Use of Calcium Supplements for the Prevention of Osteoporosis in Postmenopausal Women at King Chulalongkorn Memorial Hospital, Thai Red Cross Society
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Abstract
Objectives: To examine the uses of calcium supplements for osteoporosis prevention in Thai postmenopausal women and possible interactions with concomitant medications. Methods: This retrospective descriptive study collected data from the medical records of 40 to 80-year-old postmenopausal women who had first diagnosis of osteopenia and received calcium supplements at King Chulalongkorn Memorial Hospital between 1 January – 31 December 2020 Results: This study included 169 postmenopausal women with average age of 62.96 ± 9.14 years old. The most commonly prescribed drugs were calcium carbonate tablets (94.67%), followed by calcium carbonate effervescent tablets and calcium acetate tablets. Average amount of prescribed doses was equivalent to 403.85 ± 77.15 mg of calcium/day. The most commonly prescribed drugs interacting with calcium supplements were proton pump inhibitors (50%) resulting in the reduction of calcium absorption, levothyroxine (18.75%), polyvalent cation (15%) and fluoroquinolones (7.50%). Calcium supplement may reduce the efficacy of concomitant medications. Conclusions: Calcium carbonate tablet was the most commonly prescribed calcium supplement which entailed a possible risk of drug interaction. Therefore, healthcare professionals should advise the appropriate intake of calcium products to avoid interactions with concomitant medications.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
Vaseenon T, Luevitoonvechkij S, Wongtriratanachai P, Rojanasthien S. Long-term mortality after osteoporotic hip fracture in Chiang Mai, Thailand. J Clin Densitom. 2010;13:63-7.
Tatangelo G, Watts J, Lim K, Connaughton C, Abimanyi-Ochom J, Borgstrom F, et al. The Cost of osteoporosis, osteopenia, and associated fractures in Australia in 2017. J Bone Miner Res. 2019;34:616-25.
The Royal College Of Orthopaedic Surgeons Of Thailand and Thai Osteoporosis Foundation. Thai guideline osteoporosis 2010 [Internet]. 2010 [cited April 20, 2021]. Available from: http://www.pharutth.net/disdownload1/9.pdf.
Limpaphayom K, Taechakraichana N, Jaisamrarn U, Bunyavejchevin S, Chaikittisilpa S, Poshyachinda M, et al. Prevalence of osteopenia and osteoporosis in Thai women. Menopause. 2001;8:65-9.
Wongtriratanachai P, Luevitoonvechkij S, Songpatanasilp T, Sribunditkul S, Leerapun T, Phadungkiat S, et al. Increasing incidence of hip fracture in Chiang Mai, Thailand. J Clin Densitom. 2013;16:347-52.
Eastell R, O'Neill TW, Hofbauer LC, Langdahl B, Reid IR, Gold DT, et al. Postmenopausal osteoporosis. Nat Rev Dis Primers. 2016;2:16069.
Siraya Kitiyodom. Menopause. Maharat NaKhonRatchasima Hospital Medical Bulletin. 2012;36:61-5.
Sullivan SD, Lehman A, Nathan NK, Thomson CA, Howard BV. Age of menopause and fracture risk in postmenopausal women randomized to calcium + vitamin D, hormone therapy, or the combination: results from the Women's Health Initiative Clinical Trials. Menopause. 2017;24:371-8.
The developing committee of dietary intake for Thais. Dietary reference intake for Thais 2020. Bangkok: Bureau of Nutrition, Department of Health : Ministry of Public Health; 2020.
National Osteoporosis Foundation. Calcium and vitamin [Internet]. 2018 [cited 2020 November 06]. Available from: https://www.nof.org/patients/treatment/calciumvitamin-d/.
Thai Osteoporosis Foundation. Thai guideline osteoporosis 2021 [Internet]. 2021 [cited April 20, 2021]. Available from: http://www.thaiendocrine.org/th/wp-content/uploads/2022/03/Executive-summary_FN_1-03-65-2.pdf
Heaney RP, Gallagher JC, Johnston CC, Neer R, Parfitt AM, Whedon GD. Calcium nutrition and bone health in the elderly. Am J Clin Nutr. 1982;36:986-1013.
Pongchaiyakul C, Charoenkiatkul S, Kosulwat V, Rojroongwasinkul N, Rajatanavin R. Dietary calcium intake among rural Thais in Northeastern Thailand. J Med Assoc Thai. 2008;91:153-8.
Suwittawat C, Sanchaisuriya P, Kunarattanapruk K. Dietary intake of elderly in the slum areas of Khon Kaen metropolitan district. The Public Health Journal of Burapha University. 2009;4:11-9.
Ratanaporn Toengkhuntod. Predicting factors of osteoporosis prevention behaviors in menopausal women [master thesis]. Bangkok: Thammasat University; 2017.
Boullata JI AV. Handbook of drug-nutrient interactions. 2nd ed. New York: Humana Press; 2010.
Calcium carbonate. In: Interaction analysis Lexi-drugs online. Hudson (OH): Lexicomp Inc. [Internet]. 2021 [cited 2021 June 10]. Available from: https://online.lexi.com/lco/action/interact#lookup-tab-content.
Thai Food and Drug Administration. National drug information [Internet]. 2021 [cited December 8, 2021]. Available from: https://data.go.th/dataset/item_64a59021-3316-4e88-a56d-b8669dc99071.
Nakamura K, Saito T, Kobayashi R, Oshiki R, Kitamura K, Oyama M, et al. Effect of low-dose calcium supplements on bone loss in perimenopausal and postmenopausal Asian women: a randomized controlled trial. J Bone Miner Res. 2012;27:2264-70.
Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Bassford T, et al. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006;354:669-83.
Moyer VA. Vitamin D and calcium supplementation to prevent fractures in adults: U.S. preventive services task force recommendation statement. Ann Intern Med. 2013;158:691-6.
Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ (Clinical research ed). 2015;351:h4183-h.
Fischer V, Haffner-Luntzer M, Amling M, Ignatius A. Calcium and vitamin D in bone fracture healing and post-traumatic bone turnover. Eur Cell Mater. 2018;35:365-85.
Emmett M. A comparison of calcium-based phosphorus binders for patients with chronic kidney disease. DIALYSIS & TRANSPLANTATION. 2006:1-8.
Xing T, Hu Y, Wang B, Zhu J. Role of oral calcium supplementation alone or with vitamin D in preventing post-thyroidectomy hypocalcaemia: A meta-analysis. Medicine (Baltimore). 2019;98:e14455-e.
Nguyen KD, Bagheri B, Bagheri H. Drug-induced bone loss: a major safety concern in Europe. Expert Opin Drug Saf. 2018;17:1005-14.
Grober U, Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 2012;4(2):158-66.
Eljaaly K, Helal A, Almandeel T, Algarni R, Alshehri S. Multivalent cations interactions with fluoroquinolones or tetracyclines: A cross-sectional study. Saudi J Biol Sci. 2021;28:6929-32.
Pitman SK, Hoang UTP, Wi CH, Alsheikh M, Hiner DA, Percival KM. Revisiting oral fluoroquinolone and multivalent cation drug-drug interactions: Are they still relevant? Antibiotics (Basel). 2019;8.
Zamfirescu I, Carlson HE. Absorption of levothyroxine when coadministered with various calcium formulations. Thyroid. 2011;21:483-6.
O'Connell MB, Madden DM, Murray AM, Heaney RP, Kerzner LJ. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med. 2005;118:778-81.
Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis: screening and treatment strategies. Ther Adv Musculoskelet Dis. 2014;6:185-202.
Wood RJ, Zheng JJ. High dietary calcium intakes reduce zinc absorption and balance in humans. Am J Clin Nutr. 1997;65:1803-9.
Lynch SR. The effect of calcium on iron absorption. Nutr Res Rev. 2000;13:141-58.
Songpatanasilp T, Sritara C, Kittisomprayoonkul W, Chaiumnuay S, Nimitphong H, Charatcharoenwitthaya N, et al. Thai Osteoporosis Foundation (TOPF) position statements on management of osteoporosis. Osteoporos Sarcopenia. 2016;2:191-207.
Vasin Chotivanich and Pinyaphan Putkham. Prevalence of vitamin D and calcium deficiency among
postmenopausal women base on national comprehensive cancer network in urban rea. Vajira Med J. 2020; 64:109-16.
