Products
Calcium acetate is commercially available in the form of capsules and tablets in various strengths (Calcium Acetate Phosphate Binder Bichsel, Calcium Acetate Salmon Pharma, AcetaPhos, Renacet). It has been approved in many countries since 1992.
Structure and properties
Calcium acetate exists as calcium diacetate (C4H6CaO4, Mr = 158.2 g/mol), a white, hygroscopic powder that is readily soluble in water. It is also present in drugs as a monohydrate, C4H6CaO4 – H2O. Structure: Ca2+(CH3COO–)2
Effects
Calcium (ATC A12AA12) decreases the absorption of phosphate ions in the intestine by binding them. The poorly water-soluble calcium phosphates are excreted in the stool and not absorbed into the blood.
Indications
For prevention and treatment of renal hyperphosphatemia (renal insufficiency).
Dosage
According to the drug label. The drug is taken with meals. Comparatively many capsules or tablets must be taken throughout the day, as the daily dose is in the gram range.
Contraindications
Calcium acetate is contraindicated in hypersensitivity, hypercalcemia, hypophosphatemia, therapy with vitamin D3, and the presence of calcium-containing kidney stones. Refer to the drug label for complete precautions.
Interactions
Calcium can reduce the absorption of many drugs, for example, bisphosphonates, iron, antibiotics, and thyroid hormones. Therefore, a 2-hour interval is recommended when taking it. Other interactions are possible with cardiac glycosides. Vitamin D and its derivatives increase the mobilization of calcium from bone and increase the risk for hypercalcemia.
Adverse effects
Hypercalcemia may develop because of the increased calcium intake. Other possible adverse effects include digestive symptoms such as nausea.
