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Calcium carbonate (colorectal adenoma chemoprevention research context)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-CALCIUM-CARBONATE-CHEMOPREVENTION
TypeDrug
Aliases
CaCO3CalcichewCalcium carbonate (colorectal adenoma chemoprevention)Calcium supplementCaltrate 600Elemental calciumOs-CalTumsКальцію карбонат (хіміопрофілактика рецидиву колоректальних аденом — дослідницький контекст)
Statusreviewed 2026-05-18 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-NCCN-COLON-2025 SRC-USPSTF-CRC-2021

Drug Facts

ClassMineral / calcium salt supplement
MechanismProvides supplemental elemental calcium (~40% by mass of calcium carbonate). Absorbed in proximal small bowel via active vitamin-D- dependent transcellular transport (saturable at low calcium intake) and passive paracellular diffusion (linear with concentration). Cancer-prevention rationale: intraluminal calcium binds free bile acids and free fatty acids in the colon, reducing their proliferative and pro-inflammatory effect on colonic mucosa; additionally calcium modulates epithelial cell proliferation/differentiation via the calcium-sensing receptor. Calcium Polyp Prevention Study (Baron NEJM 1999) and follow-on trials: 1200 mg/day elemental calcium reduced metachronous adenoma recurrence by ~15-20%.
Typical dosingCancer-prevention research context (CPPS protocol): Calcium carbonate ~3000 mg/day = 1200 mg/day elemental calcium, divided BID-TID with meals. Frequently combined with vitamin D (400-1000 IU/day) in trials. Recommended dietary allowance (RDA) for adults: ~1000-1200 mg/day total elemental calcium (diet + supplements). Avoid exceeding 2000-2500 mg/day total (UL — upper level). Take with food (acid required for absorption); separate from iron, thyroid hormone, bisphosphonates, tetracycline / fluoroquinolone antibiotics by ≥2 hours.
Ukraine registeredTrue
NSZU reimbursedFalse
Ukraine last verified2026-05-18

Notes

STUB — v0.2 chemoprevention-workstream authoring; pending two-Clinical- Co-Lead signoff per CHARTER §6.1 dev-mode. CANCER-CHEMOPREVENTION CONTEXT — distinct entity from generic calcium supplementation / osteoporosis adjunct. EVIDENCE moderate but historic. Calcium Polyp Prevention Study (Baron NEJM 1999, ~930 patients with prior adenoma, 1200 mg/day elemental Ca × 4 years): ~15-20% reduction in metachronous adenoma recurrence. Confirmed in pooled meta-analyses but magnitude modest. Subsequent CaD trial (CaD + vit D) showed no incremental benefit beyond calcium alone for adenoma; large WHI did not see CRC reduction in older women. USPSTF 2018/2021 — no recommendation for calcium supplementation for cancer prevention (insufficient evidence). Engine should NOT auto-recommend for cancer prevention; appropriate when osteoporosis or dietary-deficiency indications justify use. Avoid exceeding RDA / UL.

Used By

No reverse references found in the YAML corpus.