Calcium acetate

Identification

Summary

Calcium acetate is a phosphate binder used in patients with end-stage renal disease (ESRD) to prevent elevated phosphate levels and resulting ectopic calcification and secondary hyperparathyroidism.

Brand Names
Domeboro, Eliphos, Phoslo, Phoslyra, Procalamine 3
Generic Name
Calcium acetate
DrugBank Accession Number
DB00258
Background

The chemical compound calcium acetate is the calcium salt of acetic acid. It has been commonly referred to as the acetate of lime. The anhydrous form is very hygroscopic, therefore the monohydrate is the common form.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Weight
Average: 158.166
Monoisotopic: 157.989199835
Chemical Formula
C4H6CaO4
Synonyms
  • Acetate of lime
  • Brown acetate of lime
  • Calcio acetato
  • Calcium acetate
  • calcium ethanoate
  • calcium(II) acetate
  • Gray acetate of lime
  • Lime acetate
  • Lime pyrolignite
External IDs
  • E-263
  • FEMA NO. 2228
  • INS NO.263
  • INS-263

Pharmacology

Indication

Calcium acetate is one of a number of calcium salts used to treat hyperphosphatemia (too much phosphate in the blood) in patients with kidney disease.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Management ofHyperphosphatemia••••••••••••
Used in combination to treatHigh phosphate levelsCombination Product in combination with: Magnesium carbonate (DB09481)•••••••••••••••••••• •••••••
Associated Therapies
Contraindications & Blackbox Warnings
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Pharmacodynamics

Patients with advanced renal insufficiency (creatinine clearance less than 30 ml/min) exhibit phosphate retention and some degree of hyperphosphatemia. The retention of phosphate plays a pivotal role in causing secondary hyperparathyroidism associated with osteodystrophy, and soft-tissue calcification. The mechanism by which phosphate retention leads to hyperparathyroidism is not clearly delineated. Therapeutic efforts directed toward the control of hyperphosphatemia include reduction in the dietary intake of phosphate, inhibition of absorption of phosphate in the intestine with phosphate binders, and removal of phosphate from the body by more efficient methods of dialysis. The rate of removal of phosphate by dietary manipulation or by dialysis is insufficient. Dialysis patients absorb 40% to 80% of dietary phosphorus. Therefore, the fraction of dietary phosphate absorbed from the diet needs to be reduced by using phosphate binders in most renal failure patients on maintenance dialysis. Calcium acetate when taken with meals combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the feces. Maintenance of serum phosphorus below 6.0 mg/dl is generally considered as a clinically acceptable outcome of treatment with phosphate binders. Calcium acetate is highly soluble at neutral pH, making the calcium readily available for binding to phosphate in the proximal small intestine.

Mechanism of action

Calcium acetate and other calcium salts are phosphate binders. They work by binding with the phosphate in the food you eat, so that it is eliminated from the body without being absorbed.

TargetActionsOrganism
APhosphate
binder
Humans
Absorption

40% is absorbed in the fasting state and approximately 30% is absorbed in the nonfasting state following oral administration.

Volume of distribution

Not Available

Protein binding

Not Available

Metabolism
Not Available
Route of elimination

Calcium acetate when taken with meals, combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the feces.

Half-life

Not Available

Clearance

Not Available

Adverse Effects
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Toxicity

Oral, rat: LD50 = 4280 mg/kg. Symptoms of overdose include mild hypercalcemia (constipation; loss of appetite; nausea and vomiting), and severe hypercalcemia (confusion; full or partial loss of consciousness; incoherent speech).

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AcebutololThe therapeutic efficacy of Acebutolol can be decreased when used in combination with Calcium acetate.
AcetyldigitoxinCalcium acetate may increase the arrhythmogenic and cardiotoxic activities of Acetyldigitoxin.
Alendronic acidThe serum concentration of Alendronic acid can be decreased when it is combined with Calcium acetate.
AlfacalcidolThe risk or severity of adverse effects can be increased when Alfacalcidol is combined with Calcium acetate.
AmiodaroneThe therapeutic efficacy of Amiodarone can be decreased when used in combination with Calcium acetate.
Food Interactions
  • Take with food. When taken with food, calcium acetate forms an insoluble complex with the phosphorus from food, reducing phosphorus serum concentrations.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Calcium acetate monohydrate7ZA48GIM5H5743-26-0XQKKWWCELHKGKB-UHFFFAOYSA-L
Active Moieties
NameKindUNIICASInChI Key
CalciumprodrugSY7Q814VUP7440-70-2OYPRJOBELJOOCE-UHFFFAOYSA-N
Calcium cationionic2M83C4R6ZB14127-61-8BHPQYMZQTOCNFJ-UHFFFAOYSA-N
Acetateionic569DQM74SC71-50-1QTBSBXVTEAMEQO-UHFFFAOYSA-M
Product Images
International/Other Brands
Phoslo / Teltozan
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
PhosLoCapsule667 mg/1OralFresenius Medical Care North America2001-04-02Not applicableUS flag
PhosloTablet667 mg/1OralNabi Biopharmaceuticals2007-01-01Not applicableUS flag
PhosloCapsule667 mg/1OralCardinal Health2001-04-022012-02-29US flag
PhosloCapsule667 mg/1OralPhysicians Total Care, Inc.1997-08-272006-10-11US flag
PhosloCapsule667 mg/1OralNabi Biopharmaceuticals2007-01-012007-06-14US flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Calcium AcetateCapsule667 mg/1OralMarlex Pharmaceuticals Inc2017-05-01Not applicableUS flag
Calcium AcetateCapsule667 mg/1OralCamber Pharmaceuticals2014-02-03Not applicableUS flag
Calcium AcetateCapsule667 mg/1OralCardinal Health2014-10-082020-12-31US flag
Calcium AcetateCapsule667 mg/1OralRising Pharma Holdings, Inc.2021-11-01Not applicableUS flag
Calcium AcetateCapsule667 mg/1OralLotus Pharmaceutical Co., Ltd. Nantou Plant2016-09-01Not applicableUS flag
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Calcium Acetate Tab 667mgTablet667 mgOralStanley Pharmaceuticals, A Division Of Vita Health Products Inc.1993-12-312002-07-31Canada flag
แคลซิเตดTablet, film coated1000 mgOralบริษัท โปลิฟาร์ม จำกัด จำกัด2008-07-31Not applicableThailand flag
แคลซีเตด - เอ็มTablet, film coated667 mgOralบริษัท โปลิฟาร์ม จำกัด จำกัด2014-11-04Not applicableThailand flag
แคลสตาร์Tablet, film coated1000 mgOralบริษัท ห้างขายยาตราเจ็ดดาว จำกัด2018-09-07Not applicableThailand flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
ACETATODE ALUMINIOCalcium acetate (36.45 g) + Aluminum sulfate (51.8 g)PowderTopicalSANOFI AVENTIS DE COLOMBIA S.A.2006-11-10Not applicableColombia flag
Aluminum Acetate AstringentCalcium acetate (839 mg/2030mg) + Aluminum sulfate hydrate (1191 mg/2030mg)Powder, for solutionTopicalTagi Pharma Incorporated2011-06-15Not applicableUS flag
Aluminum Acetate AstringentCalcium acetate (839 mg/2030mg) + Aluminum sulfate hydrate (1191 mg/2030mg)Powder, for solutionTopicalEpic Pharma, LLC2011-02-282013-04-30US flag
AstringentCalcium acetate monohydrate (952 mg/2299mg) + Aluminum sulfate tetradecahydrate (1347 mg/2299mg)Powder, for solutionTopicalTAGI Pharma Inc.2012-06-012024-09-30US flag
AstringentCalcium acetate monohydrate (952 mg/2299mg) + Aluminum sulfate tetradecahydrate (1347 mg/2299mg)Powder, for solutionTopicalGranulation Technology, Inc.2023-10-05Not applicableUS flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
NutrilyteCalcium acetate (22 mg/1mL) + Sodium gluconate (55 mg/1mL) + Magnesium acetate (43 mg/1mL) + Potassium acetate (34.5 mg/1mL) + Potassium chloride (125 mg/1mL) + Sodium acetate trihydrate (135 mg/1mL)Injection, solution, concentrateIntravenousAmerican Regent1990-09-302013-05-08US flag
OSVAREN 435 MG/235 MG 180 FILM KAPLI TABLETCalcium acetate (435 mg) + Magnesium carbonate (235 mg)Tablet, coatedOralFRESENIUS MEDİKAL HİZMETLER A.Ş.2019-04-302020-12-09Turkey flag
PROCALAMINE SISE 1000 ML(SETLI)Calcium acetate monohydrate (0.026 g/100ml) + Alanine (0.21 g/100ml) + Arginine (0.29 g/100ml) + Cysteine hydrochloride (0.02 g/100ml) + Glycerin (3 g/100ml) + Glycine (0.42 g/100ml) + Histidine (0.085 g/100ml) + Isoleucine (0.21 g/100ml) + Leucine (0.27 g/100ml) + Lysine (0.22 g/100ml) + Magnesium acetate tetrahydrate (0.054 g/100ml) + Methionine (0.16 g/100ml) + Phenylalanine (0.17 g/100ml) + Phosphoric acid (0.041 g/100ml) + Potassium chloride (0.149 g/100ml) + Potassium metabisulfite (0.05 g/100ml) + Proline (0.34 g/100ml) + Serine (0.18 g/100ml) + Sodium acetate trihydrate (0.204 g/100ml) + Sodium chloride (0.117 g/100ml) + Threonine (0.12 g/100ml) + Tryptophan (0.046 g/100ml) + Valine (0.2 g/100ml)SolutionParenteralECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2013-01-292024-01-23Turkey flag
PROCALAMINE SISE 500 ML(SETLI)Calcium acetate monohydrate (0.026 g/100ml) + Alanine (0.21 g/100ml) + Arginine (0.29 g/100ml) + Cysteine hydrochloride (0.02 g/100ml) + Glycerin (3 g/100ml) + Glycine (0.42 g/100ml) + Histidine (0.085 g/100ml) + Isoleucine (0.21 g/100ml) + Leucine (0.27 g/100ml) + Lysine (0.22 g/100ml) + Magnesium acetate tetrahydrate (0.054 g/100ml) + Methionine (0.16 g/100ml) + Phenylalanine (0.17 g/100ml) + Phosphoric acid (0.041 g/100ml) + Potassium chloride (0.149 g/100ml) + Potassium metabisulfite (0.05 g/100ml) + Proline (0.34 g/100ml) + Serine (0.18 g/100ml) + Sodium acetate trihydrate (0.204 g/100ml) + Sodium chloride (0.117 g/100ml) + Threonine (0.12 g/100ml) + Tryptophan (0.046 g/100ml) + Valine (0.2 g/100ml)SolutionParenteralECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2013-01-292024-01-23Turkey flag
PROCALAMINE SISE 500 ML(SETSIZ)Calcium acetate monohydrate (0.026 g/100ml) + Alanine (0.21 g/100ml) + Arginine (0.29 g/100ml) + Cysteine hydrochloride (0.02 g/100ml) + Glycerin (3 g/100ml) + Glycine (0.42 g/100ml) + Histidine (0.085 g/100ml) + Isoleucine (0.21 g/100ml) + Leucine (0.27 g/100ml) + Lysine (0.22 g/100ml) + Magnesium acetate tetrahydrate (0.054 g/100ml) + Methionine (0.16 g/100ml) + Phenylalanine (0.17 g/100ml) + Phosphoric acid (0.041 g/100ml) + Potassium chloride (0.149 g/100ml) + Potassium metabisulfite (0.05 g/100ml) + Proline (0.34 g/100ml) + Serine (0.18 g/100ml) + Sodium acetate trihydrate (0.204 g/100ml) + Sodium chloride (0.117 g/100ml) + Threonine (0.12 g/100ml) + Tryptophan (0.046 g/100ml) + Valine (0.2 g/100ml)SolutionParenteralECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2013-01-292024-01-23Turkey flag

Categories

ATC Codes
V03AE04 — Calcium acetate and magnesium carbonateA11GB01 — Ascorbic acid (vit c) and calciumV03AE07 — Calcium acetate
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as carboxylic acids. These are compounds containing a carboxylic acid group with the formula -C(=O)OH.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Carboxylic acids
Direct Parent
Carboxylic acids
Alternative Parents
Monocarboxylic acids and derivatives / Organic salts / Organic oxides / Hydrocarbon derivatives / Carbonyl compounds
Substituents
Aliphatic acyclic compound / Carbonyl group / Carboxylic acid / Hydrocarbon derivative / Monocarboxylic acid or derivatives / Organic oxide / Organic oxygen compound / Organic salt / Organooxygen compound
Molecular Framework
Not Available
External Descriptors
calcium salt (CHEBI:3310)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
Y882YXF34X
CAS number
62-54-4
InChI Key
VSGNNIFQASZAOI-UHFFFAOYSA-L
InChI
InChI=1S/2C2H4O2.Ca/c2*1-2(3)4;/h2*1H3,(H,3,4);/q;;+2/p-2
IUPAC Name
calcium diacetate
SMILES
[Ca++].CC([O-])=O.CC([O-])=O

References

Synthesis Reference

Alan B. Gancy, "Process of making calcium acetate deicing agents and product." U.S. Patent US4444672, issued November, 1946.

US4444672
General References
Not Available
Human Metabolome Database
HMDB0303554
KEGG Drug
D00931
PubChem Compound
6116
PubChem Substance
46507985
ChemSpider
5890
RxNav
214342
ChEBI
3310
ChEMBL
CHEMBL1200800
PharmGKB
PA164746897
Drugs.com
Drugs.com Drug Page
Wikipedia
Calcium_acetate
FDA label
Download (25.6 KB)
MSDS
Download (72.9 KB)

Clinical Trials

Clinical Trials

Pharmacoeconomics

Manufacturers
  • Roxane laboratories inc
  • Fresenius medical care north america
  • Cypress pharmaceutical inc
Packagers
  • Biotest Pharmaceuticals
  • Braintree Laboratories Inc.
  • Hawthorn Pharmaceuticals
  • Kaiser Foundation Hospital
  • Murfreesboro Pharmaceutical Nursing Supply
  • Physicians Total Care Inc.
  • Roxane Labs
  • Stason Pharmaceuticals Inc.
  • Tya Pharmaceuticals
  • Vangard Labs Inc.
Dosage Forms
FormRouteStrength
LotionTopical0.118 g
PowderTopical
LotionTopical0.059 g
Powder, for solutionTopical
TabletOral700 mg
Tablet, film coatedOral475 mg/1
CapsuleOral667 mg/667mg
Tablet, coatedOral667 mg/1
Tablet, film coatedOral475 MG
Tablet, film coatedOral950 MG
Tablet, film coatedOral500 mg
Tablet, film coatedOral700 mg
Tablet, film coatedOral500 mg/1
Tablet, film coatedOral700 mg/1
Tablet, film coatedOral950 mg/1
TabletTopical
Tablet, film coatedOral
LotionTopical0.59 g
SolutionIntravenous
LiquidIntravenous
Injection, solution, concentrateIntravenous
Tablet, coatedOral
Tablet, film coatedOral
Injection, solutionIntravenous
TabletOral250 mg
TabletOral1000 mg
TabletOral667 mg
TabletOral
CapsuleOral
CapsuleOral667 mg/1
TabletOral667 mg/1
SolutionOral667 mg/5mL
InjectionIntravenous
InjectionIntravenous0.21 g/100ml
SolutionParenteral
Capsule, coatedOral500 mg
Tablet, film coatedOral1000 mg
Tablet, film coatedOral667 mg
Prices
Unit descriptionCostUnit
PhosLo 667 mg capsule1.05USD capsule
Phoslo 667 mg tablet0.41USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US6576665No2003-06-102021-04-03US flag
US6875445No2005-04-052021-07-30US flag
US8591938No2013-11-262030-02-23US flag
US8592480No2013-11-262027-07-20US flag
US9089528No2015-07-282027-07-20US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)> 160 °CNot Available
Predicted Properties
PropertyValueSource
Water Solubility147.0 mg/mLALOGPS
logP0.24ALOGPS
logP-0.22Chemaxon
logS-0.03ALOGPS
pKa (Strongest Acidic)4.54Chemaxon
Physiological Charge-1Chemaxon
Hydrogen Acceptor Count2Chemaxon
Hydrogen Donor Count0Chemaxon
Polar Surface Area40.13 Å2Chemaxon
Rotatable Bond Count0Chemaxon
Refractivity23.48 m3·mol-1Chemaxon
Polarizability4.96 Å3Chemaxon
Number of Rings0Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.705
Blood Brain Barrier+0.9601
Caco-2 permeable-0.5258
P-glycoprotein substrateNon-substrate0.8366
P-glycoprotein inhibitor INon-inhibitor0.9806
P-glycoprotein inhibitor IINon-inhibitor0.9866
Renal organic cation transporterNon-inhibitor0.9609
CYP450 2C9 substrateNon-substrate0.8335
CYP450 2D6 substrateNon-substrate0.9164
CYP450 3A4 substrateNon-substrate0.7384
CYP450 1A2 substrateNon-inhibitor0.9381
CYP450 2C9 inhibitorNon-inhibitor0.9273
CYP450 2D6 inhibitorNon-inhibitor0.9462
CYP450 2C19 inhibitorNon-inhibitor0.9608
CYP450 3A4 inhibitorNon-inhibitor0.9627
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.985
Ames testNon AMES toxic0.9042
CarcinogenicityCarcinogens 0.5617
BiodegradationReady biodegradable0.9734
Rat acute toxicity1.8756 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9812
hERG inhibition (predictor II)Non-inhibitor0.9888
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-95.225822
predicted
DarkChem Lite v0.1.0
[M-H]-116.2651
predicted
DeepCCS 1.0 (2019)
[M+H]+119.72916
predicted
DeepCCS 1.0 (2019)
[M+Na]+128.3014
predicted
DeepCCS 1.0 (2019)

Targets

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Kind
Small molecule
Organism
Humans
Pharmacological action
Yes
Actions
Binder
References
  1. Mai ML, Emmett M, Sheikh MS, Santa Ana CA, Schiller L, Fordtran JS: Calcium acetate, an effective phosphorus binder in patients with renal failure. Kidney Int. 1989 Oct;36(4):690-5. [Article]
  2. Nolan CR, Qunibi WY: Calcium salts in the treatment of hyperphosphatemia in hemodialysis patients. Curr Opin Nephrol Hypertens. 2003 Jul;12(4):373-9. [Article]
  3. Nolan CR, Qunibi WY: Treatment of hyperphosphatemia in patients with chronic kidney disease on maintenance hemodialysis. Kidney Int Suppl. 2005 Jun;(95):S13-20. [Article]
  4. Nolan CR: Phosphate binder therapy for attainment of K/DOQI bone metabolism guidelines. Kidney Int Suppl. 2005 Jul;(96):S7-14. [Article]

Drug created at June 13, 2005 13:24 / Updated at March 28, 2024 03:23