A 35 year old patient has GERD and on rabeprazole. He recently diagnosed with mild asymptomatic hypocalcaemia. Which oral calcium formulation you will prefer in the above patient

A. Calcium carbonate

B. Calcium citrate

C. Any of A OR B 

D. Calcium chloride

ANSWEWR: B. Calcium citrate

ref: KDT 7E/P 336

Calcium citrate

• absorption in patients taking PPIs/H2 blockers and elderly is satisfactory

Calcium carbonate

• gastric acid is required for converting it into the absorbable form
•  absorption is increased in acidic environment
• so don’t give it with PPI like Rabeprazole as they rise the pH and decrease Calcium carbonate absorption

Calcium chloride

• is highly irritant to gastric mucosa, so not used in GERD patient

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