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Table of Contents > Supplements > Calcium > Interactions
Possible Interactions with: Calcium

If you are currently being treated with any of the following medications, you should not use calcium supplements without first talking to your healthcare provider

Calcium may interfere with the absorption of alendronate, a medication used to treat osteoporosis. Calcium containing products, therefore, should be taken at least two hours before or after alendronate.

Antacids, Aluminum-containing
When calcium citrate is taken with aluminum containing antacids, the amount of aluminum absorbed into the blood stream may be increased significantly. This is a particular problem for people with kidney disease in whom the aluminum levels may become toxic. In addition, aluminum-containing antacids may increase the loss of calcium in the urine.

Blood Pressure Medications
Taking calcium with a beta-blocker (such as atenolol), a group of medications used for the treatment of high blood pressure or heart disorders, may interfere with blood levels of both the calcium and the beta-blocker. Study results are conflicting, however. Until more is known, individuals taking atenolol, or another beta blocker, should have their blood pressure checked before and after adding calcium supplements or calcium containing antacids to their medication regimen.

Similarly, it has been reported that calcium may reverse the therapeutic effects as well as the side effects of calcium channel blockers (such as verapamil) often prescribed for the treatment of high blood pressure. These study results are also controversial. People taking verapamil or another calcium channel blocker along with calcium supplements should likely have their blood pressure checked regularly.

Cholesterol-lowering Medications
A class of medications known as bile acid sequestrants (including cholestyramine, colestipol, and colesevelam), used to treat high cholesterol, may interfere with normal calcium absorption and increase the loss of calcium in the urine. Supplementation, therefore, with calcium and vitamin D may be recommended by your healthcare provider.

Corticosteroid medications reduce the absorption of calcium, thereby increasing the risk for bone loss and osteoporosis over time. This is of particular concern for anyone who is maintained on long-term steroids.

High levels of calcium may increase the likelihood of a toxic reaction to digoxin, a medication used to treat irregular heart rhythms. On the other hand, low levels of calcium cause this medication to be ineffective. People who are taking digoxin should have calcium levels monitored in the blood closely.

Two different classes of diuretics interact with calcium in opposite ways—thiazide diuretics such as hydrochlorothiazide can raise calcium levels in the blood, while loop diuretics, such as furosemide and bumetanide, can decrease calcium levels. In addition, amiloride, a potassium-sparing diuretic, may decrease the amount of calcium excreted in the urine (and subsequently increase calcium levels in the blood), especially in people with kidney stones.

Estrogens may contribute to an overall increase in calcium blood levels. Taking calcium supplements together with estrogens improves gain in bone density significantly.

Taking calcium during treatment with the antibiotic gentamicin may increase the potential for toxic effects on the kidneys.

Metformin, a medication used to treat type 2 diabetes, can deplete levels of vitamin B12. Some early evidence suggests that calcium supplements may prevent or eliminate this negative effect of metformin. More research is needed.

Antibiotics, Quinolones
Calcium can interfere with the body's ability to absorb quinolone antibiotics (such as ciprofloxacin, levofloxacin, norfloxacin, and ofloxacin). If taking calcium containing supplements or antacids, therefore, you should take them two to four hours before or after taking quinolone antibiotics.

Seizure Medications
Low levels of calcium have been reported with high doses of seizure medications, such as phenytoin, which may decrease calcium absorption. Some physicians recommend vitamin D along with anti-seizure drugs to try to prevent the development of low calcium levels.

Calcium can interfere with the body's ability to absorb tetracycline medications (including doxycycline, minocycline, and tetracycline) and, therefore, diminish their effectiveness. Calcium containing supplements and antacids should be taken at least two hours before or after taking these drugs.

Drug Interactions
Blood Pressure Medications
Cholesterol-lowering Medications
Corticosteriod Medications
Estrogen-containing Medications
Metformin-containing Medications
Phenytoin-containing Medications

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

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