Identification
Name Calcium Acetate
Accession Number DB00258 (APRD00839)
Type small molecule
Description The chemical compound calcium acetate is the calcium salt of acetic acid. An older name is acetate of lime. The anhydrous form is very hygroscopic, therefore the monohydrate is the common form. [Wikipedia]
Structure
Categories (*)
Molecular Weight 158.166
Groups approved
Monoisotopic Weight 157.989199835
Pharmacology
Indication Calcium acetate is one of a number of calcium salts used to treat hyperphosphatemia (too much phosphate in the blood) in patients with kidney disease.
Mechanism of action Calcium acetate and other calcium salts are phosphate binders. They work by binding with the phosphate in the food you eat, so that it is eliminated from the body without being absorbed.
Absorption 40% is absorbed in the fasting state and approximately 30% is absorbed in the nonfasting state following oral administration.
Protein binding Not Available
Biotransformation Not Available
Route of elimination Calcium acetate when taken with meals, combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the feces.
Toxicity Oral, rat: LD50 = 4280 mg/kg. Symptoms of overdose include mild hypercalcemia (constipation; loss of appetite; nausea and vomiting), and severe hypercalcemia (confusion; full or partial loss of consciousness; incoherent speech).
Affected organisms
  • Humans and other mammals
Interactions
Drug Interactions
Drug Mechanism of interaction
Alendronate Calcium Salts may decrease the serum concentration of Bisphosphonate Derivatives such as alendronate. Avoid administration of oral calcium supplements within 30 minutes after alendronate.
Calcium carbonate Calcium salts may enhance the adverse/toxic effect of calcium acetate. Concurrent use of other calcium salts with calcium acetate should be avoided when possible. This combination is particularly dangerous in patients with other risk factors for hypercalcemia, such as those with end-stage renal disease.
Calcium Chloride Calcium salts may enhance the adverse/toxic effect of calcium acetate. Concurrent use of other calcium salts with calcium acetate should be avoided when possible. This combination is particularly dangerous in patients with other risk factors for hypercalcemia, such as those with end-stage renal disease.
Ceftriaxone Calcium Salts (Intravenous) may enhance the adverse/toxic effect of Ceftriaxone. Ceftriaxone binds to calcium forming an insoluble precipitate. Concurrent or sequential use (within 48 hours) of ceftriaxone with calcium-containing solutions is contraindicated in neonates (28 days of age or younger). In other patients, these solutions can be used sequentially if the infusion lines are flushed with a compatible fluid between ceftriaxone and calcium-containing solution infusion.
Ciprofloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as ciprofloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Clodronate Calcium Salts may decrease the serum concentration of Bisphosphonate Derivatives such as clodronate. Avoid administration of oral calcium supplements within 2 hours before or after tiludronate/clodronate/etidronate.
Demeclocycline Calcium salts such as calcium acetate may decrease the serum concentration of tetracycline derivatives such as demeoclocycline. In general, the coadministration of oral calcium salts and oral tetracycline derivatives should be avoided. Interactions may be able to be minimized by administering oral calcium preparations several hours before or after the dose of the oral tetracycline derivatives. Even with dose separation, therapy may still be compromised. Monitor for decreased therapeutic effect of oral tetracycline derivatives.
Doxycycline Calcium salts such as calcium acetate may decrease the serum concentration of tetracycline derivatives such as doxycycline. In general, the coadministration of oral calcium salts and oral tetracycline derivatives should be avoided. Interactions may be able to be minimized by administering oral calcium preparations several hours before or after the dose of the oral tetracycline derivatives. Even with dose separation, therapy may still be compromised. Monitor for decreased therapeutic effect of oral tetracycline derivatives.
Eltrombopag Calcium Salts such as calcium acetate may decrease the serum concentration of Eltrombopag. Separate administration of eltrombopag and any polyvalent cation (e.g., calcium-containing products) by at least 4 hours.
Estramustine Calcium salts such as calcium acetate may decrease the absorption of estramustine. Interactions can be minimized by administering estramustine on an empty stomach, at least 1 hour before or 2 hours after the dose of an oral calcium supplement. Do not coadminister estramustine with food or milk. Monitor for decreased therapeutic effects of estramustine if administered with oral calcium supplements, food or milk.
Etidronic acid Calcium Salts may decrease the serum concentration of Bisphosphonate Derivatives such as etidronic acid (etidronate). Avoid administration of oral calcium supplements within 2 hours before or after tiludronate/clodronate/etidronate.
Gemifloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as gemifloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Ibandronate Calcium Salts may decrease the serum concentration of Bisphosphonate Derivatives such as ibandronate. Avoid administration of oral calcium supplements within 60 minutes after oral ibandronate.
Levofloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as levofloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Levothyroxine Calcium salts such as calcium acetate may diminish the therapeutic effect of thyroid products such as levothyroxine. Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours. Monitor for decreased therapeutic effects of thyroid products if an oral calcium supplement is initiated/dose increased, or increased effects if an oral calcium supplement is discontinued/dose decreased.
Liothyronine Calcium salts such as calcium acetate may diminish the therapeutic effect of thyroid products such as liothyronine. Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours. Monitor for decreased therapeutic effects of thyroid products if an oral calcium supplement is initiated/dose increased, or increased effects if an oral calcium supplement is discontinued/dose decreased.
Liotrix Calcium salts such as calcium acetate may diminish the therapeutic effect of thyroid products such as liotrix. Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours. Monitor for decreased therapeutic effects of thyroid products if an oral calcium supplement is initiated/dose increased, or increased effects if an oral calcium supplement is discontinued/dose decreased.
Lomefloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as lomefloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Minocycline Calcium salts such as calcium acetate may decrease the serum concentration of tetracycline derivatives such as minocycline. In general, the coadministration of oral calcium salts and oral tetracycline derivatives should be avoided. Interactions may be able to be minimized by administering oral calcium preparations several hours before or after the dose of the oral tetracycline derivatives. Even with dose separation, therapy may still be compromised. Monitor for decreased therapeutic effect of oral tetracycline derivatives.
Nalidixic Acid Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as nalidixic acid. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Norfloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as norfloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Ofloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as ofloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Risedronate Calcium Salts may decrease the serum concentration of Bisphosphonate Derivatives such as risedronate. Avoid administration of oral calcium supplements within or 30 minutes after risedronate.
Sparfloxacin Calcium salts such as calcium acetate may decrease the absorption of quinolone antibiotics such as sparfloxacin. Of concern only with oral administration of both agents. Interactions can be minimized by administering oral quinolone at least 2 hours before, or 6 hours after, the dose of an oral calcium supplement. Monitor for decreased therapeutic effects of oral quinolones if administered with oral calcium supplements.
Tetracycline Calcium salts such as calcium acetate may decrease the serum concentration of tetracycline derivatives such as tetracycline. In general, the coadministration of oral calcium salts and oral tetracycline derivatives should be avoided. Interactions may be able to be minimized by administering oral calcium preparations several hours before or after the dose of the oral tetracycline derivatives. Even with dose separation, therapy may still be compromised. Monitor for decreased therapeutic effect of oral tetracycline derivatives.
Tiludronate The divalent cation of oral Calcium Acetate may significantly decrease the absorption of Tiludronate by forming a nonabsorbable chelate. Oral dosing should be separated by at least 2 hours.
Trientine hydrochloride Calcium salts such as calcium acetate may decrease the serum concentration of trientine. Trientine may decrease the serum concentration of Calcium Salts. The manufacturer of trientine recommends avoiding concurrent administration with mineral supplements to prevent an interaction in the gastrointestinal tract that would impair absorption of trientine. The recommendation is that trientine be taken at least one hour before or two hours after meals and at least one hour apart from any drug, food, or milk.
Trovafloxacin Calcium may decrease the absorption of orally administered Trovafloxacin. Administer Trovafloxacin 2 hours before or 6 hours after a dose of the calcium containining agent to minimize the interaction.
Food Interactions Not Available
Phosphate
Name Phosphate
Gene Name Not Available
Pharmacological action yes
Actions binder
References
  • Mai ML, Emmett M, Sheikh MS, Santa Ana CA, Schiller L, Fordtran JS: Calcium acetate, an effective phosphorus binder in patients with renal failure. Kidney Int. 1989 Oct;36(4):690-5. - Pubmed
  • Nolan CR, Qunibi WY: Calcium salts in the treatment of hyperphosphatemia in hemodialysis patients. Curr Opin Nephrol Hypertens. 2003 Jul;12(4):373-9. - Pubmed
  • Nolan CR, Qunibi WY: Treatment of hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis. Kidney Int Suppl. 2005 Jun;(95):S13-20. - Pubmed
  • Nolan CR: Phosphate binder therapy for attainment of K/DOQI bone metabolism guidelines. Kidney Int Suppl. 2005 Jul;(96):S7-14. - Pubmed
DTHybrid score Not Available