Absorption, Scintigraphy, Efficacy and Tolerability of Short-Term Calcium Carbonate Supplementation in Healthy...

Orally administered calcium carbonate tablets are commonly prescribed as a calcium supplement, and their short-term use is popular among the healthy population. However, being a nutritional supplement, the in vitro properties and clinical efficacy of calcium carbonate supplements are sometimes compromised. The present study aimed to assess the absorption, in vivo dispersion, efficacy and tolerance of Gemcal DS tablet following its short-term use for four weeks. Post-dosing, a gradual rise in serum calcium concentration was observed and the peak increment in serum calcium (4.13±0.38 µg/mL) was reached at four hours. The bioavailability, determined as the area under the curve for six hours (ΔAUC_0-6) of serum calcium, was 38.2±4.8 µg/mL/hour. Scintigraphy images showed that the disintegration of the study product initiated within 15 minutes in the stomach, with the radioactive trail suggesting complete dispersion within four hours in the small intestine. No intact tablet was observed in the small intestine or the large intestine. An increase in mean serum calcium (~3%) and procollagen type 1 N-terminal propeptide (P1NP) (~13.2%) was observed post-treatment. In contrast, a decrease in parathyroid hormone (PTH) levels was noted. Dual-energy X-ray absorptiometry (DEXA) scan results revealed an increase in bone density from 1.1968±0.05 (baseline) to 1.2115±0.06 g/cm², post-treatment. T-scores were also improved in all the subjects, except 1 subject whose T-score remained the same. The Gastrointestinal Symptom Rating (GSR) score at the end of the study (0.42±0.62) was not significantly different (p>0.05) from the baseline GSR score (0.33±0.54), indicating that the treatment was safe and tolerable. In conclusion, Gemcal DS tablets produced an appropriate pharmacokinetic and pharmacodynamic response and could be recommended for short-term use in the healthy population.