Effervescent calcium supplement Pregnancy: Can be used during pregnancy and lactation in the case of a calcium deficiency. The adequate daily intake (including food and supplementation) for normal pregnant and lactating women is 1000–1300 mg calcium, and during pregnancy the daily intake of calcium should not exceed 1500 mg. Significant amounts of calcium are secreted in milk during lactation but do not cause any adverse effects to the neonate.

Calcium carbonate with calcium lactate gluconate

Brand names: Calcium-Sandoz, Calcichew

Used in: Osteoporosis

A combination of calcium carbonate and calcium lactate gluconate, usually supplied as an effervescent tablet that provides a soluble source of elemental calcium for prevention or treatment of calcium deficiency and as an adjunct in osteoporosis.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 1000 mg per day

Route: Oral — the effervescent tablet should be dissolved in a glass of water (approx. 200 ml) and drunk immediately

Frequency: Daily

Fetched UK SPC is Calvive 1000 Effervescent Tablets (formerly Sandocal Tablets), eMC product 1191 — the calcium carbonate with calcium lactate gluconate combination named on this page. §4.2 in full reads: 'Adults and children: 1000mg per day. The effervescent tablets should be dissolved in a glass of water (approx. 200 ml) and drunk immediately. Calvive 1000 effervescent tablet may be taken with or without food.' The SPC gives the same 1000 mg per day figure for adults AND children with no per-kg or age-banded paediatric dose, no dose interval and no maximum dose — verify any under-18 use against a children's formulary. §4.4 monitoring: in mild hypercalciuria (exceeding 300 mg/24 hours or 7.5 mmol/24 hours) or with a history of urinary calculi, monitor urinary calcium excretion and, if necessary, reduce the calcium dose or discontinue therapy; recommend increased fluid intake in patients prone to urinary tract calculi; during high-dose therapy and especially with concomitant vitamin D there is a risk of hypercalcaemia with subsequent kidney function impairment — monitor serum calcium and renal function. Excipient content per tablet: 3323.0 mg citric acid, 5.95 mmol (136.90 mg) sodium (equivalent to 6.9% of the WHO recommended maximum daily intake of 2 g sodium for an adult), 30 mg aspartame (a source of phenylalanine, may be harmful in phenylketonuria), 630 micrograms sorbitol (E420), 180 nanograms benzyl alcohol, 210 nanograms sulphur dioxide, and glucose (avoid in rare glucose-galactose malabsorption; may be harmful to the teeth). One effervescent tablet contains 0.002 Carbohydrate Units and is therefore stated to be suitable for diabetics. Keep out of the reach of children. The fetched §4.5 text was truncated at the source-fetch limit part-way through the thiazide entry, so the interaction list below is incomplete. The US fallback label fetched (an antacid product, Advance Pharmaceutical Inc.) is a different indication (antacid, up to 4 tablets in 24 hours, not for more than 2 weeks at maximum dosage) and was not used.

Dose adjustments

Renal

In patients with impaired renal function, calcium salts should be taken under medical supervision with monitoring of calcium and phosphate serum levels (§4.4). No numeric dose adjustment is stated in the SPC.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substances or to any of the excipients listed in section 6.1 of the effervescent tablet
Diseases and/or conditions resulting in hypercalcaemia and/or hypercalciuria
Nephrocalcinosis, nephrolithiasis

Side effects

Hypercalcaemia and hypercalciuria — uncommon (>1/1,000, <1/100)
Flatulence, constipation, diarrhoea, nausea, vomiting and abdominal pain — rare (>1/10,000, <1/1,000)
Hypersensitivity such as rash, pruritus and urticaria — rare
Isolated cases of systemic allergic reactions (anaphylactic reaction, face oedema, angioneurotic oedema) — very rare (<1/10,000)

Interactions

Thiazide diuretics reduce the urinary excretion of calcium — because of the increased risk of hypercalcaemia, serum calcium should be regularly monitored during concomitant use (SPC §4.5; the fetched §4.5 text was truncated at this point, so this is not the complete interaction list)
Aluminium-containing preparations — literature reports allude to possible increased absorption of aluminium with citrate salts, and this product contains 3323.0 mg citric acid per tablet; use with caution in patients with severely impaired renal function, especially those also receiving aluminium-containing preparations (SPC §4.4)

Clinical monograph

How it works

Both salts dissociate to deliver elemental calcium, replenishing extracellular calcium and supporting bone mineralisation, neuromuscular function and the negative feedback that suppresses parathyroid hormone.

Prescribing in practice

Avoid in conditions associated with hypercalcaemia or hypercalciuria (such as certain malignancies, sarcoidosis or severe renal impairment) where further calcium loading can be harmful.
Separate dosing from oral tetracyclines, quinolones, levothyroxine, iron and bisphosphonates, as calcium chelates and reduces their absorption.
The effervescent preparation carries a notable sodium load, which is relevant in hypertension, heart failure or renal impairment.

Monitoring

Monitor serum calcium (and renal function) periodically, particularly with high-dose or long-term use or where there is a risk of hypercalcaemia.

Counselling the patient

Dissolve the effervescent tablet fully in water before drinking.
Take other medicines such as antibiotics or thyroid tablets a couple of hours apart from your calcium.
Report persistent nausea, constipation, excessive thirst or confusion, which can signal high calcium levels.

Evidence & guidelines

Calcium with vitamin D supplementation is recommended by NICE as an adjunct to osteoporosis treatment in those with inadequate dietary intake.

Reference: NICE NG121; ROS; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways