Recently I had an internship rotation at Publix pharmacy, and I noticed that a lot of patients and customers asked me to help them choose a calcium supplement. The most common products they decided on choosing were Caltrate (calcium carbonate) and Citracal (calcium citrate). I remember learning the differences between the two in my second year of pharmacy school, yet I felt I did not fully understand them in greater detail. Here, I will be researching these products and comparing their pharmacology and amount.
As I learned, calcium plays a vital role in human cells and the body. It activates signal transduction pathways for the heart, muscles, and nerves to function properly. The human body needs calcium to maintain bones and teeth. In older adults, it is also used to prevent osteoporosis. According to NIH, the recommended daily intake (RDI) of calcium in adults is 1,000mg per day. Its RDI increases to 1,200mg per day in women over the age of 50 and in men over the age of 70.
Calcium carbonate (Caltrate) is a calcium supplement that needs an acidic environment to be absorbed by the body. People should take it with food for better absorption results. Whereas, Calcium citrate (Citracal) does not need an acidic environment to absorb. Thus, people can take it with or without food. Calcium can absorb quicker in the body if it is administered with vitamin D. This is the reason why we see that many calcium products have vitamin D added to it. Both products are similar in price as well — a bottle of 120 tablets can cost roughly $14.
One of the disadvantages of calcium supplements is its side effects. Caltrate may cause constipation and bloating which are more common compared to Citracal. Here are several additional facts worth mentioning as well:
- Avoid caffeine with calcium supplements because caffeine increases calcium loss in the urine.
- Calcium can decrease the absorption of iron or zinc supplement, tetracycline, alendronate, and levothyroxine. When taking calcium supplements, be sure to separate them by a few hours from these medications.
- Do not exceed 2,500mg element of calcium per day. The elemental amount of calcium can be found on the label of the product. Too much calcium in the blood can weaken bones, cause kidney stones, and interfere with proper heart and brain functions.
In general, choosing the “right” product depends on the individual’s preference and tolerability. I think it is necessary to know the key differences so that we can counsel and recommend the best product that the patient or customer sees fit.
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