What is calcium carbonate?

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance.

Calcium carbonate is used to prevent or to treat a calcium deficiency.

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

Calcium carbonate may also be used for purposes not listed in this medication guide.

Calcium carbonate side effects

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

Calcium carbonate may cause serious side effects. Call your doctor at once if you have:

• little or no urinating;
• swelling, rapid weight gain; or
• high levels of calcium in your blood–nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or feeling tired.

Common side effects of calcium carbonate may include:

• upset stomach, gas; or
• constipation.

This is not a complete list of side effects and others may occur.

Warnings

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 it is safe for you to take calcium carbonate if you have ever had:

• kidney disease;
• kidney stones;
• cancer;
• a parathyroid gland disorder; or
• high levels of calcium in your blood.

Ask a doctor before using calcium carbonate 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 carbonate?

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 carbonate product to see if it should be taken with or without food.

Swallow the calcium carbonate regular tablet with a full glass of water.

The chewable tablet should be chewed before you swallow it.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Use the calcium carbonate powder as directed. Allow the powder to dissolve completely, then consume the mixture.

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

Your calcium carbonate 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. Do not freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line.

What should I avoid while taking calcium carbonate?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking calcium carbonate.

What other drugs can affect calcium carbonate?

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

Other drugs may interact with calcium carbonate, including prescription and over-the-counter medicines, vitamins, and herbal products. 

Cholecalciferol is vitamin D3. Vitamin D helps your body absorb calcium.

Cholecalciferol is used as a dietary supplement in people who do not get enough vitamin D in their diets to maintain adequate health.

Cholecalciferol may also be used for purposes not listed in this guide.

Cholecalciferol 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.

Stop taking cholecalciferol and call your doctor at once if you have:

• chest pain, feeling short of breath;
• growth problems (in a child taking cholecalciferol); or
• early signs of vitamin D overdose–weakness, metallic taste in your mouth, weight loss, muscle or bone pain, constipation, nausea, and vomiting.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

You should not take cholecalciferol if you have had an allergic reaction to vitamin D, or if you have high levels of calcium or vitamin D in your body, or any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

Before taking this medicine

You should not use cholecalciferol if you have had an allergic reaction to vitamin D, or if you have:

• high levels of vitamin D in your body (hypervitaminosis D);
• high levels of calcium in your blood (hypercalcemia); or
• any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

Tell your doctor if you have ever had:

• heart disease;
• kidney disease; or
• an electrolyte imbalance.

Certain forms of cholecalciferol may contain ingredients you should know about, such as peanut or soybean oil, sugar, aspartame (phenylalanine), or certain food dyes. Ask a doctor before using cholecalciferol if you have allergies, diabetes, or phenylketonuria (PKU).

Too much vitamin D could harm an unborn baby or a nursing baby. Ask a doctor before using cholecalciferol if you are pregnant or breastfeeding. Your dose needs may be different during pregnancy or while you are nursing.

Do not give cholecalciferol to a child without medical advice. Your child’s dose will depend on age, weight, diet, and other factors.

How should I take cholecalciferol?

Follow all directions on your prescription label and read all the guides or instruction sheets. Use only the recommended dose of cholecalciferol.

It may be best to take cholecalciferol after a meal, but you may take it with or without food.

Measure liquid cholecalciferol carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

The chewable tablet must be chewed before you swallow it.

To take a disintegrating (Quick-Melt) tablet, place it on your tongue and do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

The cholecalciferol wafer is usually taken only once per week or once per month. Follow your doctor’s dosing instructions very carefully. The wafer must be chewed before you swallow it.

While using cholecalciferol, you will need frequent blood tests. You may also need x-rays.

Your doctor will determine how long to treat you with cholecalciferol.

Cholecalciferol may be only part of a complete program of treatment that also includes dietary changes and taking calcium and vitamin supplements. Follow your doctor’s instructions very closely.

Learn about the foods you should eat to make sure you get enough calcium and vitamin D in your diet. Your cholecalciferol dose may need to be adjusted as you make changes to your diet.

Store at room temperature away from moisture, light, and heat.

Cholecalciferol dosing information

Usual Adult Dose for Vitamin/Mineral Supplementation:

US Recommended Dietary Allowance (RDA) for vitamin D:
18 to 70 years: 15 mcg (600 international units) daily
Tolerable Upper Intake Level: 100 mcg (4000 international units)

Usual Geriatric Dose for Vitamin/Mineral Supplementation:

US Recommended Dietary Allowance (RDA) for vitamin D:
70 years and older: 20 mcg (800 international units) daily
Tolerable Upper Intake Level: 100 mcg (4000 international units)

Usual Pediatric Dose for Vitamin/Mineral Supplementation:

US Recommended Dietary Allowance (RDA) for vitamin D:

0 to 6 months: 10 mcg (400 international units) daily
Tolerable Upper Intake Level (UL): 25 mcg (1000 international units)

7 to 12 months: 10 mcg (400 international units) daily
UL: 38 mcg (1500 international units)

1 to 3 years: 15 mcg (600 international units) daily
UL: 63 mcg (2500 international units)

4 to 8 years: 15 mcg (600 international units) daily
UL: 75 mcg (3000 international units)

9 to 18 years: 15 mcg (600 international units) daily
UL: 100 mcg (4000 international units)

What happens if I miss a dose?

Take cholecalciferol 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 . An overdose of vitamin D can cause serious or life-threatening side effects.

Overdose symptoms may include nausea, loss of appetite, thirst, urinating more or less than usual, body aches, stiffness, confusion, or irregular heartbeats.

What should I avoid while taking cholecalciferol?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking cholecalciferol.

What other drugs will affect cholecalciferol?

Certain medications can make it harder for your body to absorb vitamin D. If you take other medications, take them at least 2 hours before or 2 hours after you take cholecalciferol.

Other drugs may affect cholecalciferol, 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.

Boniva is a bisphosphonate medicine that alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Boniva is prescription medicine used to treat or prevent osteoporosis in women after menopause. Ibandronate helps increase bone mass and helps reduce the chance of having a spinal fracture.

It is not known how long Boniva works for the treatment and prevention of osteoporosis. You should see your doctor regularly to determine if this medicine is still right for you.

Warnings

You should not use Boniva if you have severe kidney disease or low levels of calcium in your blood.

Do not take a tablet if you have problems with your esophagus, or if you cannot sit upright or stand for at least 60 minutes after taking the tablet.

Boniva tablets can cause serious problems in the stomach or esophagus. Stop taking Boniva and call your doctor at once if you have chest pain, new or worsening heartburn, or pain when swallowing.

Also call your doctor if you have muscle spasms, numbness or tingling (in hands and feet or around the mouth), new or unusual hip pain, or severe pain in your joints, bones, or muscles.

Boniva side effects

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

Stop using this medicine and call your doctor at once if you have:

• chest pain, new or worsening heartburn;
• difficulty or pain when swallowing;
• pain or burning under the ribs or in the back;
• severe heartburn, burning pain in your upper stomach, or coughing up blood;
• new or unusual pain in your thigh or hip;
• jaw pain, numbness, or swelling;
• severe joint, bone, or muscle pain; or
• low calcium levels – muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Common Boniva side effects may include:

• heartburn, stomach pain, diarrhea;
• back pain, bone pain, muscle or joint pain;
• pain in your arms or legs;
• headache; or
• fever, chills, tiredness, flu-like symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Before taking this medicine

You should not use Boniva if you are allergic to ibandronate, or if you have:

• severe kidney disease; or
• low blood levels of calcium (hypocalcemia).

Do not take an Boniva tablet if you have problems with your esophagus, or if you cannot sit upright or stand for at least 60 minutes. Ibandronate can cause serious problems in the stomach or esophagus. You must stay upright for at least 1 full hour after taking this medicine.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• trouble swallowing;
• problems with your stomach or digestion;
• hypocalcemia;
• a dental problem (you may need a dental exam before you begin using Boniva);
• kidney disease; or
• any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use Boniva, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.

Talk with your doctor about the risks and benefits of using this medication.

It is not known whether ibandronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether ibandronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Boniva?

Use Boniva exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Boniva tablets are taken once per month. The injection is given into a vein through an IV once every 3 months. The tablets can be taken at home, but a healthcare provider must give the injection.

Take the tablet first thing in the morning, at least 60 minutes before you eat or drink anything or take any other medicine. Take the medicine on the same day each month and always first thing in the morning.

Take the tablet with a full glass (6 to 8 ounces) of plain water. Do not use coffee, tea, soda, juice, or mineral water. Do not eat or drink anything other than plain water.

Do not crush, chew, or suck on a tablet. Swallow it whole.

For at least 60 minutes (1 full hour) after taking a tablet:

• Do not lie down or recline.
• Do not take any other medicine including vitamins, calcium, or antacids.

Pay special attention to your dental hygiene while using Boniva. Brush and floss your teeth regularly. Consult your dentist before starting Boniva to ensure that you don’t need dental work soon. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using this medicine.

Boniva is only part of a complete program of treatment that may also include diet changes, exercise, bone mineral density testing, and taking calcium and vitamin supplements. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

Your doctor will determine how long to treat you with this medicine. Ibandronate is often given for only 3 to 5 years.

Dosing information

Usual Adult Dose for Osteoporosis:

Oral:
150 mg orally once a month on the same day each month

IV Injection:
3 mg by IV injection over 15 to 30 seconds every three months.

Comments:
-The IV injection should not be administered more frequently than once every 3 months.
-Obtain serum creatinine prior administration of each IV injection.
-Perform a routine oral examination prior administration of IV injection

Uses: Treatment and prevention of postmenopausal osteoporosis, to increase bone mineral density (BMD) and to reduce the incidence of vertebral fractures

Usual Adult Dose for Prevention of Osteoporosis:

Oral:
150 mg orally once a month on the same day each month

IV Injection:
3 mg by IV injection over 15 to 30 seconds every three months.

Comments:
-The IV injection should not be administered more frequently than once every 3 months.
-Obtain serum creatinine prior administration of each IV injection.
-Perform a routine oral examination prior administration of IV injection

Uses: Treatment and prevention of postmenopausal osteoporosis, to increase bone mineral density (BMD) and to reduce the incidence of vertebral fractures

What happens if I miss a dose?

Boniva tablets: If you forget to take a tablet first thing in the morning on your scheduled day, do not take it later in the day. Wait until the next morning to take the missed dose. Then return to your regular monthly schedule on your chosen dose day. If your next scheduled dose is less than 7 days away, wait until then and skip the missed dose. Do not take two (2) doses in one week.

Boniva injections: Call your doctor for instructions if you miss an appointment for your injection.

What happens if I overdose?

For Boniva tablets: Drink a full glass of milk and seek emergency medical attention or call the Poison Help line . Do not make yourself vomit and do not lie down.

Since the injections are given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What to avoid

Avoid taking any other medicines for at least 60 minutes after taking Boniva. This includes vitamins, calcium, and antacids. Some medicines can make it harder for your body to absorb ibandronate.

Avoid smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely.

Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss.

What other drugs will affect Boniva?

Tell your doctor about all your current medicines and any you start or stop using, especially:

• aspirin; or
• NSAIDs (nonsteroidal anti-inflammatory drugs) – ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ibandronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Talk with your doctor about the best dosing schedule for your other medicines.