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Qualitative and quantitative composition
Composition per tablet
Active ingredients: calcium 500 mg in the form of calcium carbonate 1250 mg; cholecalciferol 5.0 mcg (200 IU) as cholecalciferol concentrate (powder) 2.0 mg.
Full list excipients see section "List of excipients".
Description
Round, biconvex tablets, uncoated white. May have small inclusions and uneven edges. At the bottom of the bottle there may not be a large number of powder.
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Indications for use
Prevention and treatment of vitamin D and calcium deficiency.
Meeting vitamin D and calcium needs as a supplement to specific therapy osteoporosis in patients, at risk vitamin D and calcium deficiency.
Directions for use and doses
Dosage regimen
Adults, including elderly patients
Complementary therapy for osteoporosis
By 1 chewable tablet 2-3 times a day.
Calcium and vitamin deficiencyD
1 chewable tablet 1-3 times a day.
Children from 3 years old
Calcium and vitamin deficiencyD (only)
1 chewable tablet 1-2 times a day.
Special patient groups
Kidney failure
Calcium-D3 Nycomed tablets should not be used in patients with severe renal failure(see section “Contraindications”).
Liver failure
No dose adjustment is required.
Mode of application
Orally. The tablet can be chewed or dissolved. The drug is taken regardless of meals.
You should not take an additional dose of the drug if you miss a pill.
Duration of treatment
The duration of taking the drug is determined individually
Contraindications
Hypersensitivity to active substances or to any of the excipients listed in the section “List of excipients”. - Severe renal failure (rate glomerular filtration < 30 мл/мин/1,73 м 2). - Заболевания и/или состояния, приводящие к гиперкальциемии и/или гиперкальциурии. - Почечнокаменная болезнь (нефролитиаз). - Гипервитаминоз D.
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Special instructions and precautions
During long-term treatment Serum calcium levels should be monitored and renal function monitored by measuring serum creatinine. Monitoring is especially important for older patients receiving concomitant treatment cardiac glycosides or diuretics (see section “Interactions with other drugs”), and for patients with a strong tendency to form kidney stones. In case of hypercalcemia or signs of renal impairment, the dose should be reduced or treatment discontinued.
Calcium carbonate tablets with cholecalciferol should be used with caution in patients with hypercalcemia or signs of renal impairment; Calcium and phosphate levels should be monitored. The risk of soft tissue calcification must be taken into account.
At joint use with other sources of vitamin D and/or drugs or nutrients (such as milk) containing calcium, there is a risk of hypercalcemia and milk-alkali syndrome with subsequent renal impairment. Serum calcium levels and renal function should be monitored in these patients.
Calcium-D3 Nycomed should be used with caution in patients suffering from sarcoidosis due to the risk of increased metabolism of vitamin D3 to its active form. In these patients, serum and urine calcium levels should be regularly monitored.
Calcium-D3 Nycomed should be used with caution in immobilized patients with osteoporosis due to increased risk development of hypercalcemia.
Calcium-D3 Nycomed contains isomalt (E953) and sucrose. Patients suffering from such rare hereditary disorders people with fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not take this drug. With long-term use, sucrose may have Negative influence on tooth enamel.
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Interaction with other medicinal products and other types of interactions
Thiazide diuretics reduce urinary calcium excretion. Due to the increased risk of hypercalcemia during use of thiazide diuretics, serum calcium levels should be regularly monitored.
Calcium carbonate may interfere with the absorption of concomitantly prescribed tetracycline drugs. For this reason, tetracycline drugs should be used according to at least, two hours before or 4-6 hours after oral administration calcium.
The development of hypercalcemia during treatment with calcium and vitamin D may increase the toxicity of cardiac glycosides. In such patients, electrocardiogram (ECG) and serum calcium levels should be monitored.
When concomitantly using a bisphosphonate, the latter should be taken at least an hour before taking Calcium-D3 Nycomed to avoid decreased absorption in the gastrointestinal tract.
The effectiveness of levothyroxine may be reduced with concomitant use of calcium due to decreased absorption of levothyroxine. An interval of at least four hours should be maintained between taking calcium and levothyroxine.
The absorption of quinolone antibiotics may be impaired by concomitant administration of calcium. Quinolone antibiotics should be taken two hours before or six hours after taking calcium.
Calcium salts may reduce the absorption of iron, zinc and strontium ranelate. Therefore, it is recommended to take iron, zinc or strontium ranelate supplements two hours before or two hours after taking Calcium-D3 Nycomed.
Treatment with orlistat may potentially interfere with absorption fat-soluble vitamins(for example, vitamin D3).
Pregnancy and lactation
Pregnancy
The drug Calcium-D3 Nycomed can be used during pregnancy in case of vitamin D and calcium deficiency. During pregnancy, the daily dose should not exceed 2500 mg of calcium and 4000 IU of vitamin D. Animal studies have shown reproductive toxicity of high doses of vitamin D. Overdose of calcium and vitamin D should be avoided in pregnant women, as persistent hypercalcemia has been associated with adverse effects in developing fetus. There is no data on the teratogenic effect of vitamin D in therapeutic doses in humans.
Lactation
The drug Calcium-D3 Nycomed can be used during breastfeeding. Calcium and vitamin D3 penetrate into breast milk. This should be taken into account when supplementing vitamin D to a child.
Impact on the ability to drive vehicles and machinery
The effect of the drug Calcium-D3 Nycomed on the ability to drive vehicles and machines has not been identified.
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Side effect
Adverse reactions are listed below according to classification by system-organ class and frequency of development. Frequency defined as: uncommon (≥ 1/1000,< 1/100), редко (≥ 1/10000, < 1/1000), очень редко (< 1/10000); частота неизвестна (невозможно оценить на основании имеющихся данных).
Immune system disorders
Frequency unknown: hypersensitivity reactions such as angioedema or laryngeal edema.
Metabolic and nutritional disorders
Infrequently: hypercalcemia and hypercalciuria.
Very rarely: milk-alkali syndrome (frequent urge to urinate; prolonged headache; long-term loss of appetite; nausea or vomiting; unusual tiredness or weakness; hypercalcemia, alkalosis and renal failure). As a rule, it is observed only in case of overdose (see section “Overdose”).
Gastrointestinal disorders
Rarely: constipation, dyspepsia, flatulence, nausea, abdominal pain and diarrhea.
Skin and subcutaneous tissue disorders
Very rarely: itching, rash and hives.
Special patient groups
Patients with renal failure: potential risk development of hyperphosphatemia, nephrolithiasis and nephrocalcinosis (see section “Special instructions and precautions”).
Reporting suspected adverse reactions
It is important to report suspected adverse reactions after registration medicine in order to ensure continuous monitoring of the benefit-risk ratio of the medicinal product.
If an undesirable reaction occurs as indicated in this instruction manual. medical use or not mentioned herein, patients are advised to consult their physician.
Healthcare professionals and patients are advised to report any suspected adverse drug reactions to the Republican unitary enterprise“Center for Expertise and Testing in Healthcare” (see section “Send information about adverse reactions to the following address”).
Overdose
Symptoms
Overdose can lead to hypercalcemia and vitamin D hypervitaminosis. Symptoms of hypercalcemia may include anorexia, thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disorders, polydipsia, polyuria, bone pain, nephrocalcinosis, kidney stones and, in severe cases, cardiac arrhythmias. Extreme hypercalcemia can lead to coma and death. Constantly high levels calcium may cause irreversible kidney damage and soft tissue calcification.
Milk-alkali syndrome can occur in patients who ingest large amounts of calcium and absorbable alkaline foods.
Treatment hypercalcemia
Treatment is mainly symptomatic and supportive. Treatment with calcium and vitamin D should be discontinued. It is also necessary to stop treatment with thiazide diuretics and cardiac glycosides (see section “Interaction with other drugs and other types of interactions”). For patients with impaired consciousness, removal of gastric contents is indicated. Rehydration and, depending on the severity, isolated or combined treatment with loop diuretics, bisphosphonates, calcitonin and corticosteroids. Monitoring of serum electrolytes is mandatory, renal function and diuresis. In severe cases should be monitored ECG indicators and central venous pressure.
Pharmacotherapeutic group
Mineral supplements. Combinations of calcium with vitamin D and/or other agents.
ATX Code: A12AX
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Pharmacological properties
Pharmacodynamics
Vitamin D3 increases calcium absorption in the intestines.
The administration of calcium and vitamin D3 counteracts the increase in parathyroid hormone (PTH) levels caused by calcium deficiency and leading to increased bone resorption. Clinical study involving patients suffering from vitamin D deficiency, showed that daily intake of two tablets of calcium 500 mg / vitamin D 400 IU for 6 months normalized the level of the 25-hydroxylated metabolite of vitamin D3 and reduced the severity of secondary hyperparathyroidism and alkaline phosphatase levels.
Pharmacokinetics
Calcium
Absorption: The amount of calcium that is absorbed through gastrointestinal tract, is approximately 30% of the consumed dose.
Distribution and Metabolism: 99% of calcium in the body is concentrated in the hard structures of bones and teeth. The remaining amount (1%) is present in intra- and extracellular fluid. About 50% of the total calcium contained in the blood is present in the physiologically active ionized form, with approximately 10% forming complexes with citrate, phosphate and other anions; the remaining 40% is associated with proteins, mainly albumin.
Excretion: Calcium is excreted in feces, urine and sweat. Renal excretion depends on glomerular filtration and tubular reabsorption.
Cholecalciferol
Absorption: Vitamin D3 is easily absorbed in the small intestine.
Distribution and metabolism: Cholecalciferol and its metabolites circulate in the blood in association with a specific globulin. Cholecalciferol is converted in the liver by hydroxylation to the active form 25-hydroxycholecalciferol. The latter is then converted in the kidneys to 1,25-dihydroxycholecalciferol, a metabolite responsible for increasing calcium absorption. Unmetabolized vitamin D3 is stored in adipose and muscle tissues.
Excretion: Vitamin D3 is excreted from the body in feces and urine.
List of excipients
Xylitol
Isomalt
Orange flavor
Mono- and diglycerides fatty acids
Chewable tablets 500 mg/200M.E. with tasteorange.
20, 50 or 100 tablets in a polyethylene bottle high density, sealed with a screw cap, under which there is a ring for tearing off the sealing gasket, ensuring control of the first opening.
One bottle along with instructions for use is placed in a cardboard box.
Special precautions when disposing of the drug
No special requirements.
Conditions for dispensing from pharmacies
Without a doctor's prescription.
A combined drug that regulates the exchange of calcium and phosphorus in the body (in bones, teeth, nails, hair, muscles).
Reduces resorption (resorption) and increases density bone tissue, replenishing the lack of calcium and vitamin D 3 in the body, 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 coagulation system. Adequate calcium intake is especially important during growth, pregnancy and lactation.
Vitamin D 3 increases calcium absorption in the intestines.
The use of calcium and vitamin D 3 prevents an increase in the production of parathyroid hormone, which is a stimulator of increased bone resorption (leaching of calcium from the bones).
Pharmacokinetics
Suction
Typically, the amount of calcium that is absorbed from the gastrointestinal tract is approximately 30% of the dose taken.
Distribution and metabolism
99% of the calcium in the body 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 physiologically active ionized form, of which approximately 10% is complexed with citrate, phosphate or other anions, the remaining 40% is associated with proteins, primarily albumin.
Removal
Calcium is excreted through the intestines, kidneys and sweat glands. Renal excretion depends on glomerular filtration and tubular reabsorption of calcium.
Colecalciferol
Suction
Colecalciferol is easily absorbed from small intestine(about 80% of the dose taken).
Distribution and metabolism
Colecalciferol and its metabolites circulate in the blood bound to a specific globulin. Colecalciferol is metabolized in the liver by hydroxylation to 25-hydroxycolecalciferol. It is then converted in the kidneys to the active form 1.25-hydroxycolecalciferol. 1.25-hydroxycolecalciferol is a metabolite responsible for increasing calcium absorption. Unchanged colecalciferol is deposited in adipose and muscle tissue.
Removal
Colecalciferol is excreted by the kidneys and intestines.
Release form
Chewable tablets (orange), uncoated, round, biconvex, white; with orange aroma; may have small inclusions and uneven edges.
Excipients: sorbitol - 390 mg, isomalt - 62.0 mg, povidone - 36.4 mg, magnesium stearate - 6.00 mg, aspartame - 1.00 mg, orange oil - 0.97 mg, mono- and diglycerides of fatty acids - 0.0008 mg.
20 pcs. - bottles made of high-density polyethylene (1) - cardboard packs.
50 pcs. - bottles made of high-density polyethylene (1) - cardboard packs.
100 pieces. - bottles made of high-density polyethylene (1) - cardboard packs.
Dosage
The tablets can be chewed or dissolved and taken with meals.
Calcium-D 3 Nycomed
Adults for the prevention of osteoporosis - 1 tablet. 2 times/day; V complex therapy osteoporosis - 1 tablet. 2-3 times/day.
To replenish calcium and vitamin D deficiency, adults and children over 12 years old - 1 tablet. 2 times/day, children from 5 to 12 years old - 1-2 tablets/day, children from 3 to 5 years old - dosage in accordance with doctor's recommendations.
Calcium-D 3 Nycomed Forte
Adults for the prevention of osteoporosis - 1 tablet. 2 times/day or 2 tablets 1 time/day; in complex therapy of osteoporosis - 1 tablet. 2-3 times/day.
To compensate for calcium and vitamin D deficiency, adults and children over 12 years old - 2 tablets per day, children from 3 to 12 years old - 1 tablet per day or as prescribed by a doctor.
Duration of treatment
When used for prevention and in complex therapy of osteoporosis, the duration of treatment is determined by the doctor individually.
When used to replenish calcium and vitamin D 3 deficiency, the average duration of treatment is at least 4-6 weeks. The number of repeat courses during the year is determined individually.
Patients with impaired liver function do not require dose adjustment.
Should not be used in severe renal failure.
Elderly patients are prescribed the same dose as for adults. A possible decrease in creatinine clearance should be taken into account.
Overdose
Symptoms: manifestations of hypercalcemia - anorexia, thirst, polyuria, muscle weakness, nausea, vomiting, constipation, abdominal pain, increased fatigue, bone pain, mental disorders, nephrocalcinosis, urolithiasis disease and, in severe cases, cardiac arrhythmias. With long-term use of excessive doses (over 2500 mg of calcium) - kidney damage, soft tissue calcification.
If symptoms of overdose are detected, the patient should stop taking calcium and vitamin D, as well as thiazide diuretics and cardiac glycosides, and consult a doctor.
Treatment: gastric lavage, replenishment 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, renal function and diuresis. In severe cases, measurement of central venous pressure and ECG monitoring are necessary.
Interaction
Hypercalcemia may potentiate toxic effects cardiac glycosides when used simultaneously with calcium and vitamin D preparations. Monitoring of ECG and calcium levels in the blood serum is necessary.
Calcium supplements may reduce the absorption of tetracyclines from the gastrointestinal tract. Therefore, tetracycline drugs should be taken at least 2 hours before or 4-6 hours after taking the drug.
To prevent decreased absorption of bisphosphonate drugs, it is recommended to take them at least 1 hour before taking Calcium-D 3 Nycomed.
GCS reduce calcium absorption, so treatment with GCS may require an increase in the dose of Calcium-D 3 Nycomed.
With simultaneous use of thiazide diuretics, the risk of hypercalcemia increases, because they increase tubular reabsorption of calcium. When thiazide diuretics are used concomitantly, serum calcium levels should be regularly monitored.
Calcium reduces the effectiveness of levothyroxine by reducing its absorption. The period of time between doses of levothyroxine and Calcium-D 3 Nycomed should be at least 4 hours.
The absorption of quinolone antibiotics is reduced when used simultaneously with calcium supplements. Therefore, quinolone antibiotics should be taken 2 hours before or 6 hours after taking Calcium-D 3 Nycomed.
Reception food products containing oxalates (sorrel, rhubarb, spinach) and phytin (cereals), reduces calcium absorption, so you should not take Calcium-D 3 Nycomed within 2 hours after eating sorrel, rhubarb, spinach, cereals.
Side effects
Frequency side effects the drug is assessed as follows: very frequent (>1/10); frequent (>1/100,<1/10); нечастые (>1/1000, <1/100); редкие (>1/10 000, <1/1000); очень редкие (<1/10 000).
Metabolism and nutrition: uncommon - hypercalcemia, hypercalciuria.
From the digestive system: rarely - constipation, flatulence, nausea, abdominal pain, diarrhea, dyspepsia.
From the skin and subcutaneous tissue: very rarely - itching, rash, urticaria.
Indications
- prevention and treatment of calcium and/or vitamin D 3 deficiency;
- prevention and complex therapy of osteoporosis and its complications (bone fractures).
Contraindications
- hypercalcemia;
- hypercalciuria;
- nephrolithiasis;
- hypervitaminosis D;
- severe renal failure;
- active form of tuberculosis;
- sarcoidosis;
- hypersensitivity to the components of the drug, soy or peanuts.
The drug in tablet form is not used in children under 3 years of age.
The drug contains sorbitol, isomalt and sucrose, so its use is not recommended for patients with hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency.
With caution: pregnancy, lactation, renal failure.
Features of application
Use during pregnancy and breastfeeding
Calcium and vitamin D 3 are used during pregnancy to compensate for their deficiency in the body.
During pregnancy, the daily dose of the drug should not exceed 1500 mg of calcium and 600 IU of vitamin D 3 .
Hypercalcemia due to overdose during pregnancy can have an adverse effect on the developing fetus.
The drug is used during lactation.
Calcium and vitamin D 3 can pass into breast milk, so it is necessary to consider the intake of calcium and vitamin D from other sources in the mother and baby.
Use for renal impairment
The drug is contraindicated in severe renal failure.Use in children
The dosage form of the tablet is not used in children under 3 years of age.special instructions
During long-term therapy, serum calcium and creatinine levels should be monitored. Monitoring is especially important in elderly patients during concomitant treatment with cardiac glycosides and diuretics and in patients with an increased tendency to form kidney stones. In cases of hypercalcemia or signs of renal impairment, reduce the dose or discontinue treatment.
Vitamin D should be taken with caution in patients with renal failure. In this case, it is necessary to monitor the calcium and phosphate levels in the blood serum. The risk of soft tissue calcification must also be considered.
To avoid overdose, additional vitamin D intake from other sources must be taken into account.
Calcium and vitamin D 3 should be used with caution in immobilized patients with osteoporosis due to the risk of developing hypercalcemia.
Concomitant use with tetracycline or quinolone antibiotics is usually not recommended or should be done with caution.
Impact on the ability to drive vehicles and operate machinery
The drug does not affect the ability to drive vehicles or operate complex machinery.
In case of diagnosed calcium deficiency in the body, the drug of choice for most patients is Calcium D3 Nycomed. The original product is manufactured by a Norwegian pharmaceutical company registered under the name Nycomed Pharma AS. The price of the drug depends on the number of tablets and starts from 225 rubles. You can buy the supplement without a prescription at any pharmacy.
The drug "Calcium D3 Nycomed" is available in the form of soft tablets for chewing.
Number of pieces in polyethylene packaging:
- with orange flavoring – 20, 50, 100 pieces;
- “mint” - 30, 100 pieces.
The main active ingredient of the product is calcium carbonate, contained in tablets in the amount of 1250 mg. Vitamin D3 (colicalciferol) (5 mcg) promotes better absorption of the microelement. The composition contains elements such as sorbidol, aspartame, and povidone as auxiliary components. Orange or mint oil is responsible for the flavor and aroma characteristics of chewable tablets.
Why is Calcium d3 Nycomed prescribed?
The principle of action of the drug is to regulate calcium-phosphorus metabolism. As a result of taking it, bones become denser and stronger, teeth are mineralized. The trace element is involved in the process of blood clotting, hormone production, improves the condition of muscle tissue, and regulates the sensitivity of nerve cells. The presence of vitamin D3 in the composition is explained by the need to increase the absorption of calcium and prevent its leaching.
The drug is prescribed for the following disorders:
- lack of calcium;
- vitamin D3 hypovitaminosis;
- osteoporosis of various etiologies;
- insufficient bone strength;
- thinning of tooth enamel;
- frequent bone fractures.
Only 30% of the trace element is absorbed by the digestive organs. The active component enters the bones and teeth and binds to albumin. Removal of decay products is carried out through the kidneys and digestive organs, as well as through sweat.
Instructions for use of the drug
Before taking Calcium D3 Nycomed, it is strongly recommended that you read the instructions. It is located under the adhesive label on the can. Chewable tablets should be consumed directly during meals or after, chewing or dissolving.
Dosage depends on age:
- 3–5 years – determined individually by a pediatrician based on test results;
- 5 – 12 years – 1 – 2 pcs. in a day;
- from 12 years – 1 pc. 2 r. in a day.
For patients over the age of 60 years, patients with pathologies of the liver and kidneys, dosage adjustment is not performed.
If the drug is used to prevent hypocalcemia or vitamin D3 deficiency, the dosage and duration of the course of medication is determined by a specialist. In case of calcium deficiency, the duration of therapy is 4–6 weeks.
Use during pregnancy and lactation
Women are recommended to use Calcium D3 Nycomed during pregnancy to correct the deficiency of this microelement and vitamin D3. The maximum dose of calcium is 1500 mg per day. The recommended dose should not be exceeded, because the development of hypercalcemia can have a negative impact on the condition of the fetus.
During breastfeeding, the use of the drug is not contraindicated, but the intake of the microelement from food should be taken into account, because the active components of the drug penetrate into mother’s milk in small quantities.
Drug interactions
"Calcium D3 Nycomed" has the ability to reduce the absorption from the gastrointestinal tract of drugs from the following pharmacokinetic categories:
- tetracyclines;
- bisphosphonates;
- levothyroxine;
- antibiotics of the quinolone group.
If therapy with glucocorticosteroids is carried out, an increase in dosage may be necessary, since drugs in this category impair calcium absorption.
When taking thiazide diuretics together with the drug “Calcium D3 Nycomed Forte,” you need to monitor the level of the microelement in the blood serum, since the risk of developing the opposite phenomenon of deficiency—hypercalcemia—increases.
Contraindications, side effects and overdose
Taking the drug "Calcium D3 Nycomed" is rarely accompanied by unpleasant symptoms. In some cases, patients may be bothered by gastrointestinal symptoms, in particular, flatulence, nausea, and pain in the abdomen. Before starting the course, you must consult with a specialist and carefully read the instructions.
There are the following contraindications to the use of the medicine:
- hypercalcemia (high levels of calcium in the body);
- hypercalciuria (exceeding the norm of microelement content in urine);
- vitamin D hypervitaminosis;
- nephrolithiasis;
- active tuberculosis;
- severe forms of kidney and liver pathologies;
- phenylketonuria;
- sarcoidosis;
- age up to 3 years;
- sensitivity to the components of the drug, as well as to soy, peanuts and fructose.
Exceeding the dosage over a long period has a toxic effect on the patient's condition. As a result of the accumulation of excess calcium, a sharp decrease in body weight occurs, leading to the development of anorexia. The patient is accompanied by irritability, dizziness, constipation, muscle pain, the emotional and mental state worsens, and mental disorders may appear.
Due to regular use of tablets at a dose above 2500 mg, soft tissue calcification develops, and pathological processes in the kidneys become irreversible.
If an overdose is suspected, action must be taken immediately. First, you should stop taking the drug, as well as diuretics and cardiac glycosides. Secondly, go to a medical facility, where the patient will have a gastric lavage and be given medications that will reduce the absorption of calcium.
Analogues of Calcium d3 Nycomed
The pharmaceutical market offers a wide range of analogues of the original drug “Calcium D3 Nycomed”. They may differ slightly in composition and price, but the principle of operation is usually the same.
| Name | Features of application | Manufacturer (country) | Release form | Price, rub.) |
|---|---|---|---|---|
| "Complivit calcium D3" | effectiveness decreases when taken together with phenytoin and barbiturates | Pharmstandard-UfaVITA (Russia) | chewable tablets (30 pcs.) | from 135 |
| "Natekal D3" | takes part in the regulation of calcium-phosphorus metabolism | Italpharmaco S.p.A. (Italy) | chewable tablets (60 pcs.) | from 361 |
| "Vitrum Osteomag" | prescribed to patients over 8 years of age; should be used with caution in patients with kidney disease | Unifarm Inc (USA) | tablets (30 pcs.) | from 382 |
| "Kalcemin Advance" | contains a whole complex of vitamins and minerals | Sagmel Inc (USA) | tablets (30 pcs.) | from 418 |
| "Calcium + vitamin D3" | is highly effective in the treatment of osteoporosis | Unifarm Inc (USA) | coated tablets (30 pcs.) | from 254 |
Calcium deficiency is a common disorder, accompanied by such manifestations as fragility of bones and teeth, poor blood clotting, and problems in the functioning of the gastrointestinal tract. When taking calcium supplements, it is important to strictly adhere to the dosage and follow the instructions of the attending physician, because an excess of this trace element also has a negative effect on the condition of the body.
Calcium-D3 Nycomed is a mineral and vitamin preparation that regulates metabolism and replenishes the deficiency of calcium (Ca) and vitamin D3 in the body. The drug is sold over-the-counter and has a reputation as a useful remedy not only for diseases and symptoms, but also as a general tonic that improves the condition of nails, teeth and hair. However, the drug has side effects and contraindications, so before purchasing it at the pharmacy, it will be useful to read the instructions for use. Being informed about the price, as well as about cheaper analogues, will help you make the right choice.
The drug is available in the form of chewable tablets. They are round, white, have yellowish-gray inclusions and a light fruity smell.
There are 4 types of tastes (aromas):
- mint;
- citric;
- orange;
- strawberry-watermelon.
Tablets of 20, 30, 50, 100 and 120 pieces are packaged in high-density white polyethylene bottles, which, together with instructions, are placed in cardboard packaging.
The manufacturer in Russia is the Yaroslavl Pharmaceutical Plant, part of the largest Japanese pharmaceutical company Takeda Pharmaceutical.
pharmachologic effect
The main active ingredients of lemon chewable tablets are:
- calcium carbonate – 1250 mg, which corresponds to 500 mg of elemental Ca;
- colecalciferol (vitamin D3) – 10 mcg (400 IU).
In mint, strawberry-watermelon and orange tablets with the same amount of Ca, the content of vitamin D3 is 2 times less - 5 mcg (200 IU).
The combined effect of the active ingredients of the drug - calcium and D3 - is as follows:
- the level of calcium needed for health in our body is restored;
- the processes of bone tissue resorption stop, that is, the leaching of mineral salts from it, which helps to increase its density;
- Due to the presence of vitamin D3, the intensity of calcium absorption increases.
Indications for use
Calcium is necessary to ensure the vital functions of the body along with other macroelements: oxygen, carbon, nitrogen, hydrogen, iron, phosphorus, potassium, magnesium, etc. Normally, its content in the human body is 2%.
Ca is part of bone tissue, plays an important role in the transmission of nerve impulses, and takes part in the contraction of striated and smooth muscles. With a lack of calcium, normal heart function and hormone production are impossible, and the blood clotting system ceases to function.
The drug is used:
- For bone injuries.
- With different etiologies.
- As part of drug therapy and bones.
- If Ca deficiency occurs due to food poisoning, dysbiosis, past intestinal infections, chronic enterocolitis.
- With an increased need for calcium:
- during periods of accelerated growth in children,
- under significant physical or mental stress,
- for women, these are periods of pregnancy, lactation, menopause and postmenopause.
- With obvious external signs of calcium deficiency:
- brittle nails,
- deterioration of dental condition,
- dry skin and hair,
- increased bleeding,
- convulsions,
- general weakness.
Dosage, method of application
The tablets are chewed or dissolved and taken with meals. On the day you can use:
- children from 3 to 5 years old - strictly in accordance with the doctor’s prescription;
- from 6 to 12 years – 1-2 tablets;
- over 12 years old and adults – 2 tablets
(1 piece 2 times a day, or 2 pieces once a day).
The product is effective only with a course of use - from 4 to 6 weeks.
The specific duration should be determined by the attending physician, who, if necessary, will adjust the dosage, taking into account the age and data of the patient’s biochemical blood parameters.
Calcium D3 Nycomed is used with caution during pregnancy in women and subsequent breastfeeding.
Contraindications
- Excess vitamin D in the body is called hypervitaminosis if it is taken as part of other medications.
- Hypercalcemia and hypercalciuria detected by laboratory tests.
- Hypersensitivity to the active or excipients of chewable tablets, as well as to peanuts and soy.
- Nephrolithiasis and a number of other severe kidney diseases.
- Tuberculosis in the active phase.
- Phenylketonuria.
The drug is contraindicated for people with hereditary fructose intolerance, in case of sucrase-isomaltase deficiency and glucose-galactose malabsorption due to the presence of sorbitol, isomalt and sucrose in its composition as excipients.
Chewable tablets are not used to treat children under three years of age.
Side effects
Specific manifestations of impaired metabolism: hypercalcemia and (or) hypercalciuria.
From the digestive system: pain in the abdomen, constipation or diarrhea, nausea, vomiting.
Skin reactions: redness, burning, itching.
Overdose
If the doses indicated in the instructions or prescribed by the doctor are not observed, signs of hypercalcemia may occur:
- arrhythmia, cardiac dysfunction;
- severe fatigue, feeling of weakness in different muscle groups;
- bone pain;
- anorexia (exhaustion), accompanied by increased thirst;
- polyuria (significant increase in urine production);
- nausea and vomiting;
- general weakness, fainting.
Excessive doses and long-term use of the drug are fraught with such a serious complication as calcification of blood vessels and tissues, which become fragile, and with calcification of cerebral vessels, dementia or mental disorders may even occur.
Price
Prices for the drug in Moscow pharmacies depend on the number of tablets in the bottle:
- packs of 20 and 30 pieces - from 165 to 290 rubles;
- 50 pieces from 287 to 517 rubles;
- 100 and 120 pieces - from 587 to 820 rubles.
Cheaper analogues of the drug Calcium-D3 Nycomed
Russia produces many medicines that are a source of calcium and vitamins. Among the more affordable analogues of Calcium D3 Nycomed are:
- Complivit Calcium D3.
A Russian drug with a similar composition (calcium carbonate and colecalciferol), but at a slightly lower price.
A package of 20 tablets costs from 108 to 135 rubles, and a package containing 100 tablets can be bought for 350-395 rubles. - Calcium-Active.
Calcium-Active tablets contain organic, easily digestible calcium, extracted from the leaves of the medicinal plant amaranth, as well as phosphorus and vitamin D3. This drug is even more affordable: 40 tablets cost from 82 to 101 rubles, and 80 pieces cost 148-190 rubles. - Calcide.
Calcide is a biologically active food additive obtained from eggshells. The use of modern biotechnologies allows us to completely preserve the natural set of various microelements contained in the shell. In addition to Ca, the drug contains vitamins D, C, and group B. The price for 100 tablets is about 130 rubles.
Instructions for use:
Calcium-D3 Nycomed is a regulator of calcium-phosphorus metabolism, replenishing the lack of calcium and vitamin D3 in the body.
Calcium-D3 Nycomed belongs to the pharmacological group of correctors of the metabolism of cartilage and bone tissue in combinations, vitamins and vitamin-like agents in combinations.
pharmachologic effect
Calcium-D3 Nycomed is a combination drug of calcium and vitamin D3 (cholecalciferol), necessary in case of:
- Regulation of phosphorus-calcium metabolism;
- Replenishing calcium deficiency in hair, teeth, muscles, bones, nails;
- Reducing resorption (resorption) and increasing bone density;
- Replenishing the deficiency of calcium and vitamin D3, necessary for the mineralization of teeth;
- Regulation of muscle contractions, nerve conduction;
- Normalization of blood clotting;
- Decreased production of parathyroid hormone, which stimulates the leaching of calcium from bones.
Vitamin D3 in the preparation increases the absorption and distribution of calcium in tissues and organs. Entering the body, the components of the drug are absorbed by the gastrointestinal tract: vitamin D3 - by the small intestine, calcium - by the proximal part of the small intestine. The biological availability of calcium in the drug Calcium-D3 Nycomed is about 30%. About 1% of calcium is distributed in the extracellular space and inside cells, the rest of calcium is distributed into bone tissue. Vitamin D3 is partially metabolized by the liver into calcitriol (the active metabolite).
The active components of the drug are excreted from the body through the kidneys and gastrointestinal tract; additionally, calcium is excreted through the sweat glands.
Release form Calcium-D3 Nycomed
Calcium-D3 Nycomed – round chewable tablets, white, biconvex, without a shell, possible uneven edges and small inclusions:
- Orange flavored tablets – 20, 50, 100 pieces. Plastic bottle in cardboard packaging;
- Tablets with menthol flavor - 20, 50, 100 pieces. Plastic bottle in cardboard packaging;
- Lemon-flavored tablets (Calcium-D3 Nycomed Forte) – 30, 60, 120 pieces. Plastic bottle in cardboard packaging.
Analogues of Calcium-D3 Nycomed
Analogs of Calcium-D3 Nycomed for the active component - Calcium + vitamin D3 Vitrum, Calcium-D3-MIK, Complivit calcium D3, Natekal D3, Revital Calcium D3, Calcium D3 Classic.
Analogs of the drug according to the mechanism of action are Vitrum Osteomag, Calcohel (homeopathic), Kalcemin, Kalcemin Advance, Calcium-D3 Actavis.
Indications for use Calcium-D3 Nycomed
According to the instructions, Calcium-D3 Nycomed is prescribed for the treatment and prevention of calcium and vitamin D3 deficiency in the body in the following cases:
- Osteoporosis (menopausal, steroid, senile, idiopathic, etc.) for prevention and in combination with the main treatment;
- Osteomalacia – softening of bones as a result of impaired mineral metabolism;
- Hypocalcemia – with a decrease in the content of ionized calcium in the blood serum;
- The body's increased need for the components of the drug is a period of intensive growth in children after 12 years of age.
Calcium-D3 Nycomed during pregnancy
According to the instructions, Calcium-D3 Nycomed is recommended to be taken during pregnancy and breastfeeding to compensate for the deficiency of vitamin D3 and calcium. Hypercalcemia due to drug overdose may have an adverse effect on fetal development. The maximum daily dose of the drug components is calcium 1500 mg, and vitamin D3 600 IU.
The drug can be taken during lactation, but you should be aware that cholecalciferol and calcium can pass into breast milk. To calculate the daily dose of the drug in this case, it is necessary to take into account other sources of entry of these components into the body of the mother and child.
Calcium-D3 Nycomed during pregnancy and breastfeeding should be taken only as prescribed by the attending physician and under his supervision.
Contraindications
According to the instructions, Calcium-D3 Nycomed is not prescribed in the following cases:
- Increased individual sensitivity to the components of the drug, peanuts and soy;
- Hypervitaminosis D3;
- Hypercalcemia;
- Hypercalciuria;
- Nephrothiasis;
- Severe renal failure;
- Active form of tuberculosis;
- Phenylketonuria;
- Sarcoidosis;
- Hereditary fructose intolerance;
- Glucose-galactose malabsorption;
- Sugar-isomaltase deficiency.
Calcium-D3 Nycomed should be prescribed with caution for moderate renal failure, immobile patients, elderly people, and children under 12 years of age.
Method of use Calcium-D3 Nycomed
According to the instructions, Calcium-D3 Nycomed is taken orally, chewed or swallowed whole. Adults and children over 12 years of age: 1 tablet 2 times a day, morning and evening, during meals or according to the regimen prescribed by the attending physician, taking into account the individual characteristics of the body.
Drug interactions
According to the instructions, Calcium-D3 Nycomed, when taken simultaneously, interacts with the following drugs:
- Cardiac glycosides - the drug potentiates the toxic effects of glycosides in hypercalcemia. Monitoring serum calcium levels and ECG is necessary;
- Tetracycline drugs - calcium reduces their absorption from the gastrointestinal tract. Tetracyclines should be taken 2 hours before or 4-6 hours after taking the drug;
- Bisphosphonates - calcium reduces their absorption. Take at least one hour before the drug;
- GCS - reduce calcium absorption. It is possible to increase the dose of the drug;
- Thiazide diuretics – increase the risk of hypercalcemia. Regular monitoring of serum calcium is necessary;
- Levothyroxine - calcium reduces its absorption. The gap between doses of drugs is at least 4 hours;
- Antibiotics of the quinolone group - calcium reduces their absorption. Taken 2 hours before or 4 hours after taking the drug.
The absorption of calcium reduces the intake of foods containing oxalates and phytin. Therefore, according to the instructions, Calcium-D3 Nycomed can be taken 2 hours after eating cereals, spinach, sorrel, and rhubarb.
Side effects
When taking Calcium-D3 Nycomed, according to reviews, stomach pain, nausea, diarrhea, flatulence, and constipation are possible. Sometimes uncontrolled use of the drug can cause hypercalcemia or hypercalciuria.
With a severe overdose of Calcium-D3 Nycomed, according to reviews, it can cause thirst, polyuria, loss of appetite, nausea, vomiting, constipation, headache, weakness, dizziness, and fainting. With prolonged use, the formation of calcification of blood vessels and tissues is possible.
Storage conditions
Calcium-D3 Nycomed is stored at room temperature, in a dry place, inaccessible to direct sunlight.
Shelf life: 3 years from the date on the package.
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