Milk-Alkali Syndrome

Milk-alkali syndrome results from ingestion of excessive amounts of calcium and absorbable alkali (e.g., bicarbonate and citrate salts).

Historically seen during self-treatment for in...

Calcium-containing supplement use

Symptoms of hypercalcemia (“stones, bones, moans and groans”):

• Nausea, vomiting, constipation

• Polyuria

• Mental status changes including lethargy, irritabi...

Stop calcium and alkali (carbonate salts):

• Supplements

• Over-the-counter antacids

Volume expansion

• To maintain urine output of 3 L/day

Treat hypercalcemia:

• Hydra...

Kidney function

Fluid intake and output

Correction of calcium after treatment

Malcolm OT. Identification, treatment, and prevention of calcium-alkali syndrome in elderly patients. Consult Pharm.  2015;30(8):444–454.

Patel AM, Goldfarb S. Got calcium? Welc...

Over-the-counter antacid or calcium supplement use can lead to hypercalcemia.

Daily calcium supplementation should not exceed 1.2 to 1.5 g.

Treatment is based on stopping excess consumpt...