Three Calcium Carbonate Drug Interactions

Calcium carbonate is commonly used by patients. Unchecked and unmonitored, calcium carbonate drug interactions can impact patient care.  Here’s three classic examples I’ve seen from my practice.

  1. Levothyroxine is one of the most highly publicized calcium carbonate drug interactions.  The absorption of the thyroid supplement can be signicantly reduced by co-administration.  However, consistency and lab monitoring is the most important factor to monitor.  Whenever I see a patient who has to have levothyroxine increased or can’t get their levels regulated correctly, this type of binding interaction is the first thing I look for.  Here’s an example of this.
  2. Quinolone antibiotics.  Calcium will definitely bind up this class of medication. Ciprofloxacin and levofloxacin should not be co-administered with calcium.  For short courses and especially twice daily dosing, and if the patient is just using calcium for supplementation in relation to osteoporosis and not significant hypocalcemia, I’m inclined to have the patient hold the calcium for the duration of the course of the antibiotic.  Altering the timing of administration is another potential option here.
  3. Tetracyclines are the other common antibiotic class that calcium carbonate can interact with.  Again, this results in a potential reduction of drug concentrations in the body and can potentially lead to antibiotic failure.  This is something that certainly can be avoided by paying attention to administration times and/or holding the doses of the calcium for the duration of the antibiotic course.

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Written By Eric Christianson

October 8, 2017

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