Calcium + Vitamin D

Pharmacologic Category

Calcium Salt; Electrolyte Supplement, Oral; Vitamin, Fat Soluble

Dosing: Adult

OTC labeling: Dietary supplement: Oral: One to two tablets or caplets twice daily; also consult specific product information

Dosing: Renal Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Use: Labeled Indications

Dietary supplement: Use as a dietary supplement when calcium intake may be inadequate

Administration: Oral

May administer with or without food; administration with food may increase absorption.

Dietary Considerations

Take (preferably with food) 2 hours before or after other medications to minimize GI upset. Some products may contain phenylalanine.

Dietary reference intake for calcium (IOM 2011):

0 to <6 months: Adequate intake: 200 mg elemental calcium daily

6 to 12 months: Adequate intake: 260 mg elemental calcium daily

1 to 3 years: RDA: 700 mg elemental calcium daily

4 to 8 years: RDA: 1,000 mg elemental calcium daily

9 to 18 years: RDA: 1,300 mg elemental calcium daily

19 to 50 years: RDA: 1,000 mg elemental calcium daily

Females ≥51 years: RDA: 1,200 mg elemental calcium daily

Males: 51 to 70 years: RDA: 1,000 mg elemental calcium daily; >70 years: RDA: 1,200 elemental calcium daily

Pregnancy/lactating: RDA: Requirements are the same as in nonpregnant or nonlactating females

Dietary reference intake for vitamin D (IOM 2011):

0 to 12 months: Adequate intake: 400 units/day

1 to 70 years: RDA: 600 units/day

Males >70 years: RDA: 800 units/day

Pregnancy/lactating: RDA: 600 units/day

Medication Patient Education with HCAHPS Considerations

What is this drug used for?

• It is used to help growth and good health.

• It is used to prevent or treat soft, brittle bones (osteoporosis).

• It is used to treat or prevent low calcium levels.

• It may be given to you for other reasons. Talk with the doctor.

Frequently reported side effects of this drug

• Vomiting

• Nausea

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

• Severe constipation

• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Medication Safety Issues

Sound-alike/look-alike issues:

Warnings/Precautions

Concerns related to adverse effects:

• Gastrointestinal effects: Constipation, bloating, and gas are common with calcium supplements (especially carbonate salt).

Disease-related concerns:

• Achlorhydria: Calcium absorption is impaired in achlorhydria; common in elderly, use an alternate salt (eg, citrate) and administer with food.

• Hypoparathyroid disease: Hypercalcemia and hypercalciuria are most likely to occur in hypoparathyroid patients receiving high doses of vitamin D.

• Kidney stones (calcium-containing): Use caution when administering calcium supplements to patients with a history of kidney stones.

• Renal impairment: Use with caution in patients with renal failure to avoid hypercalcemia; frequent monitoring of serum calcium and phosphorus is necessary.

Concurrent drug therapy issues:

• Minerals/other oral drugs: Calcium administration interferes with absorption of some minerals and drugs; use with caution.

Dosage form specific issues:

• Phenylalanine: Some products may contain phenylalanine.

• Shellfish: Some products may be derived from shellfish.

• Soy: Some products may contain soy.

• Tartrazine: Some products may contain tartrazine.

Other warnings/precautions:

• Absorption: Taking calcium (≤500 mg) with food improves absorption.

Geriatric Considerations

Constipation and gas with calcium supplements can be significant in the elderly but are usually mild.

Vitamin D supplementation has been shown to increase muscle function and strength, as well as improve balance. Patients at risk for falls should have vitamin D serum concentrations measured and be evaluated for supplementation.

Briggs' Drugs in Pregnancy & Lactation

• Calcium Carbonate
• Vitamin D

Adverse Reactions

Frequency not defined; also see individual agents

Central nervous system: Headache

Endocrine & metabolic: Hypercalcemia

Gastrointestinal: Gastrointestinal distress

Genitourinary: Hypercalciuria

Allergy and Idiosyncratic Reactions

• Aniline Dye Allergy

Metabolism/Transport Effects

None known.

Drug Interactions Open Interactions

Acalabrutinib: Antacids may decrease the serum concentration of Acalabrutinib. Management: Separate administration of acalabrutinib from the administration of any antacids by at least 2 hours in order to minimize the potential for a significant interaction. Risk D: Consider therapy modification

Alpha-Lipoic Acid: Calcium Salts may decrease the absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease the absorption of Calcium Salts. Risk D: Consider therapy modification

Amphetamines: Antacids may decrease the excretion of Amphetamines. Risk C: Monitor therapy

Antipsychotic Agents (Phenothiazines): Antacids may decrease the absorption of Antipsychotic Agents (Phenothiazines). Risk C: Monitor therapy

Atazanavir: Antacids may decrease the absorption of Atazanavir. Risk D: Consider therapy modification

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Risk X: Avoid combination

Bictegravir: Calcium Salts may decrease the serum concentration of Bictegravir. Management: Bictegravir, emtricitabine, and tenofovir alafenamide can be administered with calcium salts under fed conditions, but coadministration with or 2 hours after a calcium salt is not recommended under fasting conditions. Risk D: Consider therapy modification

Bisacodyl: Antacids may diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur. Risk D: Consider therapy modification

Bismuth Subcitrate: Antacids may diminish the therapeutic effect of Bismuth Subcitrate. Management: Avoid administration of antacids within 30 minutes of bismuth subcitrate (tripotassium bismuth dicitrate) administration. Risk D: Consider therapy modification

Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. Risk D: Consider therapy modification

Bosutinib: Antacids may decrease the serum concentration of Bosutinib. Management: Administer antacids more than 2 hours before or after bosutinib. Risk D: Consider therapy modification

Bromperidol: Antacids may decrease the absorption of Bromperidol. Risk C: Monitor therapy

Calcium Acetate: Calcium Salts may enhance the adverse/toxic effect of Calcium Acetate. Risk X: Avoid combination

Calcium Channel Blockers: Calcium Salts may diminish the therapeutic effect of Calcium Channel Blockers. Risk C: Monitor therapy

Calcium Polystyrene Sulfonate: Antacids may enhance the adverse/toxic effect of Calcium Polystyrene Sulfonate. The combined use of these two agents may result in metabolic alkalosis and/or loss of efficacy of the cation exchange resin. Management: To minimize this interaction, consider: a)separating doses by 2 or more hours; b)rectal administration of the exchange resin; or c)alternatives to antacids. Monitor for metabolic alkalosis and attenuation of CPS effects. Avoid magnesium hydroxide. Risk D: Consider therapy modification

Captopril: Antacids may decrease the serum concentration of Captopril. Risk C: Monitor therapy

Cardiac Glycosides: Calcium Salts may enhance the arrhythmogenic effect of Cardiac Glycosides. Risk C: Monitor therapy

Cefditoren: Antacids may decrease the serum concentration of Cefditoren. Management: Concomitant use of cefditoren with antacids is not recommended. Consider alternative methods to control acid reflux (eg, diet modification) or alternative antimicrobial therapy. If antacid therapy can not be avoided, separate dosing by several hours. Risk D: Consider therapy modification

Cefpodoxime: Antacids may decrease the serum concentration of Cefpodoxime. Risk C: Monitor therapy

Cefuroxime: Antacids may decrease the serum concentration of Cefuroxime. Management: Administer cefuroxime axetil at least 1 hour before or 2 hours after the administration of short-acting antacids. Risk D: Consider therapy modification

Chloroquine: Antacids may decrease the serum concentration of Chloroquine. Management: Separate the administration of antacids and chloroquine by at least 4 hours to minimize any potential negative impact of antacids on chloroquine bioavailability. Risk D: Consider therapy modification

Corticosteroids (Oral): Antacids may decrease the bioavailability of Corticosteroids (Oral). Management: Consider separating doses by 2 or more hours. Budesonide enteric coated tablets could dissolve prematurely if given with drugs that lower gastric acid, with unknown impact on budesonide therapeutic effects. Risk D: Consider therapy modification

Cysteamine (Systemic): Antacids may diminish the therapeutic effect of Cysteamine (Systemic). Risk C: Monitor therapy

Dabigatran Etexilate: Antacids may decrease the serum concentration of Dabigatran Etexilate. Management: Dabigatran etexilate Canadian product labeling recommends avoiding concomitant use with antacids for 24 hours after surgery. In other situations, administer dabigatran etexilate 2 hours prior to antacids. Monitor clinical response to dabigatran therapy. Risk D: Consider therapy modification

Dasatinib: Antacids may decrease the serum concentration of Dasatinib. Management: Simultaneous administration of dasatinib and antacids should be avoided. Administer antacids 2 hours before or 2 hours after dasatinib. Risk D: Consider therapy modification

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider therapy modification

Delavirdine: Antacids may decrease the serum concentration of Delavirdine. Management: Separate doses of delavirdine and antacids by at least 1 hour. Monitor for decreased delavirdine therapeutic effects with this combination. Risk D: Consider therapy modification

Dexmethylphenidate: Antacids may increase the absorption of Dexmethylphenidate. Specifically, antacids may interfere with the normal release of drug from the extended-release capsules (Focalin XR brand), which could result in both increased absorption (early) and decreased delayed absorption. Risk C: Monitor therapy

Diacerein: Antacids may decrease the absorption of Diacerein. Risk C: Monitor therapy

DOBUTamine: Calcium Salts may diminish the therapeutic effect of DOBUTamine. Risk C: Monitor therapy

Dolutegravir: Calcium Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral calcium. Administer dolutegravir/rilpivirine at least 4 hours before or 6 hours after oral calcium salts. Alternatively, dolutegravir and oral calcium can be taken together with food. Risk D: Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider therapy modification

Elvitegravir: Antacids may decrease the serum concentration of Elvitegravir. Management: Separate administration of antacids and elvitegravir-containing products by at least 2 hours in order to minimize the risk for an interaction. Risk D: Consider therapy modification

Erdafitinib: Serum Phosphate Level-Altering Agents may diminish the therapeutic effect of Erdafitinib. Management: Avoid coadministration of serum phosphate level-altering agents with erdafitinib before initial dose increase period based on serum phosphate levels (Days 14 to 21). Risk D: Consider therapy modification

Erlotinib: Antacids may decrease the serum concentration of Erlotinib. Management: Separate the administration of erlotinib and any antacid by several hours in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification

Estramustine: Calcium Salts may decrease the absorption of Estramustine. Risk D: Consider therapy modification

Fosinopril: Antacids may decrease the serum concentration of Fosinopril. Management: The US and Canadian fosinopril manufacturer labels recommend separating the doses of antacids and fosinopril by 2 hours. Risk D: Consider therapy modification

Gefitinib: Antacids may decrease the serum concentration of Gefitinib. Management: Administer gefitinib at least 6 hours before or after administration of an antacid, and closely monitor clinical response to gefitinib. Risk D: Consider therapy modification

Hyoscyamine: Antacids may decrease the serum concentration of Hyoscyamine. Management: Administer immediate release hyoscyamine before meals and antacids after meals when these agents are given in combination. Risk D: Consider therapy modification

Iron Preparations: Antacids may decrease the absorption of Iron Preparations. Management: Separate dosing of oral iron preparations and antacids as much as possible to avoid decreased efficacy of iron preparation. If coadministered with antacids, monitor for decreased therapeutic effects of iron preparations. Exceptions: Ferric Carboxymaltose; Ferric Citrate; Ferric Derisomaltose; Ferric Gluconate; Ferric Hydroxide Polymaltose Complex; Ferric Pyrophosphate Citrate; Ferumoxytol; Iron Dextran Complex; Iron Sucrose. Risk D: Consider therapy modification

Itraconazole: Antacids may decrease the serum concentration of Itraconazole. Antacids may increase the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any antacids. Exposure to Tolsura brand itraconazole may be increased by antacids; consider itraconazole dose reduction. Risk D: Consider therapy modification

Ketoconazole (Systemic): Antacids may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer oral ketoconazole at least 2 hours prior to use of any antacid product. Monitor patients closely for signs of inadequate clinical response to ketoconazole. Risk D: Consider therapy modification

Lanthanum: Antacids may diminish the therapeutic effect of Lanthanum. Risk D: Consider therapy modification

Ledipasvir: Antacids may decrease the serum concentration of Ledipasvir. Management: Separate the administration of ledipasvir and antacids by 4 hours. Risk D: Consider therapy modification

Mesalamine: Antacids may diminish the therapeutic effect of Mesalamine. Antacid-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Avoid concurrent administration of antacids with sustained-release mesalamine products. Separating antacid and mesalamine administration, and/or using lower antacid doses may be adequate means of avoiding this interaction. Risk D: Consider therapy modification

Methenamine: Antacids may diminish the therapeutic effect of Methenamine. Risk D: Consider therapy modification

Methylphenidate: Antacids may increase the absorption of Methylphenidate. Specifically, antacids may interfere with the normal release of drug from the extended-release capsules (Ritalin LA brand), which could result in both increased absorption (early) and decreased delayed absorption. Risk C: Monitor therapy

Multivitamins/Fluoride (with ADE): May increase the serum concentration of Calcium Salts. Calcium Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). More specifically, calcium salts may impair the absorption of fluoride. Management: Avoid eating or drinking dairy products or consuming vitamins or supplements with calcium salts one hour before or after of the administration of fluoride. Risk D: Consider therapy modification

Multivitamins/Minerals (with ADEK, Folate, Iron): Antacids may decrease the serum concentration of Multivitamins/Minerals (with ADEK, Folate, Iron). Specifically, antacids may decrease the absorption of orally administered iron. Management: Separate dosing of oral iron-containing multivitamin preparations and antacids by as much time as possible in order to minimize impact on therapeutic efficacy of the iron preparation. Risk D: Consider therapy modification

Mycophenolate: Antacids may decrease the absorption of Mycophenolate. Management: Separate doses of mycophenolate and antacids by at least 2 hours. Monitor for reduced effects of mycophenolate if taken concomitant with antacids. Risk D: Consider therapy modification

Neratinib: Antacids may decrease the serum concentration of Neratinib. Specifically, antacids may reduce neratinib absorption. Management: Separate the administration of neratinib and antacids by giving neratinib at least 3 hours after the antacid. Risk D: Consider therapy modification

Nilotinib: Antacids may decrease the serum concentration of Nilotinib. Management: Separate the administration of nilotinib and any antacid by at least 2 hours whenever possible in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification

PAZOPanib: Antacids may decrease the serum concentration of PAZOPanib. Management: Avoid the use of antacids in combination with pazopanib whenever possible. Separate doses by several hours if antacid treatment is considered necessary. The impact of dose separation has not been investigated. Risk D: Consider therapy modification

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider therapy modification

Pexidartinib: Antacids may decrease the serum concentration of Pexidartinib. Management: Administer pexidartinib 2 hours before or after antacids. Risk D: Consider therapy modification

Phosphate Supplements: Antacids may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate administration. Separating administer of oral phosphate supplements from antacid administration by as long as possible may minimize the interaction. Exceptions: Sodium Glycerophosphate Pentahydrate. Risk D: Consider therapy modification

Phosphate Supplements: Calcium Salts may decrease the absorption of Phosphate Supplements. Management: This applies only to oral phosphate and calcium administration. Administering oral phosphate supplements as far apart from the administration of an oral calcium salt as possible may be able to minimize the significance of the interaction. Exceptions: Sodium Glycerophosphate Pentahydrate. Risk D: Consider therapy modification

Potassium Phosphate: Antacids may decrease the serum concentration of Potassium Phosphate. Management: Consider separating administration of antacids and oral potassium phosphate by at least 2 hours to decrease risk of a significant interaction. Risk D: Consider therapy modification

QuiNIDine: Antacids may decrease the excretion of QuiNIDine. Risk C: Monitor therapy

Quinolones: Antacids may decrease the absorption of Quinolones. Of concern only with oral administration of quinolones. Management: Avoid concurrent administration of quinolones and antacids to minimize the impact of this interaction. Recommendations for optimal dose separation vary by specific quinolone. Exceptions: LevoFLOXacin (Oral Inhalation). Risk D: Consider therapy modification

Quinolones: Calcium Salts may decrease the absorption of Quinolones. Of concern only with oral administration of both agents. Exceptions: LevoFLOXacin (Oral Inhalation); Moxifloxacin (Systemic). Risk D: Consider therapy modification

Raltegravir: Calcium Carbonate may decrease the serum concentration of Raltegravir. Management: Use of once-daily raltegravir with calcium carbonate is not recommended; dose separation does not appear to be adequate to minimize the significance of this interaction. Use of other raltegravir products do not require any dose change. Risk D: Consider therapy modification

Rilpivirine: Antacids may decrease the serum concentration of Rilpivirine. Management: Administer antacids at least 2 hours before or 4 hours after rilpivirine when used with most rilpivirine products. However, administer antacids at least 6 hours before or 4 hours after the rilpivirine/dolutegravir combination product. Risk D: Consider therapy modification

Riociguat: Antacids may decrease the serum concentration of Riociguat. Management: Separate the administration of antacids and riociguat by at least 1 hour in order to minimize any potential interaction. Risk D: Consider therapy modification

Rosuvastatin: Antacids may decrease the serum concentration of Rosuvastatin. Risk C: Monitor therapy

Sodium Polystyrene Sulfonate: Antacids may enhance the adverse/toxic effect of Sodium Polystyrene Sulfonate. The combined use of these two agents may result in metabolic alkalosis and/or loss of efficacy of the exchange resin. Management: To minimize this interaction, consider: a)separating doses by 2 or more hours; b)rectal administration of the exchange resin; or c)alternatives to antacids. Monitor for metabolic alkalosis and attenuation of SPS effects. Avoid magnesium hydroxide. Risk D: Consider therapy modification

Sotalol: Antacids may decrease the serum concentration of Sotalol. Management: Avoid simultaneous administration of sotalol and antacids. Administer antacids 2 hours after sotalol. Risk D: Consider therapy modification

Strontium Ranelate: Calcium Salts may decrease the serum concentration of Strontium Ranelate. Management: Separate administration of strontium ranelate and oral calcium salts by at least 2 hours in order to minimize this interaction. Risk D: Consider therapy modification

Sulpiride: Antacids may decrease the serum concentration of Sulpiride. Management: Separate administration of antacids and sulpiride by at least 2 hours in order to minimize the impact of antacids on sulpiride absorption. Risk D: Consider therapy modification

Tetracyclines: Antacids may decrease the absorption of Tetracyclines. Management: Separate administration of antacids and oral tetracycline derivatives by several hours when possible to minimize the extent of this potential interaction. Exceptions: Eravacycline. Risk D: Consider therapy modification

Tetracyclines: Calcium Salts may decrease the serum concentration of Tetracyclines. Management: If coadministration of oral calcium with oral tetracyclines can not be avoided, consider separating administration of each agent by several hours. Exceptions: Eravacycline. Risk D: Consider therapy modification

Thiazide and Thiazide-Like Diuretics: May decrease the excretion of Calcium Salts. Continued concomitant use can also result in metabolic alkalosis. Risk C: Monitor therapy

Thyroid Products: Calcium Salts may diminish the therapeutic effect of Thyroid Products. Management: Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours. Risk D: Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. Risk D: Consider therapy modification

Velpatasvir: Antacids may decrease the serum concentration of Velpatasvir. Management: Separate administration of velpatasvir and antacids by at least 4 hours. Risk D: Consider therapy modification

Vitamin D Analogs: Calcium Salts may enhance the adverse/toxic effect of Vitamin D Analogs. Risk C: Monitor therapy

Food Interactions

Food may increase calcium absorption. Calcium may decrease iron absorption. Bran, foods high in oxalates, or whole grain cereals may decrease calcium absorption. Management: Administer preferably with food.

Monitoring Parameters

Monitor serum calcium (particularly if used in patients with severe renal impairment)

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Caplet, oral:

Citracal Maximum: Calcium 315 mg and vitamin D 250 units [gluten free]

Os-Cal Calcium + D3: Calcium 500 mg and vitamin D 200 units

Os-Cal Extra D3: Calcium 500 mg and vitamin D 600 units

Capsule, oral:

Generic: Calcium 600 mg and vitamin D 100 units, calcium 600 mg and vitamin D 400 units, calcium 600 mg and vitamin D 500 units, calcium 600 mg and vitamin D 1000 units

Liquid, oral:

Generic: Calcium 1,000 mg and vitamin D 400 mg per 30 mL [sugar free]

Tablet, oral:

Calcet Petites: Calcium 200 mg and vitamin D 250 units [gluten free; contains tartrazine]

Calcitrate: Calcium 315 mg and vitamin D 250 units

Caltrate 600+D: Calcium 600 mg and vitamin D 400 units [contains soybean oil] [DSC]

Caltrate 600+D3: Calcium 600 mg and vitamin D 800 units

Caltrate 600+Soy: Calcium 600 mg and vitamin D 200 units [contains soy isoflavones 25 mg]

Caltrate ColonHealth: Calcium 600 mg and vitamin D 200 units [contains soybean oil]

Citracal Petites: Calcium 200 mg and vitamin D 250 units [gluten free]

Citracal Regular: Calcium 250 mg and vitamin D 200 units [gluten free]

Oysco D: Calcium 250 mg and vitamin D 125 units [contains brilliant blue fcf (fd&c blue #1), fd&c yellow #10 (quinoline yellow)] [DSC]

Oysco 500+D: Calcium 500 mg and vitamin D 200 units [contains tartrazine]

Generic: Calcium 250 mg and vitamin D 125 units; calcium 315 mg and vitamin D 200 units; calcium 315 mg and vitamin D 250 units; calcium 500 mg and vitamin D 125 units; calcium 500 mg and vitamin D 200 units; calcium 500 mg and vitamin D 400 units; calcium 500 mg and vitamin D 600 units; calcium 600 mg and vitamin D 125 units; calcium 600 mg and vitamin D 200 units; calcium 600 mg and vitamin D 400 units; calcium 600 mg and vitamin D 800 units

Tablet, chewable:

Caltrate Gummy Bites: Calcium 250 mg and vitamin D 400 units

Caltrate 600+D3 Soft: Calcium 600 mg and vitamin D 800 units [contains soybean oil]

Os-Cal: Calcium 500 mg and vitamin D 600 units [sugar free; contains phenylalanine; lemon chiffon flavor]

Generic: Calcium 500 mg and vitamin D 100 units; calcium 500 mg and vitamin D 200 units; calcium 500 mg and vitamin D 600 units; calcium 600 mg and vitamin D 400 units

Anatomic Therapeutic Chemical (ATC) Classification

• A12AX

Generic Available (US)

Yes

Pricing: US

Chewable (Caltrate 600+D3 Soft Oral)

600-800 mg-unit (per each): $0.13

Chewable (Caltrate Gummy Bites Oral)

250-400 mg-unit (per each): $0.14

Chewable (Os-Cal Oral)

500-600 mg-unit (per each): $0.12

Chewable (Oysco 500+D Oral)

500-600 mg-unit (per each): $0.09

Tablets (Calcet Petites Oral)

200-250 mg-unit (per each): $0.08

Tablets (Calcium Carbonate-Vitamin D Oral)

600-400 mg-unit (per each): $0.02 - $0.08

Tablets (Calcium Citrate-Vitamin D Oral)

200-125 mg-unit (per each): $0.05

315-200 mg-unit (per each): $0.05

Tablets (Calcium-Vitamin D Oral)

600-200 mg-unit (per each): $0.04

Tablets (Caltrate 600+D3 Oral)

600-800 mg-unit (per each): $0.11

Tablets (Os-Cal Calcium + D3 Oral)

500-200 mg-unit (per each): $0.07

Tablets (Os-Cal Extra D3 Oral)

500-600 mg-unit (per each): $0.11

Tablets (Oysco 500+D Oral)

500-200 mg-unit (per each): $0.07

Tablets (Pronutrients Calcium+D3 Oral)

600-800 mg-unit (per each): $0.09

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions

Effects on Dental Treatment

No significant effects or complications reported

Effects on Bleeding

No information available to require special precautions

Index Terms

Calcium Carb & Cit/Vitamin D3; Calcium Carbonate/Vitamin D2; Calcium Carbonate/Vitamin D3; Calcium Citrate and Vitamin D; Calcium Citrate/Vitamin D2; Calcium Citrate/Vitamin D3; Calcium/Vitamin D; Vitamin D and Calcium Carbonate

References

Institute of Medicine (IOM). Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press; 2011.

Brand Names: International

Calcigran Forte (NO); Calcio 600 + D (CO); Calperos D3 (HK); Calporosis D (ID); Calsical (ID); Caltrate + D 300 (HK); Caltrate 600 (QA); Caltrate 600 with Vitamin D (AE); CDR Fortos (ID); D-CAL (CN); Kalzana (LK); Momcal (LK); Os-Cal + D (SG); Os-Cal 500 + D (HK); Osteocare (QA); Osteoprotec (PH); Seacal (LK)

Last Updated 3/4/20