Please check your internet connection and try again.
# Calcium Acetate
## Overview
Calcium acetate is a phosphate binder used to manage hyperphosphatemia in patients with chronic kidney disease (CKD).
## Primary Indications
* Treatment of hyperphosphatemia in patients with end-stage renal disease (ESRD).
## Adult Dosing
* **Initial Dose:** 667 mg orally with each meal.
* **Titration:** Doses should be individualized based on serum phosphate levels. The goal is to reduce serum phosphate to less than 6 mg/dL.
* **Typical Effective Dose:** Ranges from 1334 mg to 2668 mg per day, divided with meals.
* **Maximum Dose:** Not to exceed 8000 mg per day.
## Pediatric Dosing
* Dosing in pediatric patients is not well-established and should be individualized under specialist guidance.
## Dose Adjustments
* **Renal Impairment:** Not applicable as it is used in patients with ESRD.
* **Hepatic Impairment:** No specific adjustments are typically required.
## Contraindications
* Hypercalcemia.
* Hypersensitivity to calcium acetate or any component of the formulation.
## Adverse Effects
* **Common:** Hypercalcemia, constipation, nausea, vomiting, abdominal pain.
* **Serious:** Adynamic bone disease (with long-term use), metastatic calcification.
## Key Drug Interactions
* **Tetracyclines and Fluoroquinolones:** Calcium acetate can decrease the absorption of these antibiotics. Administer at least 1 hour before or 3 hours after calcium acetate.
* **Thyroid Hormones (Levothyroxine):** Calcium acetate can reduce the absorption of levothyroxine. Separate administration by at least 4 hours.
* **Other Calcium-Containing Products:** Concurrent use can increase the risk of hypercalcemia.
* **Digoxin:** Hypercalcemia can increase the risk of digoxin toxicity.
## Monitoring
* **Serum Phosphate:** Monitor regularly to guide dose titration.
* **Serum Calcium:** Monitor regularly to prevent hypercalcemia.
* **Serum Magnesium and Alkaline Phosphatase:** May be monitored periodically.
## Clinical Pearls
* Administer calcium acetate with meals to effectively bind dietary phosphate.
* Monitor serum calcium levels closely, especially in patients taking vitamin D supplements or other calcium-containing products.
* A common target for serum phosphate is < 6 mg/dL.
***
*This information is intended for healthcare professionals. It is essential to consult the current prescribing information and local institutional protocols for the most up-to-date and complete drug information before making any clinical decisions.*
