Prevention and treatment of vitamin D and Calcium deficiencies in the elderly. Supplementation of vitamin D and calcium as a supplement to the specific treatment of osteoporosis in patients who are at risk of vitamin D and calcium deficiency.
Composition:
1 tabl for chewing and chewing contains 1250 mg of calcium carbonate (equivalent to 500 mg of calcium) and 4 mg of cholecalciferol concentrate (equivalent to 10 μg of cholecalciferol = 400 IU of vitamin D3). The preparation contains aspartame, sorbitol and sucrose.
Action:
Preparation of calcium and vitamin D. Vitamin D increases the absorption of calcium in the intestines. Administration of calcium and vitamin D counteracts the increase of secretion of parathyroid hormone (PTH) caused by calcium deficiency and increased bone resorption. Calcium is absorbed in the gastrointestinal tract at approx. 30% of the adopted dose. 99% of calcium in the body is found in hard bones and teeth. The remaining 1% is found in the intra- and extracellular fluid. Approx. 50% of the total calcium in the blood occurs in the physiologically active ionized form, about 10% in the form of complexes with citrate, phosphate and other anions, the remaining 40% in the form of combinations with proteins, mainly albumin. Calcium is excreted in the faeces, urine and then. Renal excretion depends on glomerular filtration and tubular reabsorption. Vitamin D is easily absorbed in the small intestine. Cholecalciferol and its metabolites circulate in the blood in combination with specific globulins. Cholecalciferol is converted in the liver by hydroxylation to the active 25-hydroxy-cholecalciferol, which is further converted in the kidneys to 1,25-hydroxy-cholecalciferol. 1,25-hydroxycholecalciferol is a metabolite responsible for the increase in calcium absorption. Unmetabolized vitamin D is stored in adipose tissue and muscles. Vitamin D is excreted in faeces and urine.
Contraindications:
Hypersensitivity to the components of the drug. Diseases and / or conditions resulting in hypercalcemia and / or hypercalciuria, e.g. myeloma, bone metastases, primary hyperparathyroidism. Kidney stones and / or nephrocalcinosis. Renal failure. Hypervitaminosis D.
Precautions:
During long-term treatment, serum calcium and renal function should be monitored by testing serum creatinine, especially in elderly patients treated simultaneously with cardiac glycosides or diuretics and in patients with a significant tendency to kidney stones formation. In the case of hypercalcemia or the symptoms of renal impairment, the dose should be reduced or treatment discontinued. Vitamin D should be used with caution in patients with impaired renal function (the effect on calcium and phosphate should be monitored, the risk of soft tissue calcification should be taken into account) with sarcoidosis (risk of increased metabolism of vitamin D to its active forms, the calcium content in serum should be monitored and urine) and immobilized patients with osteoporosis (increased risk of hypercalcemia). The drug should not be used in patients with severe renal impairment; in these patients, vitamin D in the form of cholecalciferol is not normally metabolized and other types of vitamin D should be used. When taking large amounts of calcium along with absorbable alkalizing agents (such as carbonates), the dairy-alkaline syndrome (Burnett syndrome) may develop. i.e. hypercalcemia, metabolic alkalosis, renal dysfunction and soft tissue calcification. It is not recommended for use in children and adolescents. The drug contains aspartame, it can be harmful for patients with phenylketonuria. In addition, the drug contains sorbitol and sucrose - patients with rare inherited disorders associated with fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not use this preparation. The drug may affect your teeth.
Pregnancy and lactation:
The drug can be used during pregnancy in the case of calcium or vitamin D deficiency. During pregnancy, the daily intake should not exceed 1500 mg of calcium and 600 IU of vitamin D.Avoid calcium and vitamin D overdose in pregnant women because long-term hypercalcaemia has been associated with adverse effects on the developing fetus. The drug can be used during breast-feeding. Calcium and vitamin D are excreted in human milk, which should be taken into account when giving the child vitamin D
Side effects:
Uncommon: hypercalcemia and hypercalciuria. Rare: constipation, bloating, nausea, abdominal pain and diarrhea. Very rare: pruritus, rash and urticaria, milk-alkaline syndrome (usually seen only in cases of overdose).
Dosage:
Orally. Adults: 1 tabl. for chewing and chewing twice a day. Do not use the medicine for more than a month without medical consultation. The tablet can be chewed or sucked.
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