Calcium-D3 Nycomed forte pills chewable lemon, 60pcs

Composition

1 chewable tablet with lemon flavor contains:

Active ingredients:  

Calcium carbonate 1250 mg (corresponds to 500 mg of calcium)

Colecalciferol (Vitamin D3) 400 IU

Auxiliary substances:  

Sorbitol

Isomalt

Povidone

Magnesium Stearate

Aspartame

Lemon Oil

Mono – and diglycerides of fatty acids

Pharmacological action

Calcium-D 3 Nicomed forte regulates the exchange of calcium and phosphorus in the body (bones, teeth, nails, hair, muscles). Reduces resorption (resorption) and increases bone density, making up for the lack of calcium and vitamin D3 in the body, which is necessary for the mineralization of teeth.

Calcium is involved in the regulation of nerve conduction, muscle contractions and is a component of the blood clotting system.

Vitamin D3 increases the absorption of calcium in the intestines.

The use of calcium and vitamin D3 prevents an increase in the production of parathyroid hormone (PTH), which is a stimulator of increased bone resorption (leaching of calcium from bones).

Pharmacokinetics

of Calcium

Suction. Usually, the amount of calcium absorbed in the gastrointestinal tract is approximately 30% of the dose taken.

Distribution and metabolism. 99% of the body’s calcium is concentrated in the rigid structure of bones and teeth. The remaining 1% is found in intra-and extracellular fluids. About 50% of the total calcium content in the blood is in a physiologically active ionized form, of which about 10% is in a complex with citrate, phosphate or other anions, the remaining 40% is bound to proteins, primarily albumin.

Output. Calcium is excreted by the intestines, kidneys, and sweat glands. Renal excretion depends on glomerular filtration and tubular calcium reabsorption.

Vitamin D3

Suction. Vitamin D3 is easily absorbed in the small intestine (about 80% of the dose taken).

Distribution and metabolism. Colecalciferol and its metabolites circulate in the blood, associated with a specific globulin. Colecalciferol is converted in the liver by hydroxylation to 25-hydroxycolecalciferol. It is then converted in the kidneys to the active form of 1,25-hydroxycolecalciferol. 1,25-hydroxycolecalciferol is a metabolite responsible for increasing the absorption of calcium. Unmetabolized vitamin D3 is deposited in adipose and muscle tissue.

Output. Vitamin D3 is excreted by the intestines and kidneys.

Indications

• Prevention and treatment of calcium and/or vitamin D3 deficiency;
• Prevention and complex therapy of osteoporosis (menopausal, senile, steroid, idiopathic).

Application during pregnancy and lactation

Calcium-D 3 Nicomed is used during pregnancy to compensate for the lack of calcium and vitamin D in the body.

During pregnancy, the daily dose should not exceed 1500 mg of calcium and 600 IU of vitamin D3.

Hypercalcemia, which develops against the background of an overdose during pregnancy, can have an adverse effect on the developing fetus.

Calcium-D3 Nicomed is used during lactation.

Vitamin D and its metabolites can pass into breast milk, so it is necessary to take into account the intake of calcium and vitamin D from other sources in the mother and child.

Contraindications

• hypersensitivity to one of the components of the drug Calcium-D 3 Nicomed Forte;
• hypercalcemia, hypercalciuria;
• nephrolithiasis;
• hypervitaminosis D;
• severe renal failure;
• active tuberculosis;
• sarcoidosis;
• children under 3 years of age.

With caution: pregnancy; lactation.

Side effects

• Allergic reactions
• Gastrointestinal dysfunction (constipation or diarrhea, flatulence, nausea, abdominal pain)
• Hypercalcemia and hypercalciuria.

Interaction

Hypercalcemia may potentiate the toxic effects of cardiac glycosides when used concomitantly with calcium and vitamin D supplements. It is necessary to monitor the ECG and the content of calcium in the blood serum.

Calcium supplements may reduce the absorption of tetracyclines from the gastrointestinal tract. Therefore, tetracycline medications should be taken at least 2 hours before or 4-6 hours after taking Calcium-D3 Nicomed Forte.

To prevent a decrease in the absorption of bisphosphonate preparations, it is recommended to take them at least an hour before taking Calcium-D 3 Nicomed Forte.

Corticosteroids reduce the absorption of calcium, so treatment with glucocorticosteroids may require an increase in the dose of Calcium-D3 Nicomed Forte.

Concomitant use of thiazide-type diuretics increases the risk of hypercalcemia, as they increase the tubular reabsorption of calcium. When using thiazide diuretics at the same time, the serum calcium content should be regularly monitored.

Calcium reduces the effectiveness of levothyroxine by reducing its absorption. The time interval between taking levothyroxine and Calcium-D3 Nicomed Forte should be at least 4 hours.

The absorption of quinolone antibiotics decreases when used concomitantly with calcium supplements. Therefore, quinolone antibiotics should be taken 2 hours before or 6 hours after taking Calcium-D3 Nicomed Forte.

Intake of foods containing oxalates (sorrel, rhubarb, spinach) and phytin (cereals) reduces the absorption of calcium, so do not take Calcium-D 3 Nicomed Forte for two hours after eating sorrel, rhubarb, spinach, cereals

How to take, course of use and dosage

Inside, chewing or resorbing, mainly during meals.

For the prevention of osteoporosis

— 1 tablet 2 times a day or 2 tablets once a day

In the complex therapy of osteoporosis

— 1 tablet 2-3 times a day.

To compensate for the lack of calcium and vitamin D: adults and children over 12 years – 2 tablets per day, children 3-12 years-1 tablet per day or as prescribed by a doctor.

Special patient groups

• Patients with impaired liver function. No dose adjustment is required.
• Patients with impaired renal function. Do not use the drug Calcium-D 3 Nicomed in severe renal failure.
• Elderly patients. The dose is the same as for adults. Possible decrease in creatinine clearance should be considered.

Duration of treatment. When used for the prevention and complex therapy of osteoporosis, the duration of treatment is determined by the doctor individually.

When used to compensate for calcium and vitamin D3 deficiency, the average duration of treatment is at least 4-6 weeks. The number of repeated courses during the year is determined individually.

Overdose

Symptoms of overdose (hypercalcemia): anorexia, thirst, polyuria, muscle weakness, nausea, vomiting, constipation, abdominal pain, fatigue, bone pain, mental disorders, nephrocalcinosis, urolithiasis and, in severe cases, cardiac arrhythmias. With prolonged use of excessive doses (over 2500 mg of calcium) – kidney damage, soft tissue calcification.

If you find signs of overdose, you should stop taking calcium and vitamin D, as well as thiazide diuretics and cardiac glycosides, and consult a doctor.

Treatment: gastric lavage, replacement of fluid loss, use of loop diuretics (for example, furosemide), corticosteroids, calcitonin, bisphosphonates.

It is necessary to monitor the content of electrolytes in the blood plasma, kidney function and diuresis. In severe cases, it is necessary to measure the central venous pressure (CVP) and monitor the ECG.

Special instructions

With long-term therapy, the content of calcium and creatinine in the blood serum should be monitored. Monitoring is especially important in elderly patients who are being treated with cardiac glycosides and diuretics, and in patients with an increased tendency to form kidney stones. In cases of hypercalcemia or signs of impaired renal function, the dose should be reduced or treatment should be discontinued.

Vitamin D should be taken with caution in patients with renal insufficiency. In this case, it is necessary to monitor the content of calcium and phosphates in the blood serum. It is also necessary to consider the risk of soft tissue calcification.

To avoid overdose, additional vitamin D supplementation from other sources should be considered.

Calcium and vitamin D3 should be used with caution in immobilized patients with osteoporosis due to the risk of hypercalcemia.

Concomitant use with tetracycline or quinolone antibiotics is usually not recommended, or should be done with caution

Form of production

Lemon chewable tablets

Storage conditions

In a dry place, at a temperature not exceeding 25 °C, in tightly closed packaging

Shelf life

3 years

Active ingredient

: Calcium carbonate, Colecalciferol

Dosage form

tablets for resorption

Indications

Hair Growth and Nail Strengthening, Cardiovascular System Improvement, Bone Strengthening