Calcium carbonate, Colecalciferol
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2019-09-19
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Clinical Pharmacology
Calcium-phosphorus metabolism regulator
Pharmacodynamics:
Combined drug that regulates the exchange of calcium and phosphorus in the body. Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium and colecalciferol (vitamin D3) in the body.
Calcium is involved in the regulation of nerve conduction, muscle contraction, hormone production and is a component of the blood coagulation system. Vitamin D3 increases calcium absorption in the gastrointestinal tract and its binding in bone tissue. The use of calcium and vitamin D3 prevents the increase in the production of parathyroid hormone (PTH), which is a stimulator of increased bone resorption (leaching of calcium from the bones).
Pharmacokinetics:
Calcium
Absorption: Calcium is absorbed in the ionized form in the proximal small intestine through an active, D-vitamin dependent transport mechanism. Absorption from the gastrointestinal tract, is approximately 30% of the dose. When taken together with food, the bioavailability of calcium increases slightly.
Distribution and metabolism: 99% of calcium in the body is concentrated in the rigid skeleton of bones and teeth. The remaining 1% is in intra-and extracellular fluids. About 50% of the total calcium in the blood is in a physiologically active ionized form, including about 10% in combination with citrate, phosphate or other anions, the remaining 40% are associated with proteins, primarily albumin.
Excretion: Calcium is excreted in the feces, urine and sweat glands. Renal excretion depends on glomerular filtration and tubular calcium reabsorption.
Colecalciferol (Vitamin D3)
Absorption: Colecalciferol (Vitamin D3) is well absorbed from the small intestine.
Distribution and metabolism: Colecalciferol and its metabolites circulate in the blood in a bound state with a specific globulin. Colecalciferol is metabolized in the liver by hydroxylation to the active form 25-hydroxycolecalciferol, then converted in the kidney to the active form 1,25-hydroxycolecalciferol. 1,25-hydroxycolecalciferol is a metabolite responsible for increasing calcium absorption. Unmetabolized vitamin D3 is deposited in adipose and muscle tissues.
Withdrawal: Colecalciferol (Vitamin D3) is excreted in the feces and urine.
Indications
- Complex therapy of osteoporosis of various origins and its complications;
- Completion of calcium deficiency and / or vitamin D3 in the elderly.
Composition
One tablet contains:
Active ingredients: calcium carbonate - 1500 mg (equivalent to calcium 600 mg), colecalciferol -1000 ME (0.025 mg).
Excipients: maltodextrin 166 mg; aspartame 8.67 mg; hyprolosis 106.07 mg; lactose monohydrate 57.65 mg; anhydrous citric acid 208.11 mg; orange flavoring 4.20 mg; stearic acid 42.03 mg; alpha-tocopherol 0.02 mg; soybean oil partially hydrogenated 0.75 mg; gelatin 3.80 mg; sucrose 3.80 mg; corn starch 1.605 mg.
Calcium carbonate, Colecalciferol is marketed under different brands and generic names, and comes in different dosage forms:
| Brand name | Manufacturer | Country | Dosage form |
|---|---|---|---|
| Natemilla | pills | ||
| Calcium-D3 Nycomed | Takeda Pharmaceuticals Ltd | Russia | pills |
| Calcium D3 | Takeda Pharmaceuticals Ltd | Russia | pills |
| Calcium-D3 Nycomed | Takeda Pharmaceuticals Ltd | Japan | pills |
| Supra vit | Candy Ltd BG | Bulgaria | effervescent pills |
| Compl Calcium D3 | Pharmstandard Ufavita | Russia | bottle |
| Compl Calcium D3 | Pharmstandard Ufavita | Russia | pills |
| Natecal D3 | Italfarmaco | Italy | pills |
| Calcium-D3 Nycomed Forte | Takeda Pharmaceuticals Ltd | Russia | pills |
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Dosage and Administration
Inside, sucking,as a prophylactic agent: adults - 1-2 tablets per day;for course prevention of osteoporosis: 1 tablet 2 times a day, in the morning and in the evening (preferably with meals),for osteoporosis therapy: The dosage and duration of the course are determined by the doctor.
Adverse reactions
Diarrheal phenomena (constipation, diarrhea, flatulence, nausea, abdominal pain); increase of calcium in blood and urine (with prolonged use).
Contraindications
- Hypersensitivity, hypercalcemia, hypercalciuria, urolithiasis, sarcoidosis and metastasis of tumors in the bone, pronounced renal impairment;
- osteoporosis due to prolonged immobilization;
- vitamin D overdose3.
Drug interactions
The effect is weakened by phenytoin and barbiturates, strengthen - cardiac glycosides. Calcium and Vitamin D3 increase the absorption of tetracyclines (required 3-hour interval between doses), reduce - bisphosphonates and fluorides (requires a 2-hour interval between doses). Corticosteroids lower calcium absorption, furosemide and other loop diuretics increase calcium excretion by the kidneys. Cholestyramine and mineral or vegetable oil-based laxatives reduce the absorption of vitamin D3. The acid reaction of food increases the absorption of calcium, weakly alkaline - reduces.
Pregnancy and Lactation
Perhaps, but not more than 1500 mg of calcium and 600 IU of vitamin D3 per day.
Special instructions
Can not be used simultaneously with vitamin-mineral complexes containing calcium and vitamin D3. Consider possible additional intake of vitamin D3 from other sources.
- Brand name: Natemilla
- Active ingredient: Calcium carbonate, Colecalciferol
- Dosage form: Round flat-cylindrical pills of white or almost white color with splashes of light orange color and a facet from two sides.
- Manufacturer: Italfarmaco
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