Ovocal-D - Tablet Calcium Carbonate - 500mg+200IU 10 Tablet(s) / Strip Beacon Pharmaceuticals PLC Indication: Heartburn, Indigestion, Calcium deficiency, Hypocalcaemia, Hyperphosphatemia, Calcium supplement, Stomach upset Administration: May be taken with or without food. Take w/ meals for better absorption. Avoid taking w/ large amount of fibre-rich food. Adult Dose: Adult: PO Hyperacidity: Take 1-2 tab as needed, up to a max of 16 tab/day. May suck or chew tablets. Hyperphosphataemia in chronic renal failure Initial: 2.5 g/day, up to 17 g/day in divided doses. Renal Dose: Renal impairment: CrCl (ml/min) <25 Dosage adjustments may be needed depending on serum calcium levels. Contraindication: Patients with Ca renal calculi or history of renal calculi; hypercalcaemia; hypophosphataemia. Patients with suspected digoxin toxicity. Mode of Action: Calcium carbonate can neutralise gastric acid rapidly and effectively. However, it may adversely activate Ca dependent processes, leading to secretion of gastric and hydrochloric acid. It can induce rebound acid secretion and, prolonged high doses may cause hypercalcemia, alkalosis and milk-alkali syndrome. Precaution: Renal impairment, hypoparathyroid disease, hypercalcaemia-associated diseases. Calcium absorption is impaired in achlorhydria; use an alternate salt and take with food. Caution when used in patients with a history of kidney stones. Lactation: Safe; crosses the placenta; appears in breast milk Side Effect: Anorexia, nausea, vomiting, constipation, flatulence; hypercalcaemia; metabolic alkalosis; milk-alkali syndrome, tissue-calcification. Gastric hypersecretion and acid rebound (with prolonged use). Pregnancy Category Note: Pregnancy category: C Lactation: Safe; crosses the placenta; appears in breast milk Interaction: Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication.