Each effervescent tablet of 500 mg contains:
1132 mg of calcium lactate gluconate and 875 mg of calcium
carbonate (equivalent to 500 mg or 12.5 mmol of calcium).
Excipient(s): aspartame (30 mg), sodium (68.45 mg), sorbitol
and dextrose.
Pharmacotherapeutic group: Mineral supplements
ATC codes: Calcium carbonate (A 12 AA 04), Calcium lactate
gluconate (A 12 AA 06)
Calcium is an essential mineral, necessary for bone formation
and maintenance, for electrolyte equilibrium in the body
and for the proper functioning of numerous regulatory
mechanisms.
 used for:
• Prevention and treatment of calcium deficiency.
• Calcium supplement as an adjunct to specific therapy in the
prevention and treatment of osteoporosis for patients who
are at risk of calcium deficiency.
• Rickets and osteomalacia, in addition to vitamin D3
therapy.

Don’t take  if you have:
Hypersensitivity to the active substances or to any of the
excipients.
Diseases and/or conditions resulting in hypercalcaemia and/
or hypercalciuria.
Nephrocalcinosis, nephrolithiasis.
Take special care :
For patients with mild hypercalciuria (exceeding 300 mg/24
hours or 7.5mmol/24hours), or with a history of urinary calculi,
monitoring of calcium excretion in the urine is required. If
necessary, the calcium dose should be reduced or therapy should
be discontinued.
An increased fluid intake is recommended for patients prone
to formation of calculi in the urinary tract.
In patients with impaired renal function, calcium salts should
be taken under medical
supervision with monitoring of calcium and phosphate serum
levels.
During high dose therapy and especially during concomitant
treatment with vitamin D, there is a risk of hypercalcaemia with
subsequent kidney function impairment. In these patients serum
calcium levels should be followed and renal function should be
monitored.
There have been literature reports alluding to possible
increased absorption of aluminium with citrate salts. Calcium
effervescent tablets (which contains citric acid) should be
used with caution in patients with severely impaired renal
function, especially those also receiving aluminium-containing
preparations.
Calcium effervescent tablets should be kept out of the reach
of children.
Special warnings about excipients
Calcium Effervescent tablets (500 mg) contain:
• Sorbitol and dextrose: Patients with rare hereditary problems
of fructose intolerance or glucose-galactose malabsorption
should not take this medicine.
• Sodium: Calcium500mg contains 2.976mmol
(corresponding to 68.42 mg) of sodium per tablet. To be taken

into consideration by patients on a controlled sodium diet.
• Aspartame: contains a source of phenylalanine
equivalent to 15 mg/dose. May be harmful for people with
phenylketonuria.
Information for diabetics:
One effervescent tablet contains 0.002 Carbohydrate Units
and is therefore suitable for diabetics.

How much to take
Adults: 500 – 1500 mg per day (1-3 tablets/day). Taken as
1 tablet/dose once, twice or three times a day.
Children: 500 – 1000 mg per day (1-2 tablets/day). Taken as
1 tablet/dose once or twice a day.
Calcium effervescent tablets may be taken with or without
food.
Effervescent tablets
How to take
• The effervescent tablet should be dissolved in a glass of
water (approx. 200 ml) and drunk immediately.

Interaction with other medicinal products and other forms
of interaction
Thiazide diuretics reduce the urinary excretion of calcium.
Due to increased risk of hypercalcaemia, serum calcium
should be regularly monitored during concomitant use of
thiazide diuretics.
Systemic corticosteroids reduce calcium absorption. During
concomitant use, it may be necessary to increase the dose
of Calcium.
Tetracycline preparations administered concomitantly with
calcium preparations may not be well-absorbed. For this
reason, tetracycline preparations should be administered at
least two hours before or four to six hours after oral intake
of calcium.
Cardiac glycoside toxicity may increase with hypercalcaemia
resulting from treatment with calcium. Patients should be
monitored with regard to electrocardiogram (ECG) and serum
calcium levels.
Oral bisphosphonate or sodium fluoride administered
concomitantly with calcium preparations may reduce the
gastrointestinal absorption of either oral bisphosphonate or
sodium fluoride. For this reason, oral bisphosphonate should be
administered at least three hours before the intake of Calcium.
Oxalic acid (e.g. found in spinach and rhubarb) and phytic acid
(e.g. found in whole cereals) may inhibit calcium absorption
through formation of insoluble compounds with calcium ions.
The patient should not take calcium products within two hours
of eating food high in oxalic acid and phytic acid.
Pregnancy and lactation
Pregnancy
Calcium can be used during pregnancy, in case of a calcium
deficiency. However, for supplementation starting during
the third trimester of pregnancy, the daily intake should not
exceed 1500 mg calcium.
In pregnant women, overdoses of calcium should be avoided
as persistent hypercalcaemia has been related to adverse
effects on the developing foetus.
Breastfeeding
Calcium can be used during breast-feeding. Calcium passes
into breast milk.
Effects on ability to drive and use machines
Calcium has no influence on the ability to drive and use
machines.
Undesirable effects
Adverse reactions are listed below, by system organ class and
frequency. Frequencies are defined as: very common (≥1/10),
common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100),
rare (≥1/10,000 to <1/1,000), very rare (<1/10,000) or not
known (cannot be estimated from available data).
Immune system disorders
Rare: Hypersensitivity, such as rash, pruritus, urticaria.
Very rare: Isolated cases of systemic allergic reactions
(anaphylactic reaction, face oedema, angioneurotic oedema)
have been reported.
Metabolism and nutrition disorders
Uncommon: Hypercalcaemia, hypercalciuria.
Gastrointestinal disorders
Rare: flatulence, constipation, diarrhoea, nausea, vomiting,
abdominal pain.
Overdose
Overdose leads to hypercalciuria and hypercalcaemia. Symptoms
of hypercalcaemia may include: nausea, vomiting, thirst,

polydipsia, polyuria, dehydration and constipation. Chronic
overdose with resulting hypercalcaemia can cause vascular and
organ calcification.
The threshold for calcium intoxication is from supplementation
in excess of 2000 mg per day, taken for several months.
Treatment of overdose
In the case of intoxication, treatment should be stopped
immediately and the fluid deficiency should be corrected.
Where overdosage requires treatment it should be via
hydration, including i.v. saline solution when needed.
A loop diuretic (e.g., furosemide) may then be used to
further increase calcium excretion and to prevent volume
overload, but thiazide diuretics should be avoided. In patients
with renal failure, hydration is ineffective and they should
undergo dialysis. In the case of persistent hypercalcaemia,
contributing factors should be excluded, e.g. vitamin A or D
hypervitaminosis, primary hyperparathyroidism,
malignancies, renal failure, or immobilisation.

Keep out of the reach and sight of children.
Do not take  after the expiry date shown on
the pack.
Store below 30 °C
Ask your pharmacist how to dispose of medicines no longer
required. This will help to protect the environment.