Indication

Osteoporosis, Calcium deficiency, Post-menopausal osteoporosis, Rickets, Osteocalcaemia, Mineral supplement

Adult Dose

Adults and Elderly: 2 tablets per day, preferably one tablet each morning and evening.

Child Dose

Children above 12 years of age: 2 tablets per day, preferably one tablet each morning and evening. Not recommended for children under 12 years.

Contraindication

Patients with a known hypersensitivity to any of the ingredients.

Mode of Action

Calcium gluconate/lactate is used to prevent or treat negative calcium 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 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.

Precaution

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. Urinary calcium excretion should also be measured. 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 7.5mmol/24 hours.

Side Effect

Mild and transient effects of gastrointestinal disturbances, like constipation, flatulence, nausea, diarrhoea may be seen in some individuals. Following administration of vitamin D supplements may cause skin rash in some rare cases. Hypercalciuria have been seen with long term use at high dosage.

Interaction

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.