• Brand: CALCIDEX®
  • Generic name:CALCIUM-Vit D3
  • Pharmaceutical form:Tab
  • Amount: 50
  • Pharmaceutical group: SUPPLEMENTS & VITAMINS
Download brochure CALCIUM-Vit D3

Calcium-Vit D3
Nutritional supplement (mineral); Antihypocalcemic.
                                   (USP DI)
Pharmacodynamic and pharmacokinetic properties:
Calcium is essential for functional integrity of the nervous, muscular, and skeletal systems. It plays a role in normal cardiac function, renal function, respiration, blood coagulation, and cell membrane and capillary permeability. Vitamin D is essential for promoting absorption and utilization of calcium and phosphate and for normal calcification of bone. Calcium carbonate is converted to calcium chloride by gastric acid. Some of the calcium is absorbed from the intestines and the unabsorbed portion is excreted in the faeces.Vitamin D substances are well absorbed from the gastrointestinal tract. The presence of bile is essential for adequate intestinal absorption; absorption may be decreased in patients with decreased fat absorption. Vitamin D and metabolites circulate in the blood bound to a specific α-globulin. Vitamin D can be stored in adipose and muscle tissue for long periods of time. It is slowly released from such storage sites and from the skin where it is formed in the presence of sunlight or ultraviolet light. Colecalciferol have a slow onset and a long duration of action. Colecalciferol hydroxylated in the liver by the enzyme vitamin D 25-hydroxylase to from 25-hydroxycholecalciferol (calcifediol). This compound undergo further hydroxylation in the kidneys by the enzyme vitamin D l-hydroxylase to from the active metabolites l,25-dihydroxycholecalciferol(calcitriol). Vitamin D is excreted mainly in the bile and faeces with only small amounts appearing in urine.
                                                                                                        (Martindale,USP DI)
It is used as supplement for treatment of hypocalcemia(chronic), hypophosphatemia and as an adjunct in the management of osteoporosis.
                                                                                                        (Martindale,USP DI)
Pregnancy and breast feeding
During pregnancy, there is an increased need for calcium to calcify fetal bones and to increase the maternal skeletal mass in preparation for lactation. This need is normally met by enhanced intestinal absorption of calcium, increased vitamin D production. However, the prescribing of calcium and vitamin D supplements during pregnancy may be necessary since standard prenatal vitamins along with normal intake of dairy products may not provide sufficient elemental calcium for the average pregnant woman. Problems in nursing babies have not been documented with intake of normal daily recommended amounts. Although some oral supplemental calcium may be distributed into breast milk, the concentration is not sufficient to produce an adverse effect in the neonate. Only small amounts of vitamin D metabolites appear in human milk. Infants who are totally breast-fed and have little exposure to the sun may require vitamin D supplementation.
                                                                                                                           (USP DI)
This supplement is contraindicated in those with hypercalcemia (primary or secondary), hypercalciuria, hypervitaminosis D, renal caculi calcium, renal osteodystrophy with hyperphosphatemia, sarcoidosis.
                                                                                                                           (USP DI)
Warning and precautions:
Calcium salts should be given cautiously to patients with renal impairment, or diseases associated with hypercalcaemia such as sarcoidosis and some malignancies. 
Plasma-calcium concentrations should be monitored closely in patients with renal impairment. Vitamin D should not be given to patients with hypercalcaemia. It should be used with caution in infants, who may have increased sensitivity to its effects, and patients with renal impairment or calculi, or heart disease, who might be at increased risk of organ damage if hypercalcaemia occurred. Plasma phosphate concentrations should be controlled during vitamin D therapy to reduce the risk of ectopic calcification.
It is advised that patients receiving pharmacological doses of vitamin D should have their plasma-calcium concentration monitored at regular intervals, especially initially or if symptoms suggest toxicity.
Similar monitoring is recommended in infants if they are breast fed by mothers receiving pharmacological doses of vitamin D.
 Hypercalcaemia has occurred when calcium carbonate are given with thiazide diuretics. Thiazide diuretics decrease its urinary excretion. Bran decreases the gastrointestinal absorption of calcium, and may therefore decrease the efficacy of calcium supplements. Corticosteroids also reduce calcium absorption.
Calcium enhances the effects of digitalis glycoside on the heart and may precipitate digitalis intoxication; Calcium carbonate reduces the absorption of a number of other drugs such as bisphosphonates, fluoride, some fluoroquinolones, and tetracyclines; doses should be separated by at least 3 hours. Some antiepileptics may increase vitamin D requirements (e.g. carbamazepine, Phenobarbital, phenytoin, and primidone). Rifampicin D. Corticosteroids may counteract the effect of vitamin D.                                                                                                
Adverse reactions:
Hypercalcemic syndrome, acute (drowsiness; continuing nausea and vomiting; weakness); renal calculi, calcific (difficult or painful urination)- with oral dosage forms.
Early symptoms of hypercalcemia
       Constipation, sever; dryness of mouth; headache, continuing; increased thirst;   
        Irritability; loss of appetite; mental depression; metallic taste; unusual tiredness  
        or weakness.
Late symptoms of hypercalcemia
        Confusion; drowsiness; high blood pressure; increased sensitivity of eyes or skin  
         to light, especially in hemodialysis patients; irregular, fast, or slow heartbeat;  
         nausea and vomiting; unusually large amount of urine or increased frequency of  
Flatulence from released carbon dioxide may occur in some patients.
Early – weakness; headache; somnolence; nausea; vomiting; dry mouth; constipation; muscle pain; bone pain; metallic taste.
Late – Polyuria; polydipsia; anorexia; irritability; weight loss; nocturia; mild acidosis; hypercalciuria; anemia; reversible azotemia, generalized vascular calcification, nephrocalcinosis; conjunctivitis (calcific); pancreatitis; photophobia; rhinorrhea; pruritus; hyperthermia; decreased libido; elevated BUN; albuminuria; hypercholesterolemia; elevated AST and ALT; ectopic calcification; hypertension; cardiac arrhythmias; overt psychosis (rare).
                                                                                             (USP DI, Facts, Martindale)
Early symptoms of vitamin D toxicity associated with hypercalcemia.
       Bone pain; constipation- usually more frequent in children and adolescents;  
       diarrhea ; drowsiness; dryness of mouth; headache, continuing; increased thirst;  
       increase in frequency of urination, especially at night, or in amount of urine;  
       irregular heartbeat; loss of appetite; metallic taste; muscle pain; nausea or  
       vomiting- usually more frequent in children and adolescents; pruritus; unusual  
       tiredness or weakness.
Late symptoms of vitamin D toxicity associated with hypercalcemia.
       Bone pain; cloudy urine; conjunctivitis (redness or discharge of the eye, eyelid, or  
       lining of the eyelid)- calcific; decreased libido(loss of sex drive); ectopic  
       calcification (calcium deposits in tissues other than bone); high fever, high blood  
       pressure; increased sensitivity of eyes to light or irritation of eyes; irregular  
       heartbeat; itching of skin; lethargy(drowsiness); loss of appetite; muscle pain;  
       nausea or vomiting and pancreatitis(stomach pain, sever); psychosis, overt(mood  
       or mental changes)- rare; rhinorrhea (runny nose); weight loss.
There is no information about calcium overdosage.
Dosage and administration:
Take one tablet twice daily. Not formulated for use in children.
Taking tablets 1 to 1½ hours after meals, unless otherwise directed by physician.
                                                                                                                           (PDR,USP DI)
Store below 30°c and protect from humidity and direct light.
How supplied:
Calcidex ® is available as calcium carbonate 500 mg /vit D3 200 IU oblong, very light green to off-white and coated tablets.
Calcidex Forte® is available as calcium carbonate 500 mg /vit D3 400 IU oblong, white and coated tablets.
There are blisters of 10 in a box of 50's.
1- Martindale 2007
2- USP DI 2004
3- PDR 2008
4- Drug Facts 2008

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