酢酸カルシウム
Calcium Acetate
Calcium acetate
別名: PhosLo · Calphron · Eliphos · Phosex · calcii acetas · acetato de calcio · kalcio acetates · kalciumacetat · kalciumasetaatti · Calcium diacetate
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hyperphosphatemia associated with chronic renal failure | 60-90 mg/kg/day | PO | divided with meals | — | 🌎 NA |
| Hyperphosphatemia in CKD | 60-90 mg/kg/day divided | PO | divided with meals | Long-term | 🌍 EU |
- Hyperphosphatemia associated with chronic renal failure: In conjunction with a low-phosphorus diet. Give with food or mixed with food, or just prior to each meal. Individualize dose to achieve desired serum phosphorus concentrations. Decrease dose if serum calcium exceeds normal limits.
- Hyperphosphatemia in CKD: Dose must be titrated based on serum phosphorus levels. Must be given with food.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Hyperphosphatemia associated with chronic renal failure | 60-90 mg/kg/day | PO | divided with meals | — | 🌎 NA |
| Hyperphosphatemia in CKD | 60-90 mg/kg/day divided | PO | divided with meals | Long-term | 🌍 EU |
- Hyperphosphatemia associated with chronic renal failure: In conjunction with a low-phosphorus diet. Give with food or mixed with food, or just prior to each meal. Individualize dose to achieve desired serum phosphorus concentrations. Decrease dose if serum calcium exceeds normal limits.
- Hyperphosphatemia in CKD: Dose must be titrated based on serum phosphorus levels. Must be given with food.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
酢酸カルシウムは、主に慢性腎臓病（CKD）に伴う高リン血症の管理に使用される経口リン吸着剤です。炭酸カルシウムと比較してリン吸着効率が高く（元素カルシウム1グラムあたり約2倍のリンを吸着）、医原性の高カルシウム血症を引き起こすリスクが低いです。また、クエン酸カルシウムとは異なり、消化管からのアルミニウム吸収を促進しません。
作用機序
When administered with meals, calcium acetate dissociates in the gastrointestinal tract. The calcium ions then bind to dietary phosphorus in the stomach and proximal small intestine to form calcium phosphate, an insoluble complex.
Dietary Phosphorus + Calcium Acetate → Insoluble Calcium Phosphate → Excreted in feces.
This mechanism effectively reduces the gastrointestinal absorption of phosphorus, thereby lowering serum phosphorus levels. It is soluble over a wide range of pH, making it highly available for binding.
安全性・警告
禁忌
- Pre-existing hypercalcemia
有害事象
- Hypercalcemia
- Gastrointestinal intolerance (nausea)
注意事項
Warning: Do not use in patients with pre-existing hypercalcemia.
- Ca × P Product: Use with extreme caution if the serum calcium and phosphorus product exceeds 60 due to the risk of metastatic soft tissue mineralization.
- Concurrent Calcitriol: The concurrent use of calcium-based binders and calcitriol is controversial; some consider it contraindicated, while others require intensified monitoring for hypercalcemia.
- Monitoring: Adequate monitoring of serum ionized calcium and phosphorus is strictly required.
医薬品相互作用
May lead to hypercalcemia; if used concomitantly, intensified monitoring for hypercalcemia is mandatory.
Not recommended; hypercalcemia induced by calcium acetate may cause serious arrhythmias in patients on digoxin.
Oral calcium can reduce the absorption of fluoroquinolones. Separate dosages by at least two hours.
Oral calcium can reduce the absorption of tetracyclines. Separate dosages by at least two hours.
Decreased absorption of levothyroxine
監視
- Serum phosphorus (after a 12-hour fast)
- Serum ionized calcium
- Monitor initially at 10-14 day intervals; once 'stable', at 4-6 week intervals
薬物動態
吸収
In humans, approximately 30% is absorbed when given with food. No specific pharmacokinetic information is available for dogs and cats.
消失
Unabsorbed calcium and bound calcium phosphate are eliminated in the feces.
過剰投与
Acute overdoses could potentially cause hypercalcemia.
- Management: Patients should be monitored and treated symptomatically.
- If the dosage was massive and recent, consider using standard protocols to empty the gut (e.g., emesis induction or gastric lavage, followed by activated charcoal, though charcoal does not bind minerals well).
製品
製剤
- Tablets
- Capsules
- Gelcaps
ヒト用医薬品
- Calcium Acetate Oral Tablets: 667 mg (169 mg elemental calcium); Calphron® (Nephro-Tech); Eliphos® (Hawthorn)
- Calcium Acetate Oral Capsules & Gelcaps: 667 mg (169 mg elemental calcium); PhosLo® (Fresenius)
規制ステータス
Human approved products used off-label
POM (Prescription Only Medicine)
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store commercially available tablets, capsules, and gelcaps at room temperature (25°C); excursions are permitted to 15-30°C.
飼主向け情報
食事中のリンを効果的に吸着させるため、必ず食事と一緒に（食直前または食事に混ぜて）与えてください。獣医師の特別な指示がない限り、食事と食事の間に与えないでください。この薬を使用している間は、カルシウムとリンの濃度が安全な範囲にあることを確認するため、継続的な血液検査が必要になります。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。