Chitosan and Calcium Carbonate
A combination oral powder containing 8% chitosan, 10% calcium carbonate, and 82% lactose. It is primarily used as an **adsorbent for intestinal uraemic toxins**, including dietary phosphate, in dogs and cats with chronic kidney disease (CKD). > **Clinical Pearl:** Phosphate-binding agents are typically introduced when dietary management (low phosphate renal diets) alone is insufficient to control hyperphosphataemia. To be effective, they **must be administered with meals** to bind the phosphorus present in the food.
Mechanism: Acts locally within the gastrointestinal tract. * **Calcium carbonate** binds to dietary phosphate in the gut → forms insoluble calcium phosphate → excreted in feces, thereby preventing systemic absorption of phosphorus. * **Chitosan** acts as an adsorbent for various uraemic toxins in the intestines, reducing their absorption and subsequent systemic accumulation.
Dosing by species
- Chronic kidney disease · 200 mg/kg · PO · q12h · Mixed with food
- Chronic kidney disease · 200 mg/kg · PO · q12h · Mixed with food
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Routes of administration
Contraindications
- Pre-existing hypercalcaemia
Adverse effects
- Hypercalcaemia (due to calcium carbonate absorption)
Drug interactions
- Calcitriol · Increased risk of hypercalcaemia when administered concurrently · major
Monitoring
- Serum phosphate (at 4-6 week intervals to adjust dosage and achieve target concentrations)
- Serum total and ionized calcium (to monitor for hypercalcaemia)
Overdose
Overdosage primarily increases the risk of **hypercalcaemia** due to excessive calcium carbonate intake. Signs of hypercalcaemia may include polyuria, polydipsia, vomiting, lethargy, and weakness. Treatment involves discontinuing the supplement, feeding a low-calcium diet, and providing supportive fluid therapy (e.g., 0.9% NaCl) to promote calciuresis if clinically indicated.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.