Home Drug Guide Calcium Acetate

Drug Guide

Generic Name

Calcium Acetate

Brand Names Procalamine

Classification

Therapeutic: Electrolyte replacement / phosphate binder

Pharmacological: Calcium salt

FDA Approved Indications

Prevention and treatment of hyperphosphatemia in patients with chronic renal failure on dialysis

Mechanism of Action

Binds dietary phosphate in the gastrointestinal tract, decreasing phosphate absorption; supplies calcium which can also bind phosphate.

Dosage and Administration

Adult: Typically 30-60 mmol daily in divided doses, adjusted based on serum phosphate levels.

Pediatric: Dosing varies; must be prescribed by a healthcare provider, generally based on weight and serum phosphate levels.

Geriatric: Careful monitoring for hypercalcemia and vascular calcification due to age-related comorbidities.

Renal Impairment: Use with caution; dose adjustments based on serum phosphate and calcium levels.

Hepatic Impairment: Not specifically indicated; use caution.

Pharmacokinetics

Absorption: Absorbed from gastrointestinal tract.

Distribution: Distributed mainly in extracellular fluid.

Metabolism: Metabolized minimally; primarily acts locally in GI tract.

Excretion: Excreted via feces; some calcium absorbed may influence serum calcium levels.

Half Life: Dependent on serum calcium and phosphate levels, not precisely defined.

Contraindications

Hypercalcemia
Patients with calcium or phosphate imbalance

Precautions

Vigilance for signs of hypercalcemia or vascular calcification; renal function monitoring.

Adverse Reactions - Common

Hypocalcemia (if overdose or inappropriate dosing) (Uncommon)
Hypercalcemia (Uncommon)

Adverse Reactions - Serious

Vascular calcification (Rare)
Gastrointestinal disturbances (nausea, vomiting, constipation) (Common)

Drug-Drug Interactions

Digoxin (altered serum calcium may enhance toxicity)
Tetracyclines (bind calcium, reducing absorption)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor serum calcium, phosphate, renal function, and signs of calcification.

Diagnoses:

Electrolyte imbalance
Risk for hypercalcemia

Implementation: Administer with meals to facilitate binding of phosphate; monitor serum levels.

Evaluation: Serum phosphate and calcium levels within target range; absence of signs of calcification or hypercalcemia.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of hypercalcemia (muscular weakness, confusion, arrhythmias).
Maintain regular follow-up for blood tests.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: N/A

Lab Test Interference: May interfere with calcium and phosphate lab assays.

Overdose Management

Signs/Symptoms: Symptoms of hypercalcemia: nausea, vomiting, confusion, arrhythmias, vascular calcification.

Treatment: Discontinuation of calcium acetate; symptomatic and supportive care; chelation if severe.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.