Side effects of calcium

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If you’re taking 4,000 mg of calcium per day, you’re taking much too much, and I urge you to reduce the amount immediately. We all need calcium to regulate nerve and muscle functions and build strong bones. You can get adequate amounts from your diet if you eat a lot of cooked greens (collards have most), molasses, sesame seeds, broccoli, and tofu (be sure to read package labels to make sure calcium was used in its preparation), as well as calcium-fortified soy milk, orange juice and, of course, dairy products.

For women who don’t think they are getting enough of these foods, I recommend a supplement of 500 to 700 mg daily in divided doses with meals. Women concerned about osteoporosis should be aware that supplemental calcium alone will not correct the problem, which is related to heredity, lifestyle and diet, and is accelerated by hormonal changes at menopause. Weight-bearing aerobic exercise (walking, jogging or aerobics) and weight lifting should be part of your prevention program. Because high protein diets also cause bones to lose calcium, keep your daily protein intake low (limit it to no more than 10 to 15 percent of total calories). Avoid soda, excessive caffeine intake, and smoking, all of which promote calcium loss in the urine.

An adequate daily intake of calcium (1,000-1,200 mg) along with magnesium and potassium works to control blood pressure by helping to regulate the amount of sodium your body retains. Most of us get all the potassium we need from fresh fruits (especially bananas) and vegetables. (Don’t take potassium supplements unless a doctor has prescribed them.) Taking too much calcium (three to four times the usual dose) can lead to such side effects as constipation, dry mouth, a continuing headache, increased thirst, irritability, loss of appetite, depression, a metallic taste in the mouth, and fatigue.

Of the many calcium supplements available, I recommend calcium citrate, because it is more easily assimilated than other forms, especially by older people with less stomach acid. Calcium carbonate is more easily available and less expensive but not as well absorbed. It is OK to use calcium supplements containing vitamin D. In fact, I recommend taking 2,000 IU of vitamin D a day to insure proper absorption and use of calcium. Along with your calcium supplements, be sure to take magnesium (half the dose of your calcium supplement); without it you may find that the calcium is constipating.

Andrew Weil, M.D.

White oval pills spilling out of a medicine bottle to illustrate calcium supplements.

Nearly half of Australians are not getting their recommended dietary intake of calcium, which may put many people—the elderly, in particular—at risk of osteoporosis and fractures.

Calcium is a mineral that is essential to healthy, strong bones. It’s found naturally mostly in dairy foods, tofu and seafood. Most adults need a total of 1,000mg of calcium per day, increasing to 1,300mg for women aged over 50 and men over 70 years.

Doctors sometimes prescribe calcium supplements to ensure patients get enough calcium every day. But there have been reports of people stopping taking calcium, believing the supplements can increase the risk of heart disease, kidney stones and stomach upsets.

But before you stop taking a calcium supplement, read this.

What the research actually says

If you need extra calcium, taking 500mg to 600mg of supplements per day is considered safe and effective, says Professor Mark Cooper, an endocrinologist and Deputy Chair of the Medical and Scientific Committee at Osteoporosis Australia.

The question of whether calcium supplements increase the risk of heart attacks or strokes arises from studies that combined data from lots of smaller studies—where doses of calcium were, on average, well above 600mg,” explains Professor Cooper. “Some researchers found a small increase in these risks, but others have not.”

If you have been recommended a supplement by your doctor and the intake is 500mg to 600mg per day, consumers should continue to take the supplement, as directed.

Some studies have reported a small increase in kidney stones among people taking calcium supplements. “The risk of this happening is very low. But calcium supplements should be used cautiously in people with a history of a kidney stone or some other kidney problems,” says Professor Cooper.

Take calcium if you need it

As always, before you start taking—or stop taking—any supplement, discuss it with your doctor first. Calcium supplements are usually only recommended for people who do not get enough calcium from their diet and who may be at risk of falls and fractures.

It’s always best to get your calcium intake from calcium-rich foods if you can. While there’s no test that reliably diagnoses a low-calcium diet, you can calculate your daily intake using the table here.

Have you already been prescribed calcium? Keep taking it. “If you have been recommended a supplement by your doctor and the intake is 500mg to 600mg per day, consumers should continue to take the supplement, as directed,” says Professor Cooper.

How to get more calcium in your diet

Think ‘food first’, and look for foods that have calcium added (‘calcium-fortified’). Here are some top sources of calcium:

Dairy

  • Reduced-fat milk fortified with calcium – 520mg per 250ml serve
  • Low-fat natural yoghurt – 488mg per 200g tub
  • Regular milk – 304mg per 250ml serve
  • Reduced-fat cheddar cheese – 209mg per 21g slice
  • Cheesecake – 163mg per 125g slice

Seafood

  • Sardines, canned in water – 486mg per 90g can
  • Pink salmon, canned in water – 279mg per 90g can
  • Red salmon, canned in water – 203mg per 90g can
  • Mussels, steamed or boiled – 173mg per 100g
  • Snapper, grilled with olive oil – 163mg per 100g fillet

Vegetables, fruit and pulses

  • Tofu, firm – 832mg per 250ml cup
  • Reduced-fat soy milk – 367mg per 250ml cup
  • Dried figs – 160mg per 6 figs
  • Soy beans, canned – 106mg per 200g cup
  • Chickpeas, canned – 90mg per 200g cup

Where to get more information

If you’d like to get an idea of your risk of osteoporosis, take the quick self-assessment at Know Your Bones, an initiative of Osteoporosis Australia and the Garvan Institute of Medical Research. See your doctor if you’re concerned about the results.

Ask your doctor about your bone health and whether it would be a good idea for you to have a bone mineral density test. If so, you may qualify to be reimbursed under the Medicare Benefits Scheme. It’s a quick and painless body scan that measures the density of your bones. Low density can increase the risk of fractures.

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Calcium and vitamin D: To supplement or not?

We live in the era of evidence-based medicine, so new interventions must meet criteria for both safety and efficacy before they are adopted. However, we have inherited many practices adopted before the current standards were in place, and we have not always been rigorous in reevaluating traditional remedies. A conservative belief in established practice or the influence of vested interests may account for this lack of rigor in reappraisal.1 Calcium and vitamin D supplements are possible examples of this phenomenon.

BONE METABOLISM IS TIGHTLY REGULATED

Bone is a connective tissue, its matrix composed principally of type 1 collagen, which provides tensile strength. Hydroxyapatite crystals, composed predominantly of calcium and phosphate, lie between the collagen fibers and provide compressive strength. In a tightly regulated process, osteoblasts lay down the collagenous matrix, and osteoclasts remove it. Mineralization of newly formed bone proceeds if normal levels of extracellular calcium and phosphate are present, in the absence of inhibitors of mineralization.

High calcium intake does not drive bone formation

The endocrine system is critical in maintaining normocalcemia. A decrease in calcium intake results in increased parathyroid hormone secretion, resulting in increased renal tubular calcium reabsorption, increased bone turnover (both formation and resorption), and increased activation of vitamin D leading to increased intestinal absorption of calcium. High calcium intake reverses these changes.

Reid IR, Bristow SM, Bolland MJ. Calcium supplements: benefits and risks. J Intern Med 2015; 278(4):354–368. Copyright 2015, The Association for the Publication of the Journal of Internal Medicine.

Figure 1. Absolute change in total body bone mineral content (BMC) over 5 years in normal postmenopausal women, as a function of each woman’s average calcium intake assessed at baseline and at year 5. The lines show the regression (with 95% confidence intervals) for this relationship (P = .53)

Thus, a normal serum calcium concentration can be maintained with calcium intake ranging from 200 to more than 2,000 mg/day, and rates of bone loss in postmenopausal women are unaffected by calcium intake (Figure 1).2

If calcium intake is very low, hypocalcemia and secondary hyperparathyroidism develop,3 and bone mineralization may be impaired. However, levels of calcium intake in Africa and in East and Southeast Asia are typically less than 400 mg/day,4 yet there is no evidence that these levels adversely affect skeletal health. In fact, fracture risk is lower in these regions than in North America, where calcium intake is several times greater.

Thus, some calcium intake is required to maintain circulating concentrations, but there is no mechanism by which high calcium intake can drive bone formation. Quite the opposite, in fact.

Vitamin D deficiency has little relationship with diet

Vitamin D is a biologically inactive secosteroid activated by hydroxylation in the liver and kidney to function as the key regulator of intestinal calcium absorption. As with calcium, its deficiency results in hypocalcemia and impaired bone mineralization.

Paradoxically, high levels of vitamin D stimulate bone resorption and inhibit bone mineralization in mice,5 and large doses increase bone resorption markers acutely in clinical studies.6 Thus, it is important to ensure an adequate vitamin D supply, but not an oversupply.

In the absence of supplements, most vitamin D is produced in the skin as a result of the action of ultraviolet light (from sunlight) on 7-dehydrocholesterol. Thus, vitamin D deficiency occurs in those deprived of skin exposure to sunlight (eg, due to veiling, living at high latitude, staying permanently indoors), but it has little relationship with diet.

ARE CALCIUM SUPPLEMENTS EFFECTIVE?

Calcium supplements are certainly biologically active. They transiently increase serum calcium concentrations, suppress parathyroid hormone, and reduce bone resorption.2 In the first year of use, they increase bone density by about 1% compared with placebo.7 However, longer use does not result in further bone density advantage over placebo,7 suggesting that the response simply reflects a decreased number of osteoclastic resorption sites and does not indicate a sustained change in bone balance.

A 1% difference in bone density would not be expected to reduce fracture risk, and a number of large, carefully conducted randomized controlled trials published over the last 15 years have failed to demonstrate anti­fracture efficacy for calcium.8–12 As a result, the US Preventive Services Task Force recommends against the routine use of calcium supplements in community-dwelling adults.13

In contrast, in a placebo-controlled trial published in 1992, Chapuy et al14 found that elderly women residing in nursing homes who received calcium and vitamin D supplements had fewer fractures. At 18 months, by intention-to-treat analysis, nonvertebral fractures had occurred in 160 (12%) of 1,387 women in the supplement group compared with 215 (15%) of 1,403 women in the placebo group (P < .001). However, these women were severely vitamin D-deficient (the mean serum 25-hydroxyvitamin D level at baseline in the placebo group was 13 ng/mL, normal range 15–50), to the extent that many must have had osteomalacia.

Thus, this study shows that calcium and vitamin D are effective in managing osteomalacia, but the subsequent trials8–12 did not observe any benefit in community-dwelling cohorts. Meta-analyses that pool the Chapuy study with community-based studies generally find that calcium with vitamin D is beneficial, but the heterogeneity of these populations means that such pooling is inappropriate.15

It is sometimes stated that calcium and vitamin D should always be given with osteoporosis medications because the efficacy of these drugs has only been demonstrated when coadministered with these supplements. This is incorrect. The addition of calcium to alendronate does not alter its effects on bone density,16 and the antifracture efficacy of both bisphosphonates17 and estrogen18,19 has been demonstrated in the absence of supplementation with calcium or vitamin D. The evidence that bisphosphonates prevent fractures in the absence of calcium supplements has recently been strengthened by the results of a randomized controlled trial comparing zoledronate with placebo in women over age 65 with osteopenia.20

Photo Credit Katherine Streeter

Personal Health

Jane Brody on health and aging.

Americans seem to think that every health problem can be solved with a pill. And certainly many are, especially infectious diseases that succumb to antibiotics, antifungals and, increasingly, antivirals.

But that leaves a medical dictionary full of ailments that continue to plague people despite the best efforts of Big Pharma. Most are chronic health problems related to how Americans live, especially what we eat and drink, and don’t eat and drink, and how we move or don’t move. In our aging society, these ailments have pushed the annual cost of medical care into the trillions of dollars and threaten to break Medicare.

Osteoporosis is one of these increasingly prevalent and costly conditions. Although there are drugs to stanch the loss of bone and the debilitating fractures that often result, the remedies are costly, difficult to administer and sometimes have side effects that can be worse than the disease they are meant to counter.

This makes prevention the preferred and more cost-effective option. But efforts to prevent bone disease have focused on a pill, namely supplements of calcium, the mineral responsible for creating bone in youth that must be maintained throughout adult life, which now routinely extends to the 80s and 90s.

But as with many other pills once regarded as innocuous, the safety and efficacy of calcium supplements in preventing bone loss is being called into question.

In February, the United States Preventive Services Task Force recommended that postmenopausal women refrain from taking supplemental calcium and vitamin D. After reviewing more than 135 studies, the task force said there was little evidence that these supplements prevent fractures in healthy women.

Moreover, several studies have linked calcium supplements to an increased risk of heart attacks and death from cardiovascular disease. Others have found no effect, depending on the population studied and when calcium supplementation was begun.

The resulting controversy has left countless people, especially postmenopausal women, wondering whether they should be taking calcium. Given the conditional evidence currently available, the answer is not likely to be greeted enthusiastically by anyone other than dairy farmers, who supply the foods and drinks that are the country’s richest dietary sources of calcium.

The one indisputable fact is that the safest and probably the most effective source of calcium for strong bones and overall health is diet, not supplements. But few American adults, and a decreasing proportion of children and teenagers, consume enough dairy foods to get the recommended intakes of this essential mineral.

Milk consumption has taken a steady nose-dive in the last four decades, largely supplanted by sugared soft drinks that are now under fire as major contributors to obesity and Type 2 diabetes. Beyond age 20, when bone loss can begin to overtake bone formation, the typical man and woman in this country consumes less than one cup of milk a day. Likewise for teenage girls, who should be striving to maximize bone formation so that there is more in reserve when bone loss begins.

Yogurt, which ounce for ounce is an even better source of calcium than fluid milk, has achieved unprecedented popularity in recent years, but few consume it more than once a day, which doesn’t come close to meeting dietary needs. Frozen yogurt, which threatens to supplant ice cream as the nation’s most popular frozen dessert, has about half the amount of calcium as regular yogurt and only slightly more than ice cream. Both are far more caloric than nonfat milk.

The only other notable calcium-rich foods are tofu (when prepared with calcium); calcium-fortified orange juice, soy milk and rice milk; canned salmon and sardines (but only if you eat the bones); almonds; kale; and broccoli. But few people consume enough of these foods to obtain the calcium they need.

Calcium was long thought to protect the cardiovascular system. It helps to lower blood pressure and the risk of hypertension, a major contributor to heart disease. The Iowa Women’s Health Study linked higher calcium intakes in postmenopausal women to a reduced risk of heart disease deaths, though other long-term studies did not find such an association.

Controversy over calcium supplements arose when a combined analysis of 15 studies by Dr. Mark J. Bolland of the University of Auckland found that when calcium was taken without vitamin D (which enhances calcium absorption), the supplements increased the risk of heart attack by about 30 percent.

Dr. Bolland then reanalyzed data from the Women’s Health Initiative and found a 24 percent increased risk of heart attack among women who took calcium with or without vitamin D. In this case, the increased risk occurred only among those women assigned to take supplemental calcium who had not already been taking it when the study began.

Yet last December, in a report published online in Osteoporosis International, a team at the Fred Hutchinson Cancer Research Center in Seattle reported that among 36,282 postmenopausal women participating in the Women’s Health Initiative, those taking 1,000 milligram supplements of calcium and 400 international units of vitamin D experienced a 35 percent reduced risk of hip fracture, and no increase in heart attacks during a seven-year follow-up.

In February yet another study, published online in JAMA Internal Medicine, found that among 388,229 men and women initially aged 50 to 71 and followed for an average of 12 years, supplemental calcium raised the risk of cardiovascular death by 20 percent among men — but not women. The increased risk was observed only among smokers.

Adding to these confusing results is the fact that none of the studies was specifically designed to assess the effects of calcium supplements on the chances of suffering a heart attack or stroke. This can cause unexpected aberrations in research findings.

One possible explanation for a link, the JAMA researchers said, is that a bolus of calcium that enters the blood stream through a supplement, but not gradually through dietary sources, can result in calcium deposits in arteries. Indeed, this is a known complication among patients with advanced kidney disease who take calcium supplements.

All the researchers agree that, given the widespread use of supplemental calcium, better studies are needed to clarify possible risks and benefits, and to whom they may apply.

Until such information is available, consumers seeking to preserve their bones would be wise to rely primarily on dietary sources of the mineral and to pursue regular weight-bearing or strength-building exercises, or both. Walking, running, weight lifting and working out on resistance machines is unquestionably effective and safe for most adults, if done properly.

Furthermore, the National Osteoporosis Foundation maintains that the findings of current studies and advice about supplements should “not apply to women with osteoporosis or broken bones after age 50 or those with significant risk factors for fracture.” For them, the benefits of calcium supplements are likely to far outweigh any risks.

Calcium and vitamin D combination

Medically reviewed by Drugs.com on May 31, 2019 – Written by Cerner Multum

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What is calcium and vitamin D combination?

Calcium is a mineral that is necessary for many functions of the body, especially bone formation and maintenance. Vitamin D helps the body absorb calcium.

Calcium and vitamin D combination is used to treat or prevent a calcium deficiency.

There are many brands and forms of calcium and vitamin D combination available. Not all brands are listed on this leaflet.

Calcium and vitamin D combination may also be used for purposes not listed in this medication guide.

Important Information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

Ask a doctor or pharmacist if calcium and vitamin D combination is safe to use if you have:

  • kidney disease;

  • kidney stones;

  • heart disease;

  • cancer;

  • high levels of calcium in your blood;

  • circulation problems; or

  • a parathyroid gland disorder.

Ask a doctor before using this product if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

How should I take calcium and vitamin D combination?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Check the label of your calcium and vitamin D combination product to see if it should be taken with or without food.

Take the regular tablet with a full glass of water.

The chewable tablet must be chewed before you swallow it.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Calcium and vitamin D may be only part of a complete program of treatment that also includes dietary changes. Learn about the foods that contain calcium and vitamin D.

Your supplement dose may need to be adjusted as you make changes to your diet. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking calcium and vitamin D combination?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking calcium and vitamin D combination.

Calcium and vitamin D combination side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have signs of too much calcium in your body, such as:

  • nausea, vomiting, constipation;

  • increased thirst or urination;

  • muscle weakness, bone pain; or

  • confusion, lack of energy, or feeling tired.

Common side effects may include:

  • an irregular heartbeat;

  • weakness, drowsiness, headache;

  • dry mouth, or a metallic taste in your mouth; or

  • muscle or bone pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Calcium and vitamin D combination dosing information

Usual Adult Dose for Osteoporosis:

Calcium – General Range: 1000 mg to 1300 mg daily
Vitamin D – General Range: 200 international units to 800 international units daily
Note: While much larger vitamin D dosages have been recommended as a single agent, many calcium-vitamin D combination supplements will contain approximately 200 international units to 400 international units of vitamin D per dose.

Usual Adult Dose for Dietary Supplement:

Calcium – General Range: 1000 mg to 1300 mg daily
Vitamin D – General Range: 200 international units to 800 international units daily
Note: While much larger vitamin D dosages have been recommended as a single agent, many calcium-vitamin D combination supplements will contain approximately 200 international units to 400 international units of vitamin D per dose.

What other drugs will affect calcium and vitamin D combination?

Calcium can make it harder for your body to absorb certain medicines, and some medicines can make it harder for your body to absorb vitamin D. If you take other medications, take them at least 2 hours before or 4 to 6 hours after you take calcium and vitamin D combination.

Other drugs may affect calcium and vitamin D combination, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 5.01.

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Consumer resources

  • Calcium and Vitamin D Capsules and Tablets
  • Calcium and Vitamin D Chewable Tablets
  • Calcium and Vitamin D Liquid
  • Calcium and Vitamin D Powder

Other brands: Caltrate 600+D, Citracal + D, Calcitrate with D, Os-Cal 500 Chewable, … +4 more

Related treatment guides

  • Dietary Supplementation
  • Osteoporosis

About calcium supplements

Type of medicine Calcium supplement
Used for Calcium deficiency
As a phosphate binder in chronic kidney disease
Also called Adcal®; Cacit®; Calcichew®; Calcium-500®; Phosex®; PhosLo®; Renacet®; Sandocal®
Available as Tablets, chewable tablets, effervescent tablets and oral liquid

Calcium is a naturally occurring substance which is important for healthy, strong bones. Our bodies usually get sufficient calcium from what we eat. Good sources of calcium in food are milk, hard cheese (such as cheddar or Edam), yoghurt, bread, calcium-fortified soya milk, and some vegetables (spinach and watercress). Sometimes though, our bodies need more calcium than normal – for example, in childhood and during pregnancy or whilst breastfeeding. Also, as we become older our bodies may not absorb as much calcium as they once did. When there is not enough calcium in our diet for our body’s needs then a calcium supplement may be useful.

Calcium tablets are also taken by people who have kidney problems. The levels of a substance in the body, called phosphate, can be too high in people with chronic kidney disease. Calcium binds to the phosphate and this allows it to be removed, helping to keep the levels normal.

Calcium supplements are also taken alongside other medicines for preventing or treating ‘thinning’ of the bones (osteoporosis). In this case calcium is often combined with vitamin D in chewable or effervescent tablets. More information about this can be found in the separate medicine leaflet called Calcium with colecalciferol.

Calcium supplements are available on prescription, or you can buy them without a prescription at pharmacies.

Before taking calcium supplements

To make sure this is the right treatment for you, before you start taking a calcium supplement it is important that your doctor or pharmacist knows:

  • If you are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • If you have kidney problems, or if you have ever had kidney stones.
  • If you have a condition called sarcoidosis which causes inflammation, particularly in your lungs and lymph system.
  • If you know you have too much calcium in your blood or urine. This can happen with some cancers or with certain medicines for high blood pressure.
  • If you are taking levothyroxine for an underactive thyroid gland (hypothyroidism). This is because calcium affects how well your body absorbs levothyroxine.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take calcium supplements

  • Before you start this treatment, read the manufacturer’s printed information leaflet from the pack. The leaflet will give you more information about how to take the supplement, and also a full list of side-effects which you may experience.
  • If you are prescribed calcium by a doctor, you will be told how many tablets to take each day and when to take them. If you have purchased the tablets from a pharmacy, read the label on the preparation carefully to find out how to take them.
  • Some tablets should be swallowed whole without being chewed, other tablets must be chewed before being swallowed, and some need to be dissolved in water. If you are unsure how to take your tablets, ask your pharmacist for advice.
  • Calcium supplements can interfere with the way your body absorbs other medicines so you may need to take these at a different time to your calcium – please ask your pharmacist for advice. Medicines that may be affected include levothyroxine (thyroid hormone) and certain antibiotics.
  • If you forget to take a dose don’t worry, just leave out the missed dose and take the next when it is due. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • Try to eat a balanced diet with plenty of fruit and vegetables and good sources of calcium such as milk and yoghurt.
  • If you are due to have an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • If you buy any medicines, check with your pharmacist that they are suitable to take with a calcium supplement.

Can calcium supplements cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. It is rare for calcium supplements to cause side-effects but the table below lists some that may occur. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome

Rare calcium side-effects – these affect less than 1 in 1,000 people who take this medicine What can I do if I experience this?
Feeling sick (nausea), stomach upset, or loose, watery stools (diarrhoea) Drink plenty of water and stick to simple food – avoid rich or spicy meals

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store calcium supplements

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • Keep containers tightly closed to prevent moisture affecting the tablets.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

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