Hemocal

Indications

Calcium is used to:

• Prevent and treat calcium deficiency when diet does not provide enough.
• Support treatment of osteoporosis (weak bones) and osteomalacia, usually together with vitamin D.
• Meet higher needs during pregnancy, breastfeeding, growth and old age.
• Treat low blood calcium (hypocalcaemia); severe cases need injections in hospital.

Some calcium salts are also used as antacids for heartburn, or to control high phosphate levels in kidney disease, as prescribed.

How It Works

Calcium is the main mineral in bones and teeth. It is also needed for muscles to contract, nerves to send signals, the heart to beat normally and blood to clot. Vitamin D helps the gut absorb calcium.

Dosage and Administration

• Adults, supplement: usually 500 to 1000 mg of elemental calcium a day (the amount of calcium itself, shown on the pack), split into doses of no more than about 500 mg at a time.
• Calcium carbonate is best taken with meals; calcium citrate can be taken with or without food.
• Kidney disease, low blood calcium and children: as prescribed.
• Injections (such as Calcium Gluconate) are given by a doctor or nurse in hospital.

Chewable and effervescent tablets should be chewed or fully dissolved in water as directed.

Interactions

• Calcium reduces the absorption of Tetracycline, Doxycycline, Ciprofloxacin, Levofloxacin, Levothyroxine, iron, zinc, Alendronate and other bisphosphonates. Take these at least 2 hours before or 4 hours after calcium (Levothyroxine at least 4 hours apart; bisphosphonates as the leaflet directs).
• Thiazide diuretics such as Hydrochlorothiazide can raise blood calcium.
• High calcium levels increase the risk of heart rhythm problems with Digoxin.
• Corticosteroids reduce calcium absorption.

Contraindications

• High blood calcium (hypercalcaemia) or high calcium in the urine.
• Calcium-containing kidney stones (unless a doctor advises).
• Severe kidney failure, unless prescribed by the doctor.
• Allergy to any ingredient of the product.

Side Effects

Common: constipation, wind, bloating and mild stomach upset. Too much calcium over time can raise blood calcium. Get urgent medical help if you have signs of high calcium (severe nausea or vomiting, extreme thirst, passing a lot of urine, confusion, muscle weakness or an irregular heartbeat), severe stomach or back pain that could be a kidney stone, or a serious allergic reaction.

Pregnancy and Lactation

Calcium supplements are commonly recommended in pregnancy and breastfeeding at normal doses, especially when diet is low in calcium. Follow the doctor's advice on dose.

Precautions and Warnings

Tell the doctor if you have kidney disease, kidney stones, heart disease or sarcoidosis. Do not take more than the recommended dose, and count calcium from all products, including antacids. Long-term high-dose use may need blood tests.

Overdose

Overdose can cause high blood calcium, with nausea, vomiting, thirst, constipation, confusion and an irregular heartbeat. Seek urgent medical help.

Therapeutic Class

Mineral supplement (calcium preparation).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep effervescent tablets tightly closed.