Calciumsuppletie bij pati√ęnten met maagzuurremmers

Calciumcitraat of calciumcarbonaat?
Stand van zaken
H.J.M. (Henk-Marijn) de Jonge, R.O.B. (Rijk) Gans en Gerwin Huls

Calcium suppletion for patients who use gastric acid inhibitors: calcium citrate or calcium carbonate?

  • Various calcium supplements are available for patients who have an indication for calcium suppletion.

  • American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids.

  • The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate absorption.

  • No convincing scientific evidence supporting the advice to prescribe calcium citrate instead of calcium carbonate to patients who also take antacids is available, and therefore deserves further investigation.

  • On the contrary, the fact that calcium carbonate does not need acid in order to be absorbed, has also not been proven.

  • In clinical practise, it appears important that calcium is taken with meals in order to improve its absorption.

  • Conflict of interest: G. Huls and his institution of employment received a fee from Celgene for lecturing at MDS Colloquium, Vienna, 2011. Financial support for this article: none declared.