Calcium salts for kidney disease

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Calcium salts for kidney disease

This leaflet is about the use of calcium salts for children with kidney disease.

Information Standard logoThis leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again. 

Name of drug

Calcium salts. This medicine may also be called calcium acetate or calcium carbonate
Brand names: Adcal®, Calcichew®, Calcichew Forte®, Rennie Soft Chews®, Remegel®, Tums®, Calcium-500, Phosex®

Why is it important for my child to take this medicine?

The kidneys remove phosphate that the body doesn't need from the blood. In children with kidney disease, phosphate levels may build up, putting them at risk of bone problems. Calcium salts are given to people with kidney disease to bind (mop up) phosphate from food in the gut. The salts form calcium phosphate, which is then removed from the body in the stool (poo). 

It is important that your child takes this medicine regularly to prevent phosphate levels from building up in their blood, which could be dangerous.

What are calcium salts available as?

  • Chewable tablets: Adcal® (1.5 g), Calcichew® (1.25 g), Calcichew Forte® (2.5 g), Rennie Soft Chews® (800 mg), Remegel® (800 mg), Tums® (500 mg), Calcium-500,
  • Tablets: Phosex® (1 g)
  • Liquid medicine (suspension): can be ordered specially from your pharmacist

When should I give calcium salts?

Your child must take calcium salts just before or during every feed, meal or snack, to bind any phosphate in that meal. They can takethe medicine just before starting the meal or during the meal. Your doctor will tell you what to do. A dietitian will give advice about what your child can eat and drink.

 If your child has overnight feeds, the calcium salts should be added to their feed as recommended by the specialist doctor who is looking after your child.

How much should I give?

Your doctor will measure the amount of phosphate in your child’s blood and from this work out how much calcium salt is right for your child. The dose may therefore change at each visit to your doctor. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions about how much to give.

How should I give calcium salts?

Chewable tablets should be chewed and then swallowed.

Phosex® tablets should be swallowed with a glass of water, milk or juice. Your child should not chew Phosex® tablets. Your child should not chew Phosex tablets.

Liquid medicine: Shake the medicine well. Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount

When should the medicine start working?

It may take a while for the level of phosphate in your child's blood to fall after they first start taking the medicine. You will not see any difference in your child but your doctor will check their blood to make sure the medicine is working.

What if my child is sick (vomits)?

If your child is sick, you do not need to give them another dose.

What if I forget to give it?

Calcium salts need to be taken at the same time as a meal or snack. If your child has already finished eating when you remember, do not give the missed dose.

What if I give too much?

You are unlikely to do harm if your child takes too much calcium salt. If you are worried you may have given your child too much calcium salt, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales). Have the packet with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side-effects you must do something about

If your child has pain when passing urine (weeing), cloudy urine, blood in their urine, or severe pain on either side of their lower back, they may have kidney stones. Call for an ambulance or take your child to hospital straight away.

  • If your child has muscle weakness, is more thirsty than normal, seems to pass urine more often than usual, feels sick (nausea) or is sick (vomits) or loses their appetite, contact your doctor, as there may be too much calcium in their blood.

Other side-effects you need to know about

  • Your child may get constipation (difficulty doing a poo). If this happens, contact your doctor for advice.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.

Can other medicines be given at the same time as calcium salts?

  • You can give your child medicines that contain paracetamol unless your doctor has told you not to.
  • Do not give your child ibuprofen unless your doctor has said that you can.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine?

  • Your child will need regular blood tests to check the levels of phosphate in their blood. It is important that you take your child for these blood tests.

General advice about medicines

  • Try to give medicines at about the same time each day, to help you remember.
  • If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
  • If you think someone else may have taken the medicine by accident, contact your doctor straight away.
  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of. Check the expiry date of any liquid medicine that you get from your pharmacist.

Where I should keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
  • The liquid medicine (suspension) should not be kept for more than 4 weeks once opened.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information

Your child’s doctor, pharmacist, nurse or dietician will be able to give you more information about calcium salts and about other medicines used to treat high phosphate levels.

You can also get useful information from: 
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