酢酸カルシウム
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.
動物種別の用量
- Hyperphosphatemia associated with chronic renal failure · 60-90 mg/kg/day · PO · divided with meals · 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 · 60-90 mg/kg/day divided · PO · divided with meals · Long-term · Dose must be titrated based on serum phosphorus levels. Must be given with food.
- Hyperphosphatemia associated with chronic renal failure · 60-90 mg/kg/day · PO · divided with meals · 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 · 60-90 mg/kg/day divided · PO · divided with meals · Long-term · Dose must be titrated based on serum phosphorus levels. Must be given with food.
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Pre-existing hypercalcemia
有害事象
- Hypercalcemia
- Gastrointestinal intolerance (nausea)
薬物相互作用
- Calcitriol · May lead to hypercalcemia; if used concomitantly, intensified monitoring for hypercalcemia is mandatory.
- Digoxin · Not recommended; hypercalcemia induced by calcium acetate may cause serious arrhythmias in patients on digoxin.
- Fluoroquinolones · Oral calcium can reduce the absorption of fluoroquinolones. Separate dosages by at least two hours. · major
- Tetracyclines · Oral calcium can reduce the absorption of tetracyclines. Separate dosages by at least two hours. · major
- Levothyroxine · Decreased absorption of levothyroxine · moderate
モニタリング
- Serum phosphorus (after a 12-hour fast)
- Serum ionized calcium
- Monitor initially at 10-14 day intervals; once 'stable', at 4-6 week intervals
過量投与
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).
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。