Calcium Acetate is indicated for the management of hyperphosphatemia in patients with end-stage renal disease (ESRD). It does not enhance the absorption of aluminum.

When taken with meals, Calcium Acetate binds with dietary phosphate in the gastrointestinal tract to form insoluble calcium phosphate, which is eliminated through the feces. Maintaining serum phosphorus levels below 6.0 mg/dl is generally considered an acceptable therapeutic goal when using phosphate binders. Calcium Acetate is highly soluble at neutral pH, allowing effective binding of phosphate in the proximal small intestine. After oral administration, approximately 40% of Calcium Acetate is absorbed under fasting conditions and about 30% under non-fasting conditions. These findings are based on studies conducted in both healthy individuals and patients undergoing renal dialysis.

The recommended initial dose of Calcium Acetate for the adult dialysis patient is 2 tablets with each meal. The dosage may be increased gradually to bring the serum phosphate level below 6 mg/dl, as long as hypercalcemia does not develop. Most patients require 3–4 tablets with each meal.

Pediatric Use: The safety and efficacy of Calcium Acetate have not been established.

Geriatric Use: In clinical studies, no overall differences in safety or effectiveness were observed between the geriatric and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Calcium Acetate may reduce the bioavailability of tetracycline when used together.

Calcium Acetate should not be used in patients with hypercalcemia.

Some patients may experience nausea during treatment with Calcium Acetate. Hypercalcemia may develop during therapy. Mild hypercalcemia (Ca >10.5 mg/dl) may be asymptomatic or present with symptoms such as constipation, loss of appetite, nausea, and vomiting. Severe hypercalcemia (Ca >12 mg/dl) may lead to confusion, delirium, stupor, and coma. Mild cases can usually be managed by reducing the dose or temporarily stopping the medication. Severe cases may require acute hemodialysis and discontinuation of therapy. Lowering calcium concentration in dialysate may reduce both the occurrence and severity of hypercalcemia. The long-term effects on vascular or soft tissue calcification are not yet clearly established. Rare cases of itching have been reported, possibly due to allergic reactions.

Pregnancy Category C. Adequate animal studies have not been conducted with Calcium Acetate. It is not known whether this drug can cause harm to the fetus or affect reproductive ability. It should be used during pregnancy only if clearly necessary.

Excessive intake of Calcium Acetate can result in hypercalcemia. Therefore, serum calcium levels should be monitored twice weekly during the initial phase of treatment and dosage adjustment. If hypercalcemia occurs, the dose should be reduced or treatment should be discontinued based on severity. Calcium Acetate should not be administered to patients receiving digitalis, as hypercalcemia may increase the risk of cardiac arrhythmias. Treatment should begin with a low dose and should not be increased without careful monitoring of serum calcium levels. Patients should be advised to follow dosage instructions strictly, adhere to dietary recommendations, and avoid the use of non-prescribed antacids. They should also be informed about the symptoms of hypercalcemia.

Excess intake beyond the recommended daily dose may result in severe hypercalcemia.

Store below 30°C, protected from light and moisture. Keep out of reach of children.