Dosing & Uses
Dosage Forms & Strengths
tablet, chewable
- 500mg (Tums Regular, Tums Freshers)
- 750mg (Tums Extra, Tums Kids, Tums Smoothies)
- 1000mg (Tums Ultra)
- 1250mg (Calci-Chew, Oysco)
- 1500mg (Caltrate)
- 1177mg (Tums Chewy Delights)
Antacid
Take at onset of GI distress
Tums Regular, Tums Freshers (500 mg): Chew 2-4 tablets; not to exceed 15 tabs/24 hr
Tums Smoothies (750 mg): Chew 2-4 tablets; not to exceed 10 tabs/24 hr
Tums Extra (750 mg): Chew 2-4 tablets; not to exceed 9 tabs/24 hr
Tums Ultra (1000 mg): Chew 2-3 tablets; not to exceed 7 tabs/24 hr
Tums Chewy Delights (1177 mg): Chew and swallow 2-3 chews; not to exceed 10 chews/24 hr
Not to exceed 7 g/day
Calcium Supplementation
500 mg to 4 g PO qDay or divided q6-12hr with meals
Recommended Dietary Allowance
19-50 years: 1 g/day PO
Females
- >51 years: 1.2 g/day PO
Males
- 51-70 years: 1 g/day PO
- >71 years: 1.2 g/day PO
Dosing Considerations
Calcium carbonate (elemental calcium equivalent)
Approximately 40% of calcium carbonate is elemental calcium; 1000mg of calcium carbonate = 400 mg of elemental calcium
- 400 mg (161 mg)
- 500 mg (200 mg)
- 750 mg (300 mg)
- 1000 mg (400 mg)
- 1250 mg (500 mg)
- 1500 mg (600 mg)
- 1177 mg (470 mg)
Hyperphosphatemia (Orphan)
Treatment of hyperphosphatemia in patients with end-stage renal disease
Orphan indication sponsor
- R & D Laboratories, Inc; 4204 Glencoe Avenue; Marina Del Rey, CA 90292
Dosage Forms & Strengths
tablet, chewable
- 500mg (Tums Regular, Tums Freshers)
- 750mg (Tums Extra, Tums Kids, Tums Smoothies)
- 1000mg (Tums Ultra)
- 1250mg (Calci-Chew, Oysco)
- 1500mg (Caltrate)
- 1177mg (Tums Chewy Delights)
Antacid
Children's Pepto
- <2 years (<11 kg): Safety and efficacy not established
- 2-5 years (12-21 kg): 400 mg (1 tablet) PO PRN; not to exceed 3 tablets/day
- 6-11 years (22-43 kg): 800 mg (2 tablets) PO PRN; not to exceed 6 tablets/day
Tums Kids
- <2 years (<11 kg): Safety and efficacy not established
- 2-4 years (11-21 kg): 375 mg (1/2 tablet) PO BID with meal
- >4 years (22-43 kg): 750 mg (1 tablet) PO TID with meal
Recommended Dietary Allowance
Dosage expressed as elemental calcium
0-6 months: 200 mg/day PO
7-12 months: 260 mg/day PO
1-3 years: 700 mg/day PO
4-8 years: 1000 mg/day PO
9-18 years: 1300 mg/day PO
Dosing Considerations
Calcium carbonate (elemental calcium equivalent)
- 400 mg (161 mg)
- 500 mg (200 mg)
- 750 mg (300 mg)
- 1000 mg (400 mg)
- 1250 mg (500 mg)
- 1500 mg (600 mg)
- 1177 mg (470 mg)
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Frequency Not Defined
Anorexia
Constipation
Flatulence
Nausea
Vomiting
Hypercalcemia
Hypophosphatemia
Milk-alkali syndrome
Warnings
Contraindications
Hypersensitivity
Hypercalciuria
Renal calculi
Hypophosphatemia
Hypercalcemia
Suspected digoxin toxicity
Cautions
Shake suspension well; chew tablets thoroughly
Bloating, gas, and constipation may occur with therapy
Hypercalcemia may occur from long-term use, which may exacerbate nephrolithiasis or cause generalized soft tissue and vascular calcification; may also increase mortality in patients with chronic kidney disease
Drug administration impaired by achlorhydria, common in the elderly; consider using an alternate salt form of calcium
Hypercalciuria and hypercalcemia may occur in patients with hypoparathyroid disease, receiving high doses of vitamin D
Kidney stones reported with use; exercise caution in patients with history
Use caution in patients with renal insufficiency; patients more susceptible toe effects of excess calcium
Advise patients to limit intake of oxalate-rich foods (soy; green, leafy vegetables; animal protein) to avoid reduced absorption through Ca-oxalate formation
Pregnancy & Lactation
Pregnancy category: C
Lactation: Safe; crosses the placenta; appears in breast milk
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Antacid: Neutralizes gastric acidity
Dietary supplement: Prevents or treats negative Ca balance; oral Ca supplements may protect against renal calculi formation by chelating with oxalate in gut and preventing its absorption
Phosphate binder: Binds with dietary phosphate to form insoluble calcium phosphate, which is excreted in feces
Absorption
Bioavailability: 25-35%; food increases absorption 10-30%; antacid action dependent on gastric emptying time
Peak plasma time: 20-60 min (fasting state); up to 3 hr (ingested 1 hr after meals)
Distribution
Protein bound: 45%
Elimination
Renal clearance: 50-300 mg/day
Excretion: Feces, as unabsorbed calcium (80%); urine (20%)
