Calcium Lactate

• Hypocalcemia: Treatment and prevention of calcium deficiency in conditions such as hypoparathyroidism, vitamin D deficiency, and chronic renal disease.
• Osteoporosis: Adjunctive therapy for prevention and treatment to improve bone mineral density.
• Rickets and Osteomalacia: Supplementation in vitamin D and calcium-deficient states causing defective bone mineralization.
• Calcium Supplementation: General supplementation in dietary calcium deficiency.
• Tetany and Muscle Spasms: Resulting from low serum calcium levels.
• Dental Applications: As a calcium source in remineralization therapies.
• Off-label Uses:
• Supportive therapy in patients with certain metabolic bone disorders.
• Adjunctive treatment in blood transfusion-induced hypocalcemia due to citrate toxicity.

Adults:

• Oral dosage generally provides 500 mg to 1500 mg elemental calcium daily, divided into 2-3 doses.
• Typical calcium lactate dosage: 1.5–3 grams daily, providing approximately 270–540 mg elemental calcium.
• Administer with meals to improve absorption and reduce gastrointestinal discomfort.

Pediatrics:

• Dose based on weight and clinical indication, generally 20–50 mg elemental calcium/kg/day in divided doses.

Elderly:

• Use standard dosing; monitor for calcium levels and renal function.

Special Populations:

• Renal Impairment: Use with caution; monitor serum calcium and phosphate regularly.

Administration Route:

• Oral tablets, capsules, or powder for suspension.

Duration:

• As prescribed by physician; long-term supplementation may be necessary in chronic conditions.

Calcium lactate dissociates in the gastrointestinal tract to release bioavailable calcium ions, which are essential for various physiological functions including bone mineralization, muscle contraction, nerve transmission, and blood coagulation. By replenishing serum calcium levels, calcium lactate corrects hypocalcemia and supports normal skeletal function. It also modulates parathyroid hormone activity, which regulates calcium and phosphate balance.

• Absorption: Approximately 30–40% of orally administered calcium lactate is absorbed in the small intestine, with absorption enhanced by gastric acidity.
• Distribution: Calcium is primarily distributed in extracellular fluid and stored in bone.
• Metabolism: Calcium ions are physiologically utilized or stored; calcium itself is not metabolized.
• Elimination: Excess calcium is excreted mainly by the kidneys.
• Onset: Oral calcium levels rise within hours after ingestion.
• Half-life: Serum calcium half-life is variable, dependent on physiological and pathological states.

• Pregnancy: Category C. Calcium supplementation is essential during pregnancy; use only if clearly needed.
• Lactation: Calcium passes into breast milk; generally considered safe during breastfeeding at recommended doses.

• Therapeutic Class: Mineral Supplement
• Subclass: Calcium Salt

• Known hypersensitivity to calcium lactate or excipients.
• Hypercalcemia or hypercalciuria.
• Ventricular fibrillation or cardiac arrhythmias related to hypercalcemia.
• Concurrent use with calcium-containing phosphate supplements without monitoring.

• Use cautiously in patients with renal impairment or history of nephrolithiasis.
• Monitor serum calcium and phosphate levels to avoid hypercalcemia or hyperphosphatemia.
• Excessive intake can lead to gastrointestinal side effects and vascular calcification.
• Patients on digitalis glycosides require close monitoring due to risk of toxicity with calcium.
• Avoid concomitant administration with tetracyclines or bisphosphonates as calcium reduces their absorption.

Common:

• Gastrointestinal discomfort including nausea, constipation, flatulence, and abdominal pain.

Serious/Rare:

• Hypercalcemia: confusion, polyuria, muscle weakness.
• Allergic reactions: rash, itching, swelling (rare).
• Nephrolithiasis with prolonged high doses.

• Tetracyclines and Fluoroquinolones: Reduced absorption when taken with calcium supplements; separate dosing by at least 2 hours.
• Bisphosphonates: Calcium reduces absorption; administer calcium at least 1 hour after bisphosphonates.
• Digitalis Glycosides: Hypercalcemia increases risk of digoxin toxicity.
• Thiazide Diuretics: May enhance hypercalcemia risk.
• Levothyroxine: Calcium may reduce absorption; separate administration times.

• Current guidelines emphasize individualized calcium supplementation tailored to dietary intake and clinical need.
• Recommendations support calcium lactate as an effective alternative to calcium carbonate in patients with reduced gastric acidity.
• No recent major changes in approved indications; focus remains on monitoring to avoid complications of over-supplementation.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep container tightly closed.
• Keep out of reach of children.