Calcium Carbonate + Calcium Gluconate + Vitamin-C
Indications
Calcium Carbonate + Calcium Gluconate + Vitamin-C is used for:
Nutritional Supplement in Osteoporosis, Calcium and vitamin C deficiency, Premenstrual syndrome, Postmenopausal problems, Increased demand for Calcium and Vitamin C, pregnancy, Lactation, Periods of rapid growth (childhood,Adolescence), In old age, During infectious disease and convalescence.
Adult Dose
Adults: 1 effervescent tablet daily.
Child Dose
Children above 7 years: 1 effervescent tablet daily.
Children 3 to 7 years : 1/2 effervescent tablet daily,
Renal Dose
Administration
Contra Indications
Absolute contraindications are hypercalcaemia resulting from myeloma, bone metastases or other malignant bone disease, sarcoidosis; primary hyperparathyroidism and Vitamin-D overdosage. It is also contraindicated in severe renal failure and hypersensitivity to any of the tablet ingredients.
Precautions
Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma Calcium levels and urinary Calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria. In patients with a history of renal stones urinary Calcium excretion should be measured to exclude hypercalciuria.
With long-term treatment it is advisable to monitor serum and urinary Calcium levels and kidney function, and reduce or stop treatment temporarily if urinary Calcium exceeds 7.5 mmol/24 hours.
Lactation: Calcium enters human milk; use with caution
Pregnancy-Lactation
Interactions
Calcium Carbonate: Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication.
Calcium Gluconate: Co-admin of high calcium doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcaemia. May potentiate digoxin toxicity. Decreases effects of calcium-channel blockers. Enhanced absorption with calcitriol (a vitamin D metabolite).
Vit C: Deferroxamine, hormonal contraceptives, flufenazine, warfarin, elemental iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine, vitamin B12.
Adverse Effects
Side effects of Calcium Carbonate + Calcium Gluconate + Vitamin-C :
Anorexia, Constipation, Flatulence, Nausea, Vomiting, Hypercalcemia, Hypophosphatemia, Xerostomia, Acid rebound, Milk-alkali syndrome, Hypotension, Headache, Diarrhea.
Mechanism of Action
Calcium prevents or treats negative Ca balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function. Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways.
Vitamin C: Necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.