Calcium and Magnesium

NHSL Medicines Guidance
NHS Lanarkshire

Calcium Supplements

Preferred list (P)

ADCAL® chewable tablets

  • Each tablet contains calcium carbonate 1.5 g (calcium 600 mg or Ca2+ 15  mmol)

 

Total list (T)

CALVIVE® 1000 effervescent tablets (formerly Sandocal® 1000 effervescent tablets)

  • Each tablet contains calcium carbonate 1.75 gram and calcium lactate gluconate 2.263 gram (calcium 1000 mg or Ca2+ 25 mmol).
  • Sandocal® has been rebranded as Calvive®. Active ingredients remain the same, however excipients differ.

Prescribing Notes:

Anti-Parathyroid Agents

Specialist initiation (S1)

CINACALCET tablets

Restricted to specialist initiation for:

  • the treatment of secondary hyperparathyroidism in adult patients with end-stage renal disease on maintenance dialysis therapy, or; 
  • reduction of hypercalcaemia in adult patients with parathyroid carcinoma, or primary hyperparathyroidism for whom parathyroidectomy would be indicated on the basis of serum calcium levels (as defined by relevant treatment guidelines), but in whom parathyroidectomy is not clinically appropriate or is contraindicated.

Prescribing Notes:

  • All monitoring and review of this medicine should be carried out by specialist secondary care clinics.
  • Only non-branded generic cinacalcet tablets are included in the NHS Lanarkshire formulary. Other Cinacalcet brands and formulations may require additional paperwork for prescribing - see Which Form Do I Need To Complete?

Magnesium

Preferred list (P)

MAGNESIUM ASPARTATE (Magnaspartate® sachets)

  • Each 6.5g Magnaspartate® sachet contains magnesium aspartate equivalent to 243mg (10mmol) of magnesium.
  • One or two sachets once daily.
  • Dissolve sachet contents in 50–200 mL water, tea or orange juice and take immediately.
  • When dissolved in bottled water and stored below 25°C, the solution can be taken within 24 hours.

 

Total list (T)

MAGNESIUM GLYCEROPHOSPHATE 

  • Each magnesium glycerophosphate chewable tablet contains magnesium 97mg (4mmol Mg2+).
  • The dosage regimen should be adjusted according to the serum total magnesium level of the individual patient
  • Starting doses for adult patients are recommended as 4-8 mmol (1-2 tablets) administered 3 times a day
  • Manufacturer advises to monitor serum magnesium levels every 3–6 months.

Prescribing Notes:

  • There are other magnesium preparations available however, many are unlicensed supplements.
  • Unlicensed supplements should not be prescribed where the licensed medicinal product will meet the needs of the patient.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.