Usual Adult Dose for Hypocalcemia

Recommended dose: 1250 mg orally 2 to 3 times a day with meals

Use: Prevention of calcium deficiency

Usual Adult Dose for Dyspepsia

Chewable Tablets:

• Recommended dose: 1000 to 3531 mg orally up to 4 times a day as needed
• Maximum dose: 6750 to 7500 mg/day
• Duration of therapy: Up to 2 weeks

Gum:
Recommended dose: 500 mg (1 piece) orally every 2 to 4 hours as needed
Maximum dose: 6000 mg/day (12 pieces/day)
Duration of therapy: Up to 2 weeks

Liquid:
Recommended dose: 1250 mg orally as needed for symptoms
Maximum dose: 7500 mg/day
Duration of therapy: Up to 2 weeks

Powder Packets:
Recommended dose: 1000 mg (1 packet) orally as needed for symptoms
Maximum dose: 8000 mg/day (8 packets/day)
Duration of therapy: Up to 2 week

Comment:

• This drug should only be used for 2 weeks except under the supervision of a healthcare provider.

Use: Relief of upset stomach due to heartburn, acid indigestion, and/or sour stomach

Usual Pediatric Dose for Dyspepsia

Chewable Tablets:
2 to 5 years OR 24 to 47 pounds:

• Recommended dose: 400 mg orally up to 3 times a day as needed
• Maximum dose: 1200 mg/day
• Duration of therapy: Up to 2 weeks

6 to 11 years OR 48 to 95 pounds:

• Recommended dose: 800 mg orally up to 3 times a day as needed
• Maximum dose: 2400 mg/day
• Duration of therapy: Up to 2 weeks

12 years and older:

• Recommended dose: 1000 to 2000 mg orally up to 3 times a day as needed
• Maximum dose: 7500 mg/day
• Duration of therapy: Up to 2 weeks

Granule Formulations:
2 to 5 years OR 24 to 47 pounds:

• Recommended dose: 375 mg orally up to 2 times a day as needed

6 to 11 years OR 48 to 95 pounds:

• Recommended dose :750 mg orally once a day as needed
• Duration of therapy: Up to 2 weeks

Gum:
12 years and older:

• Recommended dose: 500 mg (1 piece) orally every 2 to 4 hours as needed
• Maximum dose: 6000 mg/day (12 pieces/day)
• Duration of therapy: Up to 2 weeks

Comments:

• Weight-based dosing is preferred for pediatric patients.
• This drug should only be used for 2 weeks except under the supervision of a healthcare provider.
• Once opened, granule packets should be used within 2 weeks.

Use: Relief of upset stomach due to heartburn, acid indigestion, sour stomach, and/or overindulgence in food/drink

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Pregnant patients:
Dyspepsia:

• Maximum daily dose: 4500 to 5000 mg/day

Precautions

Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Chewable tablets: Patients should thoroughly chew or suck on the tablet before swallowing.
• Effervescent tablets: Patients should completely dissolve the tablet in water before drinking the solution.
• Granule packets: Once the correct dose is determined, the powder should be poured into a cup with 0.51 oz (approximately 15 mL) of water, stirred, and consumed.
• Liquid formulations: Shake well before use.
• Powder packets: Once the packet is opened, the powder should be placed on the tongue and swallowed, with or without water.

Storage requirements:

• The manufacturer product information should be consulted.

General:

• Effervescent tablets contain insoluble calcium carbonate; when the tablet is added to water, it is converted into absorbable calcium carbonate.

Monitoring:

• Periodic plasma calcium levels and urine calcium excretion tests, especially in patients with mild to moderate renal dysfunction, on prolonged treatment, or those with mild hypercalciuria and/or with a history of kidney stones
• Serum creatinine and other renal function tests, especially with long-term treatment and/or those on treatment with cardiac glycosides or diuretics

Patient advice:

• Patients should be advised to report any signs/symptoms of milk-alkali syndrome (e.g., frequent urination, continuous headache, loss of appetite, nausea, vomiting, unusual tiredness/weakness, hypercalcemia, alkalosis, renal impairment).