Calcetate

Each tablet contains Calcium acetate 1000 mg, equivalent to calcium 253 mg (31.625% Thai RDI).

Patients with advanced renal insufficiency (creatinine clearance less than 30 mL/min) exhibit phosphate retention and some degree of hyperphosphatemia. The retention of phosphate plays a pivotal role in causing secondary hyperparathyroidism associated with osteodystrophy, and soft tissue calcification. Therapeutic efforts directed toward the control of hyperphosphatemia include reduction in the dietary intake of phosphate, inhibition of absorption of phosphate in the intestine with phosphate binders, and removal of phosphate from the body by more efficient methods of dialysis. The rate of removal of phosphate by dietary manipulation or by dialysis is insufficient. Dialysis patients absorb 40% to 80% of dietary phosphorous. Therefore, the fraction of dietary phosphate absorbed from the diet needs to be reduced by using phosphate binders in most renal failure patients on maintenance dialysis. Calcium acetate when taken with meals, combines with dietary phosphate to form insoluble phosphate which is excreted in the feces. Maintenance of serum phosphorus below 6.0 mg/dL is generally considered as a clinically acceptable outcome of treatment with phosphate binders. Calcium acetate is highly soluble at neutral pH, making the calcium readily available for binding to phosphate in the proximal small intestine.
Orally administered calcium acetate from pharmaceutical dosage forms has been demonstrated to be systemically absorbed up to approximately 40% under fasting conditions and up to approximately 30% under nonfasting conditions.

Calcetate is indicated for control of hyperphosphatemia in chronic renal failure and does not promote aluminum absorption.
Treatment of calcium deficiency states which may occur in diseases such as; acute and chronic hypoparathyroidism, postmenopausal and senile osteoporosis, rickets and osteomalacia.
Calcium supplement in children, pregnant and lactating women.

The initial dose of Calcetate for the adult dialysis patient is 1 tablet with each meal. The dosage may be increased gradually to bring serum phosphate value below 6 mg/dL, as long as hypercalcemia does not develop. Most patients require 2-3 tablets with each meal.
Hypocalcaemia: 1-2 tablets 2 times daily after meals, or as prescribed by the physician.

Patients with hypercalcemia.

Patients with end stage renal failure may develop hypercalcemia when given calcium with meals. No other calcium supplements should be given concurrently with Calcetate.

Excessive dosage of Calcetate induces hypercalcemia; therefore, early in the treatment during dosage adjustment serum calcium should be determined twice weekly. Should hypercalcemia develop, the dosage should be reduced or the treatment discontinued immediately depending on the severity of hypercalcemia. Calcetate should not be given to patients on digitalis, because hypercalcemia may precipitate cardiac arrhythmias.

Hypercalcemia may occur during treatment with Calcetate. Mild hypercalcemia (Ca >l0.5 mg/dL) may be asymptomatic or manifest itself as constipation, anorexia, nausea and vomiting. More severe hypercalcemia (Ca >l2 mg/dL) is associated with confusion, delirium, stupor and coma.

Store below 30°C in a dry place and protected from light.

Calcium/with Vitamins

V03AE07 - calcium acetate ; Belongs to the class of drugs used in the treatment of hyperkalemia and hyperphosphatemia.

NDD