Combination drug, regulating 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 fatty acids- 0.0008 mg.

20 pcs. - polyethylene bottles high density(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.

The drug Calcium D3 Nycomed has occupied an important place in medical practice for a long time. The medicine is practically irreplaceable for diseases of the joints and bones; doctors often prescribe the drug for regular injuries of various origins and when complications of chronic diseases occur.

The vitamin preparation corresponds to two groups in its effect:

• stabilizes metabolism in bones and cartilage;
• the composition is a combination of vitamins.

The drug is responsible for the correct exchange of orthophosphoric and pyrophosphoric acids, as well as the content of macronutrients in living cells.

Types of vitamin preparation

Chewable vitamin complex tablets come in different flavors: lemon, orange and mint. Capsules differ depending on the flavoring agent included in the composition.

Orange is available in jars with different amounts of vitamins contained in the package: 20, 50 and 100 pieces. White oval dragees do not have a shell.

The composition of mint and orange preparations is almost identical, except that one contains orange oil, and the other, respectively, mint essence. Released in bottles of 30 and 100 pieces.

Chewable vitamins with lemon differ in appearance and composition. Their name also changes; the drug with lemon is called Calcium D3 Nycomed Forte. Its composition, in addition to citric acid, contains a different number of components. There are also minor differences in the form of release: bottles contain 30, 60 or 120 pieces.

pharmachologic effect

It has already been mentioned that the main action is aimed at compensating for the lack of macroelements in the body, but this is not the entire pharmacological effect that the drug has on humans.

The drug is prescribed exclusively for joint ailments and bone diseases. Due to the main active component, thinned bones and cartilage tissue will be restored and strengthened.

It is worth considering in more detail the effects of the active components:

• Calcium. The optimal dose contained in the drug allows the human body to replenish the availability of the macronutrient (approximately 30%), which is subsequently absorbed by the sorbent in the small intestine.

Most of the element is deposited on the bones, but only 1% of it is evenly distributed into the extracellular space. Therefore, the percentage ratio is approximately the following: 99% to 1%, with half of the substance contained in the bloodstream in ionized form.

About 10% is associated with phosphate, citrate and other elements. The residues are combined with soluble protein and other proteins.

Excreted through the kidneys and urinary canals.

• Vitamin D3. Absorption occurs an order of magnitude better - up to 80% of the taken amount is absorbed in the small intestine. Combining with globulin, vitamin D3 is absorbed into the human blood and converted in the liver. In the liver, it turns into a metabolite, which accelerates the absorption of the substance. The remaining substance is absorbed into muscles and fatty tissues.

It is excreted through the human intestines and kidneys.

Indications for use

This combination complex is usually used together with other medications aimed at treating various diseases.

This is a disease characterized by brittle bones. Usually only older people are at risk, but with the acceleration of the pace of life, similar changes are observed in the younger generation, moreover, the progression of the disease occurs twice as fast. In other words, for people of retirement age these are normal age-related changes.

Reasons provoking the appearance and intensive development of the disease:

• female;
• thin bone tissue;
• age over 60 years;
• heredity.

These factors cannot be changed to prevent the disease from developing. However, there are those that can be influenced:

• macronutrient deficiency;
• some medications;
• passive lifestyle;
• bad habits;
• overweight.

The main danger lies in the fact that the disease is completely asymptomatic - a person may not be aware of it until he gets a fracture. The only symptoms are back pain, stooped posture, spinal deformity, and significantly low weight relative to height.

As a result of the development of the disease, serious complications develop: pathological fractures that do not heal for a long time, external defects, and difficulty moving.

Diseases of the musculoskeletal system

The predominantly inactive lifestyle of modern people leads to the development of many joint diseases:

• ankylosis - joint immobility;
• arthralgia - flying pain that occurs periodically;
• arthropathy is a secondary symptom of many diseases;
• chondrocalcinosis - salt deposition;
• Bekhterev's disease - loss of normal curves of the ridge;
• gout is a metabolic disorder;
• arthrosis or osteoarthrosis is a chronic disease that causes joint deformation;
• hemarthrosis - bleeding into the joint cavity;
• osteochondrosis - degeneration, dystrophy of joints.

Inflammatory joint diseases:

• arthritis is an inflammatory process, Still's disease is a type of it that appears in children under 16 years of age, Felty's syndrome is a complication of the rheumatoid form;
• infectarthritis - affects small synovial joints;
• periarthritis - inflammation of periarticular tissues;
• synovioarthritis, or synovitis - inflammation of the synovial membrane inside the capsule;
• spondyloarthritis - inflammation of the intervertebral joints;
• hip dysplasia - underdevelopment;
• bursitis - inflammation of the mucous membranes.

Characteristic symptoms are pain, discomfort (ache), redness, swelling of the skin, difficulty moving. Fever is characteristic of inflammatory infectious processes.

Bone injuries (fractures)

Fractures can be open or closed. Characteristic for closed bone injuries is the occurrence of swelling, redness of the skin, hematomas; for open ones - lacerations with bone fragments.

Lack of content.

Hypocalcemia is a condition of the body with a deficiency of a macronutrient.

The causes of the disease may be the following:

• congenital genetic changes;
• diseases of the circulatory system;
• cancer of the parathyroid glands, metastases;
• lack of vitamin D.

The symptoms of the disease are varied: people with a lack of calcium and vitamin D are characterized by constant weakness and fatigue. The condition of the skin and nail plates worsens: the skin dries out, often peels, and nails break. Calcium deficiency affects teeth - caries develops.

In addition, the deficiency affects the neuromuscular system, causing cramps and bone pain. Heart problems arise because the macronutrient is needed to contract the heart muscle. With chronic hypocalcemia, cataracts develop.

Immune defense and skin coagulability are significantly reduced, and in case of wounds it is not possible to stop bleeding for a long time. Heart failure develops.

Calcium D3 Nycomed is prescribed by many doctors as an auxiliary drug in the treatment of diseases of the musculoskeletal system.

Application and contraindications for use

• Application:

To treat the resulting deficiency, you need to drink Calcium D3 Nycomed, 1 tablet twice a day for children from 12 years of age and for adults; 1 tablet once a day for children from 5 to 12 years. The dosage for young children is prescribed by the attending physician, however, it is not advisable to take the drug for children under 3 years of age. The duration of taking the drug is from 4 to 6 weeks.

Treatment of diseases of the musculoskeletal system has some nuances; the attending physician prescribes mainly taking Calcium D3 Nycomed Forte, 1 piece three times a day. As a preventive measure, take a tablet twice a day. The duration of treatment is calculated individually.

Pregnant women, if it is necessary to compensate for the deficiency of calcium and vitamin D3, are prescribed an individual dosage, since excess calcium can negatively affect the growth of the fetus.

The chewable drug is used during or after meals. The vitamin can be chewed or washed down.

• Contraindications:

Do not take if there is a possibility of an allergic reaction to the components, or if there is an intolerance to some components. The drug is also contraindicated if there is a high content of vitamin D and calcium, or if there are stones in the kidneys or bladder. It is not recommended to take Calcium D3 Nycomed Forte for chronic kidney disease or tuberculosis.

• Side effects:

Metabolism is disrupted - an excess of calcium and vitamin D, gastrointestinal ailments appear. Skin allergies may occur with accompanying symptoms: redness, hives, itching and a small rash.

It is necessary to consult a doctor about how to properly take calcium, even though it is a vitamin. Reviews from people who took the vitamin complex vary: some talk about obvious side effects, others talk about overdoses. For example, one of these reviews: “I’ve been taking this vitamin complex for a month now, it really works. In just a month, my teeth became stronger, bruises began to heal faster, and my hair even grew a couple of centimeters. However, we started taking it at the same time as my friend, and her situation is completely opposite: she has problems with her intestines. And they stopped almost immediately after she stopped taking vitamins.”

Analogues of the drug

Similar vitamin complexes that can replace taking Calcium D3 Nycomed: Complivit, Ideos, Natekal D3. All of them are prescribed to prevent calcium deficiency in the development of diseases of the musculoskeletal system. However, the analogues differ in purpose, affecting the condition of the joints rather indirectly, without having the same extensive effect.

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.

Prescribe 1 tablet of the drug 2 times a day, children 5-12 years old - also 1 tablet of “Calcium-D3 Nycomed” 1-2 times a day. The dosage for 3-5 years is determined by the pediatrician. The duration of treatment for vitamin deficiency is 4-6 weeks. Repeated courses are recommended after consulting a doctor.

When treating osteoporosis, 1 tablet of the drug is prescribed three times a day. To prevent osteoporosis - 1 tablet 2 times a day. The duration of treatment is determined individually, depending on the severity of the condition. Pregnant women are advised to strictly adhere to the dosage prescribed by the doctor, since excess calcium can adversely affect the development of the fetus.

The drug can be taken with meals or on its own. The tablets can be dissolved, chewed or swallowed with water.

Contraindications and precautions

The drug should not be taken if you are hypersensitive to any of its components, including sucrose and fructose. This drug is contraindicated in case of hypervitaminosis of vitamin D, hypercalcemia, urolithiasis accompanied by the presence of calcium stones. The drug is also contraindicated in cases of severe renal failure, sarcoidosis, phenylketonuria, and active tuberculosis. The drug is not prescribed to children under 3 years of age.

When using Calcium-D3 Nycomed simultaneously with cardiac drugs and diuretics, regular monitoring of calcium levels in the blood serum is necessary. Antibiotics must be taken separately from the calcium supplement with an interval of at least 3 hours. Concomitant use with laxatives reduces the absorption of vitamin D.

Foods such as sorrel, spinach, rhubarb and cereals reduce calcium absorption. After using them, it is recommended to take the drug no earlier than 2 hours later.

Side effects

When treating with Calcium-D3 Nycomed, adverse reactions may occur in the form of hypercalcemia, hypercalciuria, flatulence, or stomach pain, as well as skin allergies (urticaria, itching, rash).

In some cases, drug problems may occur. Its signs are thirst, nausea, muscle weakness, pain, increased fatigue, urolithiasis, cardiac arrhythmia. If symptoms of overdose appear, you need to stop taking the drug itself, as well as cardiac and diuretic drugs (if they were present), do a gastric lavage, replenish the loss of fluid in the body and consult a doctor.

Tip 2: How to take calcium D3 Nycomed during pregnancy

Calcium supplemented with vitamin D3 is a drug intended to replenish calcium deficiency and regulate phosphorus-calcium metabolism. During pregnancy, a lack of these elements may occur, which is manifested by the occurrence of cramps in the limbs, back pain, tooth decay, and hair loss.

You will need

• - blood analysis;
• - doctor’s recommendation;
• - chewable calcium tablets D3 Nycomed.

Instructions

During pregnancy, any pharmaceutical drugs, including vitamins, should be taken only on the recommendation and prescription of a doctor. If you notice that you are experiencing symptoms of calcium deficiency, ask for a referral for a blood test. Based on this examination, you will be prescribed appropriate vitamin complexes or calcium D3 Nycomed.

Your doctor should take into account that if there is a lack of calcium, the growing fetus will replenish the microelement from the mother's body. This, in turn, will lead to the woman’s hair falling out, teeth decaying, and nails becoming brittle. In addition, calcium deficiency increases the synthesis of parathyroid hormone, which inevitably leads to excessive bone resorption.

When prescribing calcium D3 Nycomed during pregnancy, the daily dose of calcium should not exceed 1500 mg, vitamin D3 (cholecalciferol) - 600 IU, so more than one chewable dose is not worth it.

As a rule, the drug is quite well tolerated. And only in isolated cases may pain in the epigastric region, nausea, and disturbances in appetite and bowel movements occur. Itching, urticaria and skin rash are symptoms that occur in patients with individual intolerance to the components of calcium D3 Nycomed.

Name: Calcium-D3 Nycomed

Active substance

Calcium carbonate + Colecalciferol*

ATX

A12AX Calcium supplements in combination with vitamin D and/or other medications

Pharmacological groups

• Calcium-phosphorus metabolism regulator [Correctors of bone and cartilage tissue metabolism in combinations]
• Calcium-phosphorus metabolism regulator [Vitamins and vitamin-like products in combinations]

Compound

Description of the dosage form

Round, biconvex, uncoated, white tablets with orange or mint flavor. May have small inclusions and uneven edges.

pharmachologic effect

Pharmacological effect - replenishes the deficiency of calcium and vitamin D3.

Pharmacodynamics

A combined drug that regulates the exchange of calcium and phosphorus in the body (bones, teeth, nails, hair, muscles). Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium and vitamin D3 in the body, necessary for the mineralization of teeth. Calcium is involved in the regulation of nerve conduction, muscle contractions and is considered a component of the blood coagulation system.

Vitamin D3 increases calcium absorption in the intestines. The use of calcium and vitamin D3 interferes with the production of parathyroid hormone (PTH), which is thought to stimulate increased bone resorption (the leaching of calcium from the bones).

Pharmacokinetics

Calcium

Suction. Often, the amount of calcium absorbed in the gastrointestinal tract is somewhere around 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 a physiologically active ionized form, of which about 10% is complexed with citrate, phosphate or other anions, the remaining 40% is associated with proteins, primarily albumin.

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

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 bound to 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 1,25-hydroxycolecalciferol. 1,25-hydroxycolecalciferol is considered a metabolite responsible for increasing calcium absorption.

Unmetabolized vitamin D3 is stored in adipose and muscle tissue.

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

Indications for the drug Calcium-D3 Nycomed

prevention and treatment of calcium and/or vitamin D3 deficiency;

prevention and complex therapy of osteoporosis and its complications.

Contraindications

hypersensitivity to the components of the drug;

hypersensitivity to soy or peanuts;

hypercalcemia, hypercalciuria;

nephrolithiasis;

hypervitaminosis D;

severe renal failure;

active form of tuberculosis;

sarcoidosis;

children's age (up to 3 years).

Carefully:

pregnancy;

lactation period.

renal failure.

Calcium-D3 Nycomed contains aspartame, which is transformed into phenylalanine in the body. Therefore, the drug should not be taken by patients with phenylketonuria.

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.

Use during pregnancy and breastfeeding

Calcium-D3 Nycomed is used during pregnancy to replenish calcium and vitamin D deficiency in the body.

The daily dosage should not exceed 1500 mg of calcium and 600 IU of vitamin D3.

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

Calcium-D3 Nycomed is used during lactation.

Vitamin D and its metabolites can pass into breast milk, so the intake of calcium and vitamin D from other sources in the mother and baby must be considered.

Side effects

Itching, rash, urticaria, gastrointestinal dysfunction (constipation or diarrhea, flatulence, nausea, abdominal pain, dyspepsia), hypercalcemia and hypercaliciuria.

Interaction

Hypercalcemia may potentiate the toxic effects of cardiac glycosides when used concomitantly with calcium and vitamin D medications. Monitoring of ECG and serum calcium levels 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 Calcium-D3 Nycomed.

To prevent decreased absorption of bisphosphonate drugs, it is recommended to take them at least an hour before taking Calcium-D3 Nycomed.

GCS reduce calcium absorption, so treatment with GCS may require an increase in the dosage of Calcium-D3 Nycomed.

With the simultaneous use of thiazide diuretics, the risk of hypercalcemia increases, because they increase tubular reabsorption of calcium. When using thiazide diuretics simultaneously, 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-D3 Nycomed should be at least 4 hours.

The absorption of quinolone antibiotics is reduced when used simultaneously with calcium medications. Therefore, quinolone antibiotics should be taken 2 hours before or 6 hours after taking Calcium-D3 Nycomed.

Ingestion of foods containing oxalates (sorrel, rhubarb, spinach) and phytin (cereals) reduces the absorption of calcium, so you should not take Calcium-D3 Nycomed within 2 hours after eating sorrel, rhubarb, spinach, cereals.

Directions for use and doses

In complex therapy of osteoporosis: adults - 1 tablet. 2-3 times a day; to prevent osteoporosis - 1 table. 2 times a day.

For calcium and vitamin D deficiency: adults and children over 12 years old - 1 tablet. 2 times a day; children from 5 to 12 years old - 1–2 tablets. in a day; 3–5 years - dosage in accordance with doctor’s recommendations.

Special patient groups

Patients with impaired liver function. No dosage adjustment is required.

Patients with impaired renal function. The drug Calcium-D3 Nycomed should not be used in case of severe renal failure.

Elderly patients. The dosage is the same as for adults. A possible decrease in creatinine clearance should be taken into account.

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 replenish calcium and vitamin D3 deficiency, the average duration of treatment is at least 4–6 weeks. The number of repeat 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 long-term use of excessive doses (over 2500 mg of calcium) - kidney damage, soft tissue calcification.

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

Treatment: gastric lavage, fluid replacement, use loop diuretics(in particular 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 (CVP) and ECG monitoring are necessary.

special instructions

During long-term therapy, serum calcium and creatinine levels should be monitored.

Monitoring is especially important in elderly patients during simultaneous treatment with cardiac glycosides and diuretics (see “Interaction”) and in patients with an increased tendency to form kidney stones. In cases of hypercalcemia or signs of renal dysfunction, 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. You also need to consider the risk of soft tissue calcification.

To avoid overdose, additional vitamin D intake from other sources must be taken into account.

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 often not recommended, or should be done with caution (see “Interactions”).

Release form

Chewable tablets (orange). 20, 50 or 100 tablets. in a HDPE bottle, sealed with a screw cap, under which there is a ring for tearing off the sealing gasket, ensuring control of the first opening. 1 fl. placed in a cardboard box.

Chewable tablets (mint). 30 or 100 tablets. in a HDPE bottle, sealed with a screw cap, under which there is a ring for tearing off the sealing gasket, ensuring control of the first opening. 1 fl. placed in a cardboard box.

Manufacturer

Nycomed Pharma AS, Norway.

Conditions for dispensing from pharmacies

Over the counter.

Storage conditions for the drug Calcium-D3 Nycomed

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

Keep out of the reach of children.

Shelf life of the drug Calcium-D3 Nycomed

Do not use after the expiration date stated on the package.