ordered for you by your health care professional and you will be taking it in large doses or for a long time, your health care professional should check your progress at regular visits. This is to make sure the calcium is working properly and does not cause unwanted effects.
Do not take calcium supplements within 1 to 2 hours of taking other medicine by mouth . To do so may keep the other medicine from working properly.
Unless you are otherwise directed by your health care professional, to make sure that calcium is used properly by your body:
Some calcium carbonate tablets have been shown to break up too slowly in the stomach to be properly absorbed into the body. If the calcium carbonate tablets you purchase are not specifically labeled as being ``USP,"" check with your pharmacist. He or she may be able to help you determine which tablets are best.
Side Effects of This Dietary Supplement
Along with its needed effects, a dietary supplement may cause some unwanted effects. Although the following side effects occur very rarely when the calcium supplement is taken as recommended, they may be more likely to occur if:
Check with your health care professional as soon as possible if any of the following side effects occur:
More common (for injection form only)
Dizziness; flushing and/or sensation of warmth or heat; irregular heartbeat; nausea or vomiting; skin redness, rash, pain, or burning at injection site; sweating; tingling sensation
Difficult or painful urination; drowsiness; nausea or vomiting (continuing); weakness
Early signs of overdose
Constipation (severe) ; dryness of mouth ; headache (continuing) ; increased thirst ; irritability ; loss of appetite ; mental depression ; metallic taste ; unusual tiredness or weakness
Late signs of overdose
Confusion ; drowsiness (severe) ; high blood pressure ; increased sensitivity of eyes or skin to light ; irregular, fast, or slow heartbeat; unusually large amount of urine or increased frequency of urination
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your health care professional.
Once a medicine or dietary supplement has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, calcium supplements are used in certain patients with the following medical condition:
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.
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