Calcium Acetate

Calcium acetate, when taken with meals, combines with dietary phosphate to form an insoluble calcium phosphate complex, which is excreted in the feces, resulting in decreased serum phosphorus concentration.

• Calcium acetate is a phosphate binder indicated to reduce serum phosphorus in patients with end stage renal disease (ESRD). Calcium acetate is a phosphate binder indicated for the reduction of serum phosphorus in patients with end stage renal disease.

• Patients with hypercalcemia. Hypercalcemia.contraindicated

The recommended initial dose of calcium acetate for the adult dialysis patient is 2 capsules with each meal. Increase the dose gradually to lower serum phosphorus levels to the target range, as long as hypercalcemia does not develop. Most patients require 3-4 capsules with each meal. Starting dose is 2 capsules with each meal. (2) Titrate the dose every 2-3 weeks until acceptable serum phosphorus level is reached. Most patients require 3-4 capsules with each meal. (2)

Treat mild hypercalcemia by reducing or interrupting calcium acetate capsules and Vitamin D. Severe hypercalcemia may require hemodialysis and discontinuation of calcium acetate capsules. ( 5.1 ) Hypercalcemia may aggravate digitalis toxicity. ( 5.2 ) 5.1 Hypercalcemia Patients with end stage renal disease may develop hypercalcemia when treated with calcium, including calcium acetate. Avoid the use of calcium supplements, including calcium based nonprescription antacids, concurrently with calcium acetate. An overdose of calcium acetate may lead to progressive hypercalcemia, which may require emergency measures. Therefore, early in the treatment phase during the dosage adjustment period, monitor serum calcium levels twice weekly. Should hypercalcemia develop, reduce the calcium acetate dosage, or discontinue the treatment, depending on the severity of hypercalcemia. More severe hypercalcemia (Ca >12 mg/dL) is associated with confusion, delirium, stupor and coma. Severe hypercalcemia can be treated by acute hemodialysis and discontinuing calcium acetate therapy. Mild hypercalcemia (10.5 to 11.9 mg/dL) may be asymptomatic or manifest as constipation, anorexia, nausea, and vomiting. Mild hypercalcemia is usually controlled by reducing the calcium acetate dose or temporarily discontinuing therapy. Decreasing or discontinuing Vitamin D therapy is recommended as well. Chronic hypercalcemia may lead to vascular calcification and other soft-tissue calcification. Radiographic evaluation of suspected anatomical regions may be helpful in early detection of soft tissue calcification.

Hypercalcemia is discussed elsewhere [see Warnings and Precautions (5.1) ]. The most common (>10%) adverse reactions are hypercalcemia, nausea and vomiting. ( 6.1 ) In clinical studies, patients have occasionally experienced nausea during calcium acetate therapy. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Cipla Ltd. at 1-866-604-3268 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch 6.1 Clinical Trial Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. In clinical studies, calcium acetate has been generally well tolerated. Calcium acetate was studied in a 3-month, open-label, non-randomized study of 98 enrolled ESRD hemodialysis patients and an alternate liquid formulation of calcium acetate was studied in a two week double-blind, placebo-controlled, cross-over study with 69 enrolled ESRD hemodialysis patients. Adverse reactions (>2% on treatment) from these trials are presented in Table 1.

8.1 Pregnancy Pregnancy Category C Calcium acetate capsules contain calcium acetate. Animal reproduction studies have not been conducted with calcium acetate, and there are no adequate and well controlled studies of calcium acetate use in pregnant women. Patients with end stage renal disease may develop hypercalcemia with calcium acetate treatment [see Warnings and Precautions (5.1) ] . Maintenance of normal serum calcium levels is important for maternal and fetal well being. Hypercalcemia during pregnancy may increase the risk for maternal and neonatal complications such as stillbirth, preterm delivery, and neonatal hypocalcemia and hypoparathyroidism. Calcium acetate treatment, as recommended, is not expected to harm a fetus if maternal calcium levels are properly monitored during and following treatment. 8.2 Labor and Delivery The effects of calcium acetate on labor and delivery are unknown. 8.3 Nursing Mothers A calcium acetate capsule contains calcium acetate and is excreted in human milk. Human milk feeding by a mother receiving calcium acetate is not expected to harm an infant, provided maternal serum calcium levels are appropriately monitored. 8.4 Pediatric Use Safety and effectiveness in pediatric patients have not been established.

Administration of calcium acetate in excess of the appropriate daily dosage may result in hypercalcemia [see Warnings and Precautions (5.1) ].

• Feb 26, 2008ANDAANDA077728Hikma
• Jun 1, 2012ANDAANDA091312Chartwell Rx
• Feb 5, 2013ANDAANDA202420Chartwell Molecular
• Feb 7, 2013ANDAANDA203135Invagen Pharms
• Oct 6, 2014ANDAANDA201658Amneal Pharms
• Jan 22, 2015ANDAANDA202885Heritage Pharms Inc
• Jun 29, 2015ANDAANDA202315Heritage Pharms Inc
• Oct 26, 2015ANDAANDA203179Mpp Pharma

1. 1Renal Failure4899.1%
2. 2Chronic Kidney Disease4668.7%
3. 3End Stage Renal Disease4378.2%
4. 4Acute Kidney Injury3807.1%
5. 5Diarrhoea3266.1%
6. 6Nausea2654.9%
7. 7Fatigue2574.8%
8. 8Death2454.6%
9. 9Dyspnoea2284.3%
10. 10Nephrogenic Anaemia2134.0%
11. 11Pain1903.5%
12. 12Asthenia1803.4%
13. 13Vomiting1703.2%
14. 14Pneumonia1693.2%
15. 15Pruritus1693.2%

Recent PubMed references pinned to Calcium Acetate as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.

• Valorization of bamboo vinegar through modified biochar for synergistic cadmium immobilization and phosphorus activation in saline alkaline soil.
  Bioresource technology · 2026 · Yang C, Xie Y, Wei L, et al.
  PMID 42219121DOI 10.1016/j.biortech.2026.135032
• Ethylenediaminetetraacetic acid-mediated structural enhancement and interfacial stabilization for high-performance starch-based adhesives.
  International journal of biological macromolecules · 2026 · Li Y, Lee SH, Deng S, et al.
  PMID 42190770DOI 10.1016/j.ijbiomac.2026.152714
• K(2)-EDTA anticoagulant suppresses calcium-dependent paraoxonase 1-mediated hydrolysis in human plasma stability assays.
  Drug metabolism and pharmacokinetics · 2026 · Tang LWT
  PMID 42068798DOI 10.1016/j.dmpk.2026.101541
• The physiological effects of induced prepartum subclinical hypocalcemia in multiparous Holstein cows.
  Journal of dairy science · 2026 · Frizzarini WS, Monteiro PLJ, Nascimento Andrade JP, et al.
  PMID 41679639DOI 10.3168/jds.2025-27370
• Effects of intravenous rehydration protocols based on an acetate-containing electrolyte solution, isotonic saline, and an isotonic mixture of saline/sodium bicarbonate on acid-base status and plasma electrolyte concentrations in calves with diarrhoea.
  Veterinary journal (London, England : 1997) · 2026 · Badura D, Lorch A, Urgibl-Bauer A, et al.
  PMID 41581824DOI 10.1016/j.tvjl.2026.106571
• Cyclohexyl acetate functions like a volatile sex pheromone mimic in Caenorhabditis nematodes.
  BMC biology · 2026 · Wan X, Togawa Y, Gronquist MR, et al.
  PMID 41540414DOI 10.1186/s12915-026-02510-0
• Efficient removal of EDTA-Cu by a novel Green Fe-Ca-Al composite metal material coupled with NaClO.
  Environmental research · 2026 · Wang Y, Yu X, Wen S, et al.
  PMID 41456663DOI 10.1016/j.envres.2025.123645
• Bone-targeting lipid-polymer hybrid nanoparticles for less invasive, injectable local antibiotic treatment of bone infections by methicillin-resistant Staphylococcus aureus (MRSA).
  International journal of pharmaceutics · 2026 · Guo P, Buttaro BA, Xue HY, et al.
  PMID 41455565DOI 10.1016/j.ijpharm.2025.126539

The 10 most recently updated of 286 ClinicalTrials.gov registrations naming Calcium Acetate as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.

• A Study to Compare Blinatumomab Alone to Blinatumomab With Nivolumab in Patients Diagnosed With First Relapse B-Cell Acute Lymphoblastic Leukemia (B-ALL)
  Recruiting · Phase 2 · Interventional · 461 enrolled · National Cancer Institute (NCI)
  NCT04546399updated 2026-06-12
• Dexamethasone in Controlling Dyspnea in Patients With Cancer
  Active not recruiting · Phase 2 · Interventional · 135 enrolled · M.D. Anderson Cancer Center
  NCT03367156updated 2026-06-11
• Venetoclax, MLN9708 (Ixazomib Citrate) and Dexamethasone for the Treatment of Relapsed or Refractory Light Chain Amyloidosis
  Active not recruiting · Phase 1 · Interventional · 24 enrolled · National Cancer Institute (NCI)
  NCT04847453updated 2026-06-11
• Lenalidomide and Dexamethasone With or Without Bortezomib in Treating Patients With Previously Untreated Multiple Myeloma
  Active not recruiting · Phase 3 · Interventional · 525 enrolled · National Cancer Institute (NCI)
  NCT00644228updated 2026-06-11
• Time to First Rescue Antiemetic With Ondansetron Plus Metoclopramide Versus Dexamethasone Plus Metoclopramide for PONV Prophylaxis in Laparoscopic Cholecystectomy
  Not yet recruiting · Phase 4 · Interventional · 264 enrolled · Faisalabad Medical University
  NCT07638527updated 2026-06-11
• Testing the Addition of the Anti-cancer Drug Venetoclax and/or the Anti-cancer Immunotherapy Blinatumomab to the Usual Chemotherapy Treatment for Infants With Newly Diagnosed KMT2A-rearranged or KMT2A-non-rearranged Leukemia
  Recruiting · Phase 2 · Interventional · 153 enrolled · National Cancer Institute (NCI)
  NCT06317662updated 2026-06-11
• Comparing Combinations of Drugs to Treat Newly Diagnosed Multiple Myeloma (NDMM) When a Stem Cell Transplant is Not a Medically Suitable Treatment
  Recruiting · Phase 3 · Interventional · 510 enrolled · SWOG Cancer Research Network
  NCT05561387updated 2026-06-10
• Testing Blinatumomab With or Without Revumenib in Patients With B-cell Acute Lymphoblastic Leukemia With a Genetic Change Requiring More Treatment
  Not yet recruiting · Phase 2 · Interventional · 90 enrolled · SWOG Cancer Research Network
  NCT07636564updated 2026-06-09
• Potential Therapeutic Role of Effervescent Calcium-Magnesium Citrate in Chronic Kidney Disease Stage V
  Active not recruiting · Phase 2 · Phase 3 · Interventional · 269 enrolled · University of Texas Southwestern Medical Center
  NCT03565913updated 2026-06-03
• Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma
  Active not recruiting · Phase 3 · Interventional · 847 enrolled · National Cancer Institute (NCI)
  NCT02112916updated 2026-06-03

Frequently asked questions

How does Calcium Acetate work?

Calcium acetate, when taken with meals, combines with dietary phosphate to form an insoluble calcium phosphate complex, which is excreted in the feces, resulting in decreased serum phosphorus concentration.

What is Calcium Acetate used for?

According to FDA labeling, Calcium Acetate carries indications including: Calcium acetate is a phosphate binder indicated to reduce serum phosphorus in patients with end stage renal disease (ESRD). Calcium acetate is a phosphate binder indicated for the reduction of serum phosphorus in patients with end stage renal disease.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.

What class of drug is Calcium Acetate?

Calcium Acetate is classified as Drugs for treatment of hyperkalemia and hyperphosphatemia, Bone Resorption Alteration, Increased Renal PO4-- Excretion.

What are the brand names for Calcium Acetate?

Calcium Acetate is marketed under brand names including Calphron, Domeboro, Nutrilyte, Phoslo, Phoslyra, ProcalAmine 3.

What are the contraindications for Calcium Acetate?

Calcium Acetate labeling lists contraindications including: Patients with hypercalcemia. Hypercalcemia.. Always consult the full prescribing information and a clinician.