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MASTICAL 500 mg CHEWABLE TABLETS

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use MASTICAL 500 mg CHEWABLE TABLETS

Translated with AI

This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Mastical 500 mg Chewable Tablets

Calcium

Read the entire package leaflet carefully before starting to take this medication, as it contains important information for you.

  • Follow the administration instructions for this medication exactly as indicated in this package leaflet or as directed by your doctor or pharmacist. Keep this package leaflet, as you may need to read it again.
  • If you need advice or more information, consult your pharmacist.
  • If you experience side effects, consult your doctor or pharmacist, even if they are side effects not listed in this package leaflet. See section 4.

Contents of the Package Leaflet

  1. What is Mastical and what is it used for
  2. What you need to know before taking Mastical
  3. How to take Mastical
  4. Possible side effects
  5. Storage of Mastical
  6. Package Contents and Additional Information

1. What is Mastical and what is it used for

Mastical is a chewable tablet that contains calcium, an essential substance for bone formation.

Mastical is used to prevent and treat calcium deficiency and as a supplement in the treatment of osteoporosis. Mastical is also used under medical prescription as a phosphate binder in patients with high phosphate levels in the blood.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before taking Mastical

Do not take Mastical:

-if you are allergic to calcium or any of the other components of this medication (listed in section 6).

  • -if you have high levels of calcium in the blood or urine.
  • -if you have kidney stones.

Warnings and Precautions

Consult your doctor or pharmacist before starting to take Mastical:

  • -if you are taking diuretics (used to treat high blood pressure or edema) or cardiac glycosides (used to treat heart conditions).
  • -if you have excessive calcium levels in the blood or signs of kidney failure or have had kidney stones in the past.
  • -if you are taking high doses of calcium and also using products containing vitamin D.
  • -if you are taking high doses of calcium and also using antacids.

Using Mastical with Other Medications

Tell your doctor or pharmacist if you are taking, have recently taken, or may take any other medication.

Calcium carbonate may interfere with the absorption of tetracyclines if taken at the same time. For this reason, tetracyclines should be taken at least 2 hours before or 4-6 hours after taking Mastical.

Medications containing bisphosphonates should be taken at least 1 hour before taking Mastical.

Calcium may reduce the effects of levothyroxine. For this reason, levothyroxine should be taken at least 4 hours before or 4 hours after Mastical.

The effects of some antibiotics (quinolones) may be reduced if taken at the same time as calcium. For this reason, quinolones should be taken 2 hours before or 6 hours after taking Mastical.

Calcium salts may reduce the absorption of iron, zinc, and strontium ranelate. Consequently, iron, zinc, or strontium ranelate preparations should be taken at least 2 hours before or after Mastical.

Other medications that may interact with Mastical include thiazide diuretics and cardiac glycosides.

If you are using any of the mentioned medications, your doctor will provide you with more instructions.

Taking Mastical with Food and Drinks

Mastical can be taken with or without food and drinks.

Pregnancy, Breastfeeding, and Fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medication.

During pregnancy, the daily intake of calcium should not exceed 2500 mg (including food and supplements). Mastical can be used during pregnancy in case of calcium deficiency.

Mastical can be used during breastfeeding. Calcium passes into breast milk.

Driving and Using Machines

Mastical has no known influence on the ability to drive and use machines.

Mastical Contains Isomalt

Mastical contains isomalt (E953). If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.

3. How to Take Mastical

Follow the administration instructions for this medication exactly as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Dosage:

The recommended dose in adults is 500-1500 mg of calcium per day.

Use in Children

The recommended dose in children is 500-1000 mg of calcium per day.

The tablets can be chewed or sucked.

If You Take More Mastical Than You Should:

If you have taken more Mastical than you should, consult your doctor or pharmacist immediately.

If You Forget to Take Mastical:

Do not take a double dose to make up for forgotten doses.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible Side Effects

Like all medications, this medication can cause side effects, although not everyone will experience them.

Dyspepsia has occurred with an unknown frequency (cannot be estimated from available data).

Uncommon Side Effects (may affect up to 1 in 100 people)

High levels of calcium in the blood or urine.

Rare Side Effects (may affect up to 1 in 1,000 people)

Constipation, gas, nausea, abdominal pain, diarrhea.

Very Rare Side Effects (may affect up to 1 in 10,000 people)

Itching and urticaria. The milk-alkali syndrome usually occurs only when high amounts of calcium have been ingested; symptoms include frequent urge to urinate, headache, loss of appetite, nausea or vomiting, unusual fatigue and weakness, high levels of calcium in the blood, and kidney damage.

Reporting Side Effects

If you experience any side effects, consult your doctor or pharmacist, even if they are possible side effects not listed in this package leaflet. You can also report them directly through the Spanish Medicines Monitoring System: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medication.

5. Storage of Mastical

Keep out of sight and reach of children.

Do not use this medication after the expiration date stated on the packaging. The expiration date is the last day of the month indicated.

Plastic bottle: Do not store above 30°C. Keep the container tightly closed to protect from moisture.

Shelf life after opening: 6 months.

Blister: Do not store above 25°C. Store in the original packaging to protect from moisture.

Medications should not be disposed of through wastewater or household waste. Dispose of packaging and unused medications at the pharmacy's SIGRE point. If in doubt, ask your pharmacist how to dispose of packaging and unused medications. This will help protect the environment.

6. Package Contents and Additional Information

Mastical 500 mg Composition

The active ingredient is 1250 mg of calcium carbonate (equivalent to 500 mg of calcium).

The other ingredients are:

Xylitol (E967), povidone, isomalt (E953), flavor enhancer (orange), magnesium stearate, sucralose (E955), mono- and diglycerides of fatty acids.

Product Appearance and Package Contents

Mastical is a round, white tablet.

Package sizes:

Plastic bottle: 20, 30, 50, 60, 90, 100, 120, and 180 tablets of 500mg.

30, 60, 90, 100 tablets of 1000mg.

Blister: 50 x 1 tablet (single dose).

Not all package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

CHEPLAPHARM Arzneimittel GmbH.

Ziegelhof 24.

17489 Greifswald.

Germany.

Manufacturers:

Asker Contract Manufacturing AS.

Drammensveien 852.

NO-1383 Asker, Norway.

or

Tjoapack Netherlands B.V.

Nieuwe Donk 9.

4879 AC Etten-Leur, Netherlands.

Local Representative:

Laboratorios Rubió, S.A.

Industria, 29 - Pol. Ind. Comte de Sert.

08755 Castellbisbal (Barcelona).

Spain.

This medication is authorized in the Member States of the European Economic Area under the following names:

500 mg:

Belgium: Calci - Chew.

Finland: Calcichew appelsiini 500 mg purutabletti.

Greece: Calcioral.

Luxembourg: Calcichew.

Netherlands: Caci - Chew 500 mg.

Spain: Mastical.

Sweden: Calcitugg 500 mg.

This package leaflet was approved in February 2023.

Online doctors for MASTICAL 500 mg CHEWABLE TABLETS

Discuss questions about MASTICAL 500 mg CHEWABLE TABLETS, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
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  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine 18 years exp.

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

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  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Anastasiia Shalko

Family medicine 13 years exp.

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.

Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
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Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

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  • recurrent infections in children
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  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance.

His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation.

Patients commonly consult Dr Daniel Cichi for:

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Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.
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Frequently Asked Questions

Is a prescription required for MASTICAL 500 mg CHEWABLE TABLETS?
MASTICAL 500 mg CHEWABLE TABLETS does not require a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in MASTICAL 500 mg CHEWABLE TABLETS?
The active ingredient in MASTICAL 500 mg CHEWABLE TABLETS is calcium carbonate. This information helps identify medicines with the same composition but different brand names.
How much does MASTICAL 500 mg CHEWABLE TABLETS cost in pharmacies?
The average pharmacy price for MASTICAL 500 mg CHEWABLE TABLETS is around 2.75 EUR. Prices may vary depending on the manufacturer and dosage form.
Who manufactures MASTICAL 500 mg CHEWABLE TABLETS?
MASTICAL 500 mg CHEWABLE TABLETS is manufactured by Cheplapharm Arzneimittel Gmbh. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of MASTICAL 500 mg CHEWABLE TABLETS online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether MASTICAL 500 mg CHEWABLE TABLETS is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to MASTICAL 500 mg CHEWABLE TABLETS?
Other medicines with the same active substance (calcium carbonate) include CAOSINA 1000 mg ORAL SUSPENSION POWDER, CARBOCAL 600 MG TABLETS, NATECAL 600 mg CHEWABLE TABLETS. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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