Calcium interactions

Calcium binds to several drugs in the gut and blocks their absorption; separating doses by a few hours usually solves it.

Calcium has 62 documented interactions across the FDA labels and fact sheets we index: 6 major, 27 moderate, 27 minor, and 2 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This vitamin and mineral page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (6)

  • Calcitriolvitamin D analogMajor

    Calcium Supplements Uncontrolled intake of additional calcium-containing preparations should be avoided (see PRECAUTIONS: General ). (Calcitriol label, Drug interactions)

  • Calcium acetatephosphate binderMajor

    Avoid the use of calcium supplements, including calcium-based nonprescription antacids, concurrently with calcium acetate capsules. (Calcium acetate label, Warnings and precautions)

  • CeftriaxonecephalosporinMajor

    Do not administer simultaneously with calcium-containing IV solutions. (Ceftriaxone label, Warnings and precautions)

  • NeomycinaminoglycosideMajor

    If blockage occurs, calcium salts may reverse these phenomena but mechanical respiratory assistance may be necessary. (Neomycin label, Boxed warning)

  • PhenytoinanticonvulsantMajor

    Calcium carbonate, aluminum hydroxide, magnesium hydroxide Prevention or Management: Phenytoin and antacids should not be taken at the same time of day Antineoplastic agents (usually in combination) Bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate Antiviral agents Fosamprenavir, nelfinavir, ritonavir Antiepileptic drugs Carbamazepine, vigabatrin Other… (Phenytoin label, Drug interactions)

  • RisedronatebisphosphonateMajor

    Calcium supplements, antacids, magnesium-based supplements or laxatives, and iron preparations interfere with the absorption of Risedronate sodium delayed-release and should not be taken together. (Risedronate label, Drug interactions)

Moderate interactions (27)

  • • If treatment with a gastric acid reducing agent is required, consider using a H2‑receptor antagonist (e.g., ranitidine or famotidine) or an antacid (e.g., calcium carbonate). (Acalabrutinib label, Drug interactions)

  • AlendronatebisphosphonateModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • Calcium supplements can reduce absorption of these medicines; take them several hours apart. (NIH Office of Dietary Supplements, Calcium)

  • Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • CinacalcetCYP2D6 inhibitorModerate

    If corrected serum calcium falls below the lower limit of normal or symptoms of hypocalcemia develop, start or increase calcium supplementation (including calcium, calcium-containing phosphate binders, and/or vitamin D sterols or increases in dialysate calcium concentration). (Cinacalcet label, Warnings and precautions)

  • CiprofloxacinfluoroquinoloneModerate

    …polymeric phosphate binders (for example, sevelamer, lanthanum carbonate); sucralfate; Videx ® (didanosine) chewable/buffered tablets or pediatric powder; other highly buffered drugs; or products containing calcium, iron, or zinc and dairy products) Ciprofloxacin should be taken at least two hours before or six hours after Multivalent cation-containing products administration… (Ciprofloxacin label, Drug interactions)

  • Demeclocyclinetetracycline antibioticModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • DolutegravirantiretroviralModerate

    Calcium supplements can reduce absorption of these medicines; take them several hours apart. (NIH Office of Dietary Supplements, Calcium)

  • Doxercalciferolvitamin D analogModerate

    Hypercalcemia may be exacerbated by concomitant administration of high doses of calcium-containing preparations, thiazide diuretics, or other vitamin D compounds [see Drug Interactions ( 7 )]. (Doxercalciferol label, Warnings and precautions)

  • Doxycyclinetetracycline antibioticModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • …Interactions Concomitant Drug Class: Drug Name Effect on Concentration Increase = ↑; Decrease = ↓; No Effect = ↔ Clinical Comment Antacids: antacids (e.g., aluminum, magnesium hydroxide, or calcium carbonate) ↔ RPV (antacids taken at least 2 hours before or at least 4 hours after RPV) ↓ RPV (concomitant intake) Administer antacids at least 2 hours before or at least 4… (Emtricitabine, rilpivirine, and tenofovir label, Drug interactions)

  • IbandronatebisphosphonateModerate

    Instruct patients to take supplemental calcium and vitamin D if their dietary intake is inadequate (see Dosage and Administration [2.3] ) . (Ibandronate label, Warnings and precautions)

  • LevofloxacinfluoroquinoloneModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • Levothyroxinethyroid hormoneModerate

    Calcium supplements can reduce absorption of these medicines; take them several hours apart. (NIH Office of Dietary Supplements, Calcium)

  • Liothyroninethyroid hormoneModerate

    Calcium supplements can reduce absorption of these medicines; take them several hours apart. (NIH Office of Dietary Supplements, Calcium)

  • Lithiumserotonergic drugModerate

    Calcium supplements can reduce absorption of these medicines; take them several hours apart. (NIH Office of Dietary Supplements, Calcium)

  • Minocyclinetetracycline antibioticModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • MoxifloxacinfluoroquinoloneModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • OfloxacinfluoroquinoloneModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • PamidronatebisphosphonateModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • Paricalcitolvitamin D analogModerate

    Hypercalcemia may be exacerbated by concomitant administration of high doses of calcium-containing preparations, thiazide diuretics, or other vitamin D compounds [see Drug Interactions (7) ] . (Paricalcitol label, Warnings and precautions)

  • Phentermine and topiramateCNS stimulantModerate

    Increased ratio of urinary calcium/citrate increases the risk of kidney stones and/or nephrocalcinosis. (Phentermine and topiramate label, Warnings and precautions)

  • RilpivirineantiretroviralModerate

    …Drug Name Effect on Concentration of Rilpivirine or Concomitant Drug Clinical Comment ↑=increase, ↓=decrease, ↔=no change Antacids: antacids (e.g., aluminum or magnesium hydroxide, calcium carbonate) ↔ rilpivirine (antacids taken at least 2 hours before or at least 4 hours after rilpivirine) The combination of EDURANT or EDURANT PED and antacids should be used… (Rilpivirine label, Drug interactions)

  • Tetracyclinetetracycline antibioticModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • Tigecyclinetetracycline antibioticModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

  • TopiramateanticonvulsantModerate

    This increased ratio of urinary calcium/citrate increases the risk of kidney stones and/or nephrocalcinosis. (Topiramate label, Warnings and precautions)

  • Zoledronic acidbisphosphonateModerate

    Calcium binds these drugs in the gut and can sharply cut how much is absorbed; separate the doses. (NIH Office of Dietary Supplements, Calcium)

Minor mentions (27)

  • AmikacinaminoglycosideMinor

    If neuromuscular blockade occurs, it may be reversed by the administration of calcium salts but mechanical respiratory assistance may be necessary. (Amikacin label, Warnings and precautions)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • CabotegravirantiretroviralMinor

    Concomitant Drug Class: Drug Name Effect on Concentration Clinical Comment Antacids containing polyvalent cations (e.g., aluminum or magnesium hydroxide, calcium carbonate) ↓Cabotegravir Administer antacid products at least 2 hours before or 4 hours after taking VOCABRIA. (Cabotegravir label, Drug interactions)

  • Calcinosis cutis can occur with or without extravasation of Calcium Chloride Injection, is characterized by abnormal dermal deposits of calcium salts, and clinically manifests as papules, plaques, or nodules that may be associated with erythema, swelling, or induration. (Calcium chloride label, Warnings and precautions)

  • Calcinosis cutis can occur with or without extravasation of Calcium Gluconate Injection, is characterized by abnormal dermal deposits of calcium salts, and clinically manifests as papules, plaques, or nodules that may be associated with erythema, swelling, or induration. (Calcium gluconate label, Warnings and precautions)

  • Candesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Chlorothiazidethiazide diureticMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Chlorthalidonethiazide diureticMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • GentamicinaminoglycosideMinor

    If neuromuscular blockade occurs, calcium salts may reverse it. (Gentamicin label, Drug interactions)

  • Hydrochlorothiazidethiazide diureticMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Indapamidethiazide diureticMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Irbesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Metolazonethiazide diureticMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Olmesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Olmesartan, amlodipine, and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Telmisartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Minor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

No significant interaction reported (2)

  • OseltamivirantiviralNo interaction

    …Clinically Significant Drug Interaction with TAMIFLU No dose adjustments are needed for either oseltamivir or the concomitant drug when coadministering oseltamivir with amoxicillin, acetaminophen, aspirin, cimetidine, antacids (magnesium and aluminum hydroxides and calcium carbonates), rimantadine, amantadine, or warfarin [see Clinical Pharmacology (12.3) ] . (Oseltamivir label, Drug interactions)

  • RaltegravirantiretroviralNo interaction

    Moreover, atazanavir, atazanavir/ritonavir, boceprevir, calcium carbonate antacids, darunavir/ritonavir, efavirenz, etravirine, omeprazole, or tipranavir/ritonavir did not have a clinically meaningful effect on the pharmacokinetics of raltegravir. (Raltegravir label, Drug interactions)

Check Calcium against everything you take. Add your full list; every pair is checked at once.

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.