The side effects of precipitated calcium carbonate tablets (Caltan) mainly include digestive system discomfort and metabolic abnormalities, and most symptoms can be alleviated by adjusting the medication method. The following is an explanation from three aspects: common side effects, serious adverse reactions, and corresponding treatment measures.

1. Common side effects and alleviation

(1) Gastrointestinal reactions such as bloating, belching, and constipation are common. It is recommended to take them with meals or switch to chewable tablets to increase dietary fiber intake. (2) Gastrointestinal irritation can cause nausea and abdominal pain when taken on an empty stomach. It can be changed to be administered in divided doses one hour after meals, and if necessary, proton pump inhibitors can be used in combination. (3) Long term high doses of metabolic abnormalities may lead to hypercalcemia, manifested as polyuria and thirst. Regular monitoring of blood calcium and control of daily intake are necessary.

2. Treatment of serious adverse reactions

(4) Individuals at risk of kidney stones and elevated urinary calcium levels should maintain a daily water intake of>2000ml and regularly monitor 24-hour urinary calcium excretion. (5) When blood calcium levels exceed 2.75mmol/L in patients with vascular calcification and renal dysfunction, medication should be stopped immediately and intravenous injection of physiological saline should be administered for diuresis. (6) Sudden palpitations or QT interval prolongation due to arrhythmia require emergency treatment, including the use of calcium antagonists and electrocardiographic monitoring.

3 Precautions for Special Groups

(7) It is recommended to use osmotic laxatives such as lactulose in combination with constipation in the elderly to avoid exacerbating electrolyte imbalances with irritating laxatives. (8) It is recommended to use vitamin D3 supplements for children with malabsorption, but blood phosphorus should be monitored to prevent soft tissue calcification. (9) If excessive calcium supplementation during pregnancy leads to reduced fetal movement or uterine contractions, immediate medical attention should be sought, and if necessary, calcium lowering treatment should be performed.