Index of drugs

Prevention and treatment of vitamin D and Calcium deficiency in the elderly. A preparation that supplements the specific treatment of osteoporosis in patients who are at risk of calcium and vitamin D deficiency.

1 tabl for chewing contains 500 mg of calcium (in the form of carbonate) and 10 μg (400 IU) of vitamin D₃. Table. contain: aspartame, isomaltose, sorbitol, sucrose.

Preparation with combined action of calcium and vitamin D₃. Calcium is a mineral component necessary for the formation and mineralization of bones, and vitamin D₃ facilitates its absorption from the gastrointestinal tract and incorporation into the bone. The combined administration of calcium and vitamin D counteracts the increased secretion of parathyroid hormone, intensifying bone resorption, leading to a reduced number of femoral neck fractures, which was confirmed in a controlled clinical trial. The amount of calcium absorbed in the gastrointestinal tract is approximately 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. About 50% of the total calcium in the blood occurs in the physiologically active ionized form, about 10% in the form of complexes with citrates, phosphates and other anions, the remaining 40% in the form of links to proteins, mainly albumin. Calcium is excreted in the faeces, urine and then. After absorption from the gastrointestinal tract, cholecalciferol is hydroxylated in the liver to the active 25-hydroxycalciferol, which is further converted in the kidneys to 1,25-hydroxycalciferol, which is responsible for the increase in calcium absorption. Vitamin D is excreted in faeces and urine.

Hypersensitivity to the active substances or to any of the excipients. Diseases and / or conditions leading to hypercalcaemia and / or hypercalciuria. Kidney stones. Hypervitaminosis D.

During long-term use, calcium and serum creatinine should be monitored, especially in elderly patients treated with digitalis or diuretic agents, and in patients with a tendency to form stones. In the case of hypercalcemia or symptoms of impaired renal function, the dose should be reduced or treatment discontinued. Vitamin D should be used with caution in patients with impaired renal function, monitoring the effect on calcium and phosphate. The risk of soft tissue calcification should be considered. In patients with severe renal insufficiency, the metabolism of vitamin D in the form of calciferol is not normal; other forms of vitamin D should be used. The preparation should be used with caution in patients with sarcoidosis, because of the risk of increasing the metabolism of vitamin D to its active metabolites. In these patients, serum and urinary calcium levels should be monitored. The preparation should be used with caution in immobilized patients with osteoporosis, due to the risk of hypercalcemia. The content of vitamin D in the preparation should be taken into account when prescribing other medicines containing vitamin D. Additional doses of vitamin D and calcium should be used under close medical supervision. In these cases, frequent testing of serum calcium and urinary calcium is necessary. The dairy-alkaline syndrome (Burnett syndrome), i.e. hypercalcaemia, alkalosis and renal failure, can develop when large amounts of calcium are ingested along with easily absorbed alkaline drugs. Co-administration with tetracyclines or quinolones is not usually recommended; in case of concomitant use, appropriate precautions should be taken. The preparation contains aspartame (source of phenylalanine) - it may be harmful for patients with phenylketonuria. The preparation contains sorbitol, isomaltose and sucrose - it should not be used in patients with rare congenital disorders with fructose intolerance, poor glucose-galactose absorption or sucrase-isomaltase deficiency.

The preparation can be used during pregnancy only in the case of calcium and vitamin D deficiency. During pregnancy, the daily intake should not exceed 1500 mg of calcium and 600 IU. vitamin D.In pregnant women, overdose of calcium and vitamin D should be avoided because persistent hypercalcaemia has been associated with adverse effects on the developing fetus. There is no evidence of teratogenic effect of vitamin D in therapeutic doses in humans. The preparation can be used during breastfeeding. Calcium and vitamin D are excreted in human milk, which should be taken into account when adding vitamin D to your child.

Uncommon: hypercalcemia and hypercalciuria. Rarely: constipation, bloating, nausea, abdominal pain, diarrhea. Very rare: milk-alkaline syndrome (usually only in cases of overdose), indigestion, pruritus, rash and urticaria.

Orally. Adults and the elderly: 1 tabl. 2 times a day. No dosage adjustment is required in patients with hepatic impairment. Table. you can chew or suck.