Calcium carbonate + vitamin d3


Full Generic Medicine Info
Dosage/Direction for Use

Oral
Calcium deficiency, Vitamin D deficiency
Elderly: Same as adult dose.
Contraindications
Nephrolithiasis, nephrocalcinosis, hypervitaminosis D, hypercalcaemia, hypercalciuria; diseases leading to hypercalcaemia or hypercalciuria (e.g. bone metastases or other malignant bone diseases, myeloma, primary hyperparathyroidism). Severe renal failure and impairment.
Special Precautions
Patient with achlorhydria, hypoparathyroidism; risk factor for hypercalcaemia (e.g. sarcoidosis), history of kidney stones, high tendency to calculus formation. Immobilised patients with osteoporosis. Mild to moderate renal impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Monitor serum Ca levels and renal function (e.g. serum creatinine).
Adverse Reactions
Significant: Hypercalcaemia, Milk-alkali syndrome, constipation, bloating, flatulence. Gastrointestinal disorders: Nausea, abdominal pain, diarrhoea. Immune system disorders: Hypersensitivity reactions. Renal and urinary disorders: Hypercalciuria. Skin and subcutaneous tissue disorders: Rarely, rash, pruritus, urticaria.
Overdosage
Symptoms: Hypercalcaemia characterised by anorexia, thirst, vomiting, nausea, abdominal pain, muscle weakness, fatigue, mental disturbances, polyuria, polydipsia, nephrocalcinosis, bone pain, renal calculi, and cardiac arrhythmia and coma in severe cases. High amounts of Ca ingestion may cause Milk-alkali syndrome, irreversible renal damage and soft calcification. Management: Discontinue use of Ca carbonate and vitamin D3 treatment. Empty contents of the stomach in patients with impaired consciousness, rehydrate, and based on the severity may consider combined or isolated treatment with bisphosphonates, loop diuretics, corticosteroids and calcitonin. Closely monitor serum electrolytes, renal function and diuresis.
Drug Interactions
May enhance the arrhythmogenic effects of cardiac glycosides. Calcium carbonate: Increased risk of hypercalcaemia with thiazide diuretics. May decrease the gastrointestinal absorption of bisphosphonates, Na fluoride, quinolones, tetracyclines, levothyroxine, Fe, zinc and strontium. Ca absorption may be reduced by systemic corticosteroids. Vitamin D3: Decreased effects with phenytoin, barbiturates, rifampicin, glucocorticosteroids. May reduce gastrointestinal absorption with colestyramine or paraffin oil.
Food Interaction
Food may increase Ca absorption. Bran, foods high in oxalates, or whole grain cereals may decrease Ca absorption.
Action
Ca and vitamin D3 administration counteracts the rise of PTH that is caused by Ca deficiency and increased bone resorption. Calcium carbonate is used as a supplementary source of Ca to help prevent or decrease the rate of bone loss in osteoporosis. It also acts as an antacid by neutralising gastric acidity resulting in increased gastric and duodenal pH. Vitamin D3 is a fat-soluble sterol essential for the proper regulation of Ca and phosphate homeostasis, bone metabolism and mineralisation. Synonym: vitamin D3: colecalciferol, cholecalciferol.
Absorption: Calcium carbonate: Absorbed from the gastrointestinal tract, predominantly in the duodenum. Vitamin D3<90>: Well-absorbed from the gastrointestinal tract (in the presence of bile).
Distribution: Enters breastmilk. Calcium carbonate: Primarily in bones and teeth. Plasma protein binding: Approx 40%, to albumin.
Metabolism: Calcium carbonate: Converted into Ca chloride by gastric acid. Vitamin D<209>3
: Metabolised in the liver by vitamin D 25-hydroxylase via hydroxylation into active metabolite, 25-hydroxycolecalciferol; further converted in the kidneys by vitamin D 1-hydroxylase to form the active 1,25-dihydroxycolecalciferol (calcitriol).
Excretion: Via faeces and urine.
Storage
Oral: Store below 25°C. Protect from light and moisture.
ATC Classification
A12AA04 - calcium carbonate ; Belongs to the class of calcium-containing preparations. Used as dietary supplements.
A02AC01 - calcium carbonate ; Belongs to the class of calcium-containing antacids.
A11CC05 - colecalciferol ; Belongs to the class of vitamin D and analogues. Used as dietary supplements.
Disclaimer: This information is independently developed by CIMS based on calcium carbonate + vitamin d3 from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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