Tums Regular

Name: Tums Regular

Adverse Effects

Frequency Not Defined

Anorexia

Constipation

Flatulence

Nausea

Vomiting

Hypercalcemia

Hypophosphatemia

Milk-alkali syndrome

Warnings

Contraindications

Hypersensitivity

Hypercalciuria

Renal calculi

Hypophosphatemia

Hypercalcemia

Suspected digoxin toxicity

Cautions

Shake suspension well; chew tablets thoroughly

Absorption impaired in achlorhydria

Hypercalcemia and hypercalciuria may result from long-term use

Advise patients to limit intake of oxalate-rich foods (soy; green, leafy vegetables; animal protein) to avoid reduced absorption through Ca-oxalate formation

Pregnancy & Lactation

Pregnancy category: C

Lactation: Safe; crosses the placenta; appears in breast milk

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

Pharmacology

Mechanism of Action

Antacid: Neutralizes gastric acidity

Dietary supplement: Prevents or treats negative Ca balance; oral Ca supplements may protect against renal calculi formation by chelating with oxalate in gut and preventing its absorption

Phosphate binder: Binds with dietary phosphate to form insoluble calcium phosphate, which is excreted in feces

Absorption

Bioavailability: 25-35%; food increases absorption 10-30%; antacid action dependent on gastric emptying time

Peak plasma time: 20-60 min (fasting state); up to 3 hr (ingested 1 hr after meals)

Distribution

Protein bound: 45%

Elimination

Renal clearance: 50-300 mg/day

Excretion: Feces, as unabsorbed calcium (80%); urine (20%)

Patient Handout

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