CALCICHEW Chewable tablet Ref.[7214] Active ingredients: Calcium Calcium carbonate

Source: Medicines & Healthcare Products Regulatory Agency (GB)  Revision Year: 2021  Publisher: Neon Healthcare Limited, 8 The Chase, John Tate Road, Hertford, SG13 7NN, United Kingdom

Therapeutic indications

Calcichew 500mg Chewable Tablets are to be chewed as a supplemental source of calcium in the correction of dietary deficiencies or when normal requirements are high.

Calcichew 500mg Chewable Tablets may be used as an adjunct to conventional therapy in the prevention and treatment of osteoporosis. They may be used as a phosphate binding agent in the management of renal failure in patients on renal dialysis.

Posology and method of administration

Posology

Adults

Adjunctive therapy in osteoporosis: 2 to 3 tablets daily.

Prevention and treatment of calcium deficiency: 2 to 3 tablets daily.

Phosphate binder: Dose as required by the individual patient depending on serum phosphate level.

Special patient populations

Elderly patients

Dosage as for adults.

Paediatric patients

Prevention and treatment of calcium deficiency: 2 to 3 tablets daily.

Phosphate Binder: Dose as required by the individual patient depending on serum phosphate level.

Impaired renal function

In patients with severe renal failure having a creatinine clearance of less than 30 ml/minute, dosage adjustments may be necessary dependent on serum calcium levels. See section 4.4.

Impaired hepatic function:

No dose adjustment is required.

Method of administration

Oral.

Tablets may be chewed or sucked.

For phosphate binding, the tablets should be taken just before, during or just after each meal in order to bind phosphate in the food.

Overdose

Overdose can lead to hypercalcaemia. Symptoms of hypercalcaemia may include anorexia, thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disturbances, polydipsia, polyuria, bone pain, nephrocalcinosis, nephrolithiasis and in severe cases, cardiac arrhythmias. Extreme hypercalcaemia may result in coma and death. Persistently high calcium levels may lead to irreversible renal damage and soft tissue calcification.

Milk-alkali syndrome may still occur in patients who ingest large amounts of calcium and absorbable alkali. It is not uncommon as a cause of hypercalcaemia requiring hospitalisation. The syndrome has also been reported in a patient taking recommended doses of antacids containing calcium carbonate for chronic epigastric discomfort, and in a pregnant woman taking high, but not grossly excessive, doses of calcium (about 3 g of elemental calcium daily). Metastatic calcification can develop.

Treatment of hypercalcaemia: The treatment with calcium must be discontinued. Treatment with thiazide diuretics, lithium, vitamin A, vitamin D and cardiac glycosides must also be discontinued. Treatment: rehydration, and, according to severity of hypercalcaemia, isolated or combined treatment with loop diuretics, bisphosphonates, calcitonin and corticosteroids should be considered. Serum electrolytes, renal function and diuresis must be monitored. In severe cases, ECG and CVP should be followed.

Shelf life

3 years.

Special precautions for storage

Do not store above 30°C.

Keep the container tightly closed to protect from moisture.

Nature and contents of container

Securitainer containing 100 tablets.

Special precautions for disposal and other handling

No special requirements.

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