Calcium + Vitamin D3
Indications
Calcium + Vitamin D3 is used for:
Postmenopausal osteoporosis, Osteoporosis, Osteomalacia/rickets, Hypoparathyroidism, Latent tetany, Hypocalcaemia, Calcium and vitamin D deficiency, Bone & Teeth developement.
Adult Dose
Adult: PO: 1 tab once/twice daily.
Child Dose
Child>3 Years
Chewing Gum
2-3 chewing gum in 2 divided doses daily.
Renal Dose
Administration
Should be taken with food.
Contra Indications
Patients with hypercalcaemia and/or hypercalciuria. Nephrolithiasis, hypervitaminosis D, hypophosphataemia.
Precautions
Impaired calcium absorption in achlorhydria which is common in elderly. Increased risk of hypercalcaemia and hypercalciuria in hypoparathyroid patients receiving high doses of vitamin D. Caution when using in patients with history of kidney stones. Renal impairment; frequent monitoring of serum calcium and phosphorus is recommended.
Lactation: Distributed in human breast milk
Supplement calcium and vitamin D during pregnancy and lactation according to recommended daily allowance
Pregnancy-Lactation
This is safe to take during pregnancy at the recommended doses. However, during pregnancy the daily dose should not exceed 1500 mg of calcium and 600 IU of vitamin D. Animal studies have shown toxic effects on reproduction at high doses of vitamin D. In pregnant women, all calcium or vitamin D overdoses must be avoided as prolonged hypercalcaemia in pregnancy may lead to retardation of physical and mental development, supravalvular aortic stenosis and retinopathy in the child. There are no indications that Vitamin D3 at therapeutic doses is teratogenic in human.
Interactions
May affect the absorption of tetracycline when used together. Concurrent use with systemic corticosteroids may reduce calcium absorption. Thiazide diuretics may decrease urinary excretion of calcium. Concurrent use with ion-exchange resins may reduce GI absorption of vitamin D. Hypercalcaemia may increase the toxicity of cardiac glycosides during treatment with calcium and vitamin D, monitor ECG and serum calcium levels. Bisphosphonate or sodium fluoride should be given at least 3 hr before calcium-containing preparations.
Adverse Effects
Side effects of Calcium + Vitamin D3 :
Calcium
Anorexia, Constipation, Flatulence, Nausea, Vomiting, Hypercalcemia, Hypophosphatemia, Xerostomia, Acid rebound, Milk-alkali syndrome
Vitamin D
Hypercalcemia, Muscle/bone pain, Metallic taste, Headache, Nausea, Vomiting, Dry mouth, Constipation, Arrhythmias
Mechanism of Action
Calcium /vitamin D3 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 D3 is a fat-soluble sterol. It is necessary for the regulation and regulation of calcium and phosphate homoeostasis and bone mineralisation.
Vitamin D is also essential for healthy bones as it aids in Calcium absorption from the GI tract. In addition to this it stimulates bone formation. Clinical studies also show that Calcium and Vitamin D has synergistic effects on bone growth as well as in Osteoporosis and fracture prevention.