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Latin name: Calcium-D3 Nycomed

ATX code: A12AX

Active substance: Calcium carbonate + Cholecalciferol

Manufacturer: Nycomed Pharma (Switzerland)

Description is valid on: 12.10.17

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The drug Calcium D3 Nycomed has been taking its place in medical practice for quite some time now. It is especially often used for.

Calcium D3 Nycomed is a drug based on two main components - calcium and vitamin D3, which is also called cholecalciferol. In turn, calcium is a vital element for teeth, bones, bone tissue, and even neurotransmission in the central and peripheral nervous system of humans.

In addition, the drug balances the synthesis of parathyrin, a failure in the production of which can result in the appearance of periodic processes of destruction of bone tissue.

Vitamin D3 promotes the formation of active primary metabolites in the liver, which accelerate metabolism in the human body.

The medicine belongs to two groups:

• stabilizer of metabolic processes in bone and cartilage tissue;
• combined vitamins and vitamin-like preparations.

Simply put, it is a medicine that regulates the exchange of ortho and pyrophosphoric acid and Ca in living cells.

Types of the drug and its composition

The drug is manufactured and available in the form of chewable tablets with lemon, orange and mint flavors.

Orange-flavored tablets are produced without a shell, round in shape and white in color. Contains Calcium-D3 Nycomed with orange contains the main substances:

• calcium carbonate – 1250 milligrams;
• vitamin D3 – 5.0 mcg (200 IU);

and minor elements:

• isomaltitol – 62.0 mg;
• glucite – 390 mg;
• orange olive – 0.97 mg;
• di and monoglycerides of carboxylic fatty acids – 0.08 mcg.

The products are produced in boxes of 20, 50, 100 pieces per box.

The mint-flavored product, which is also available on store shelves, is completely similar in composition to orange tablets.

The only difference between them is that instead of orange oil, the drug contains mint flavor essence. Available in high-density polyethylene bottles of 30 and 100 pieces.

Chewable tablets with lemon flavor are somewhat different from other types in their composition, and, more precisely, in the amount of elements they contain. They are called Calcium D3 Nycomed Forte.

Primary substances:

• calcium carbonate – 1250 mg;
• equivalent to regular Ca – 500 mg;
• cholecalciferol – 10.0 mcg (400 IU);
• colecalciferol concentrate – 4.0 mg;

and additional elements:

• Zomaltit – 49.9 mg;
• povidone (enterosorbent) – 36.4 mg;
• magnesium stearate – 6.00 mg;
• L-Aspartyl-L-phenylalanine – 1.00 mg;
• glucite – 390 mg;
• lemon oil – 0.78 mg;
• di- and monoglycerides of carboxylic fatty acids – 0.0006 mg.

The product is released in polyethylene bottles of 30, 60, 120 pieces.

Pharmacological profile

As already indicated above, the main pharmacological effect of the drug is to compensate for the lack of calcium and cholecalciferol, but this is not its only effect on the body.

Therefore, from this we can conclude that it would be entirely appropriate to prescribe a remedy for diseases of the joints and (or) bones. It is due to the increased calcium content that weakened joints and bones will draw the necessary substance to strengthen them.

Since Calcium D3 Nycomed has two separately active ingredients, they can and should also be considered separately.

Impact and effect of calcium

Thanks to the optimal dosage of calcium, when using the drug, the human body receives stable bioavailability of calcium (about 30%), which is absorbed by the sorbent in the small intestine of the human digestive system.

A larger percentage of calcium in the drug is fixed on the bones, and only one percent is distributed into the extracellular space.

As a percentage it looks like 99/1%. Of the total percentage, half of the calcium in the blood is ionized.

About 10% is associated with negatively charged particles (phosphate, citrate, etc.). The rest is in reaction with soluble protein and other proteins.

Vitamin D3

Unlike calcium, vitamin D3 is absorbed better - about 80% of the total dose. The element is absorbed in the small intestine.

In conjunction with globulin, it circulates in the human circulatory system. The transformation of the element occurs in the liver during the process of hydroxylation of 25-OH vitamin D3.

After which, there it turns into a metabolite of vitamin D3, which promotes rapid absorption of the substance (1.25 dihydroxycholecalciferol). The component of the vitamin that is not metabolized is stored in muscle and adipose tissue.

The substance is eliminated through the intestines and kidneys.

Scope of application

Often this complex is prescribed in combination with other drugs for the treatment of:

• of various etiologies;
• joint diseases in various manifestations;
• bone injuries;
• diseases associated with a deficiency of the element Ca or vitamin D3.

By and large, these tablets are prescribed by doctors as auxiliary in the complex treatment of many diseases of the musculoskeletal system.

Restrictions on the use of the drug

Despite its usefulness, there are still a number of organic problems for which the use of the drug is not recommended, or it should be used with the utmost care:

Dosage regimen depending on goals

• adults- one unit of the drug (tablet) 2-3 times a day for treatment of the disease, and one unit 2 times a day for prevention;
• teenagers under twelve years old– one tablet for 24 hours.

For children, in order to restore calcium balance, Calcium-D3 Nycomed is prescribed in the following dosages:

• from three to five years– according to the recommendations of the attending physician;
• from five to twelve years old– one or two tablets per day;
• from twelve years old– one or two tablets, twice a day.

A type of drug with the designation “Forte”

• adults– two tablets / once a day, or one 2-3 times a day;
• teenagers under twelve years of age– one unit of medicine per day.

When restoring Ca balance in children:

• from three to twelve years– one tablet per day and only as prescribed by your local doctor;
• after twelve years– two tablets per day.

During pregnancy and breastfeeding

Most often, at this time, P-H-Cholecalciferol and Ca are needed to restore the reserves of the corresponding vitamins.

The daily intake of Calcium D3 Nycomed during pregnancy should not exceed 1500 mg of calcium and 12.0 mcg of vitamin D3 per day.

During gestation, an overdose of the drug and excess Ca in the blood should not be allowed, as this has an adverse effect on the pregnant child.

During the treatment of joint and bone diseases, before using this drug, it is strictly recommended to consult with a medical specialist who will determine the degree and form of the disease and prescribe the appropriate dosage of the drug.

What are the risks of an overdose?

Exceeding the safe dose begins with 2500 mg of calcium. Overdose is manifested by the following side effects:

• pain in the bones;
• feeling of thirst;
• abdominal pain;
• arrhythmia;
• rapid fatigue;
• headache;
• nausea and vomiting;
• nephrocalcinosis.

With prolonged abuse of these tablets, kidney function is impaired.

special instructions

In addition, special attention when using the product is required for those patients who have impaired liver and kidney function. With this problem, it is necessary to monitor the amount of phosphates and calcium in the blood plasma.

Due to the fact that excess calcium is harmful to the body, when taking the drug it is necessary to pay attention to the amount of the substance obtained from other foods and medications.

Drinking alcohol during the course of taking the drug is prohibited.

Interaction with other drugs

The following points should be taken into account when using Calcium D3 Nycomed and other drugs and elements together:

Doctors' point of view

The opinion of practicing specialists is especially valuable.

Very often, Calcium D3 Nycomed was purchased by people with brittle bones and joint pain. The product is especially often purchased by people with fractures.

And indeed, the drug works, the required amount of calcium and vitamin D3 perfectly mineralizes the bone cover and increases its density.

Kiselskaya A.N., pharmacist in a pharmacy

I have been prescribing this drug to patients with fractures and dislocations for about 10 years. A successful combination of components in tablets allows bones and bone tissue not only to quickly recover, but also to become stronger.

Medzhoev Artashes Artakyan, traumatologist

From patient experience

And here is what patients write in their reviews about Calcium D3 Nycomed.

I was on my left leg, the sensation was not pleasant. The doctor prescribed this drug, and the pain in the bones seemed to disappear, but itching and rash appeared, although the dosage was not exceeded. An unclear drug, I do not recommend it.

Plesnevaya Olga Olegovna

I've been taking these tablets like vitamins for about 5 years now. When I started drinking because of pain in my elbow and knee joints, the pain disappeared and the joints became more mobile. I decided not to stop taking the drug.

Old Nadezhda Andreevna

To the main thing - the pros and cons in brief

So, having studied the reviews of doctors and people who use Calcium D3 Nycomed, we can draw conclusions in which we can emphasize the pronounced disadvantages and advantages of the product.

• effective component composition;
• pleasant taste;
• relieves cramps;
• clear effect on osteoporosis.

• high price;
• chemistry in the composition;
• bad for the liver;
• destroys the kidneys;
• unpleasant side effects.

Purchase and storage

The price of Calcium D3 Nycomed for a package of 20 tablets ranges from 192 rubles, while the cost for 50 tablets is 288 rubles.

And the largest package of 100 tablets can be purchased for 420 rubles. As a rule, Calcium D3 Nycomed Forte is always about 30-40 rubles more expensive.

The drug should be stored in a dry place, out of reach of children, at a temperature of up to 25 degrees Celsius. Dispensed without a doctor's prescription.

If your pocket is empty

Due to the high price of the product, people often look for Russian analogues of Calcium D3 Nycomed, many of which are cheaper, and therefore more accessible to a wide range of buyers:

Calcemin VS Calcium D3 Nycomed

The choice can be made by looking at the composition of both drugs, and from this we can conclude that Calcemin is stronger than its rival.

Calcemin has more than two active elements, including natural minerals copper, zinc, boron and manganese. It is thanks to its composition that the drug is more effective, but its price is an order of magnitude higher, which makes you think.

Calcium D3 Nycomed is a drug used to regulate the metabolism of phosphorus (P) and calcium (Ca) in the body.

Release form and composition Calcium D3 Nycomed

The drug can be purchased in pharmacies in the form of white chewable tablets with mint, lemon and orange flavors.

Main active ingredients: colecalciferol and calcium carbonate.

The following were used as excipients:

• in mint tablets: sorbitol, povidone, mint flavor, aspartame, magnesium stearate;
• in orange tablets: isomalt, sorbitol, magnesium stearate, povidone, aspartame, di- and monoglycerides of fatty acids, orange oil;
• in lemon tablets: isomalt, sorbitol, magnesium stearate, povidone, aspartame, di- and monoglycerides of fatty acids, lemon oil.

Pharmacological action Calcium D3 Nycomed

Calcium D3 Nycomed is a combination drug that helps regulate the processes of phosphorus and Ca metabolism in teeth, bones, hair, nails and muscles.

Ca, which is part of the drug, is an active participant in the process of regulating the conduction of nerve impulses, muscle contractions, and also participates in the process of blood clotting. Adequate calcium intake is especially necessary for women during pregnancy, breastfeeding, and children and adolescents during the growth period.

Vitamin D 3 helps improve the absorption of Ca in the intestine.

The drug increases bone density and reduces their resorption, replenishes the lack of vitamin D 3 and calcium.

Taking Ca along with vitamin D 3 prevents the increase in the production of parathyroid hormone, which causes increased leaching of calcium from bone tissue.

Indications for use Calcium D3 Nycomed

According to the instructions, Calcium D3 Nycomed is used:

• for the treatment and prevention of deficiency of Ca and vitamin D 3 in the body;
• as part of complex therapy and as a means of preventing osteoporosis.

Contraindications to the use of Calcium D3 Nycomed

According to the instructions, Calcium D3 Nycomed cannot be used for:

• severe renal failure;
• high level of sensitivity of the body to the components included in the drug, peanuts or soy;
• hypercalcemia;
• nephrolithiasis;
• hypercalciuria;
• active form of tuberculosis;
• hypervitaminosis D;
• sarcoidosis;

and also up to three years of age.

The drug should also not be taken by persons with phenylketonuria, since it contains aspartame, which is transformed in the body into phenylalanine.

It is also not recommended to take the drug for persons with glucose-galactose malabsorption, hereditary fructose intolerance, sucrase-isomaltase deficiency, since the tablets of the drug contain isomalt, sorbitol, and sucrose.

Calcium D3 Nycomed should be taken with caution during pregnancy, lactation and in the presence of renal failure.

Directions for use and dosage

The tablets are intended for oral administration. However, they can be sucked, chewed or taken with food.

Dosage:

• for the prevention of osteoporosis – 2 times a day, one tablet;
• as part of complex therapy for osteoporosis - 2-3 times a day, one tablet;
• in order to compensate for the lack of vitamin D and calcium:
• children 3-5 years old - as prescribed by a doctor;
• children 5-12 years old – 1-2 tablets per day;
• children over 12 years old and adults - 2 times a day, one tablet.

Duration of therapy:

• for osteoporosis - determined by a doctor.
• when using the drug to replenish vitamin D and Ca deficiency, the duration of the course is at least 4-6 weeks. Courses of taking the drug can be repeated throughout the year.

Side effects of Calcium D3 Nycomed

According to reviews, Calcium D3 Nycomed can cause various adverse reactions.

• Digestive system: constipation, nausea, flatulence, abdominal pain, dyspepsia, diarrhea.
• Metabolism: hypercalciuria, hypercalcemia.
• Skin and subcutaneous tissue: rash, itching, urticaria.

Overdose

According to reviews of Calcium D3 Nycomed, symptoms of drug overdose appear in the form of: anorexia, polyuria, thirst, muscle weakness, nausea, vomiting, abdominal pain, constipation, bone pain, increased fatigue, nephrocalcinosis, mental disorders, urolithiasis, cardiac arrhythmia.

With long-term use of high doses of the drug (more than 2500 mg of calcium), the following may occur: soft tissue calcification, kidney damage.

To treat an overdose, the following measures are used: gastric lavage with replenishment of lost fluid, loop diuretics, calcitonin, glucocorticosteroids, bisphosphonates.

Use during pregnancy and lactation

The drug can be used during pregnancy to compensate for the lack of calcium and vitamin D in the body.

Calcium D3 Nycomed during pregnancy can be used in doses of no more than 600 IU of vitamin D and no more than 1500 mg of calcium.

The drug can also be used during lactation, but the supply of vitamin D and Ca to the mother and child from other sources should be monitored.

Interaction with other drugs

The drug may reduce the absorption of tetracyclines and quinolones from the intestine. In this case, tetracycline and quinolone antibiotics must be taken 4-6 hours after or two hours before taking this drug.

Glucocorticosteroids reduce calcium absorption, and an increase in the dose of this drug may be required.

When taking cardiac glycosides concomitantly, hypercalcemia can cause toxic effects.

When taking the drug with bisphosphonates, the absorption of the latter may be reduced. Therefore, it is better to take them an hour before taking this drug.

Ca may reduce the effectiveness of levothyroxine. Therefore, at least 4 hours should pass between taking Calcium D3 Nycomed and levothyroxine.

When taking this drug simultaneously with thiazide diuretics, the risk of developing hypercalcemia increases.

Consumption of foods that contain oxalates and phytin (rhubarb, spinach, sorrel; cereals) reduces the absorption of Ca. In this regard, it is better to take this remedy 2 hours after consuming these foods.

special instructions

Long-term use of Calcium D3 Nycomed requires monitoring of creatinine and Ca levels in the blood serum. If hypercalcemia or renal impairment occurs, treatment should be discontinued or the dose reduced.

To prevent an overdose of Ca and vitamin D, it is necessary to control their intake from other sources.

The drug should be used with caution in immobilized patients with osteoporosis due to the risk of developing hypercalcemia.

In the presence of renal failure, the content of phosphate and calcium in the blood serum should be monitored and the possibility of developing soft tissue calcification in this category of patients should be taken into account.

Storage conditions

Calcium D3 Nycomed is stored in places with limited access to children, storage temperature is not higher than 25ºС.

Calcium is very important for the human body. Thanks to it, iron is absorbed, joints and bones are strengthened, the functioning of the nervous system improves and sleep is normalized. If there is a lack of this important element, the patient develops osteoporosis, teeth decay, and seizures occur. To compensate for calcium deficiency, you need to take medications based on this substance.

Such a unique medical product is Calcium D3 Nycomed. Thanks to this remedy, the patient will receive additional calcium and phosphate, as well as vitamin D3.

Description of the medical product

It is produced in the form of chewable strips with orange, lemon and mint flavors.

The medicine contains the following substances:

• Calcium carbonate 1250 mg, which corresponds to regular calcium 500 mg in one tablet;
• Colecalciferol or vitamin D3 in the amount of 200 IU.

Answer to the question: read here.

The product is available in plastic bottles 30, 60 and 120 pieces each. The tablet is round, convex with small inclusions and uneven edges.

pharmachologic effect

Refers to the form of drugs with combined substances, in which contains calcium and vitamin D3. As you know, calcium is necessary for the formation of bone tissue, the normal functioning of joints and cartilage, and for dental health. Once in the stomach, the drug is evenly distributed throughout the body.

When taken orally, the drug is completely absorbed in the stomach and intestines. The bioavailability of tablets is approximately 30 percent. The drug is mainly metabolized in the liver to form metabolites. The active substances in the drug are excreted in urine and feces, and calcium is excreted through the sweat glands.

The drug is eliminated from the body within 24 hours. In this case, there is no irritation of the intestinal mucosa.

Indications

• Prevention of osteoporosis;
• Replenishment of vitamin D3 and calcium deficiency;
• Prescribed in combination with other drugs in the treatment of osteoporosis;
• Prevention of fractures and injuries of bones and joints.

Contraindications

• Severe pathology of the liver and kidneys;
• High content of vitamin D3 in the body;
• Hypersensitivity to the components of the drug;
• Sarcoidosis;
• Tuberculosis;
• Phenylketonuria;
• Urolithiasis disease;
• Children under 5 years old;
• Elderly people.

Dosage and course of treatment

Calcium tablets D3 Nycomed are prescribed for oral administration. The medicine has a pleasant orange, mint or lemon scent, which can be swallowed whole or chewed.

The remedy can be taken at any time and does not depend on food intake. The course of treatment depends on the severity of the disease and the individual characteristics of the patient’s body. Children over 12 years old and adults Prescribe one tablet once or three times a day. The dosage is determined only by the doctor after examining and examining the patient.

Children over five and under 12 years old The medicine is prescribed to take one tablet once or twice a day. In the presence of osteoporosis in combination with other drugs, the drug is prescribed in a dose of one tablet two or three times a day.

To replenish vitamin D3, adults and children over 12 years of age are recommended to take two tablets per day. From 5 to 12 years, one tablet per day.

Overdose

When treated with the drug in large doses for a long period, hypercalcemia may develop.

Symptoms of the disease are:

• Vomiting reflex;
• Migraine;
• Feeling dizzy;
• Lack of appetite;
• Increased weakness;
• The creatinine level in the blood increases and the patient may fall into a coma;
• Kidney failure.

At the first signs of overdose the patient is stopped taking the drug, the body is saturated with plenty of fluid and prescribed to take a special diet with a small calcium content. In more severe cases, it is necessary to prescribe somatic treatment and hormonal therapy.

Concomitant use with other groups of drugs

• Other drugs containing calcium and vitamin D3;
• Tetracycline antibiotics;
• Barbiturates;
• Corticosteroids;
• Laxatives;
• Diuretics.

Side effects

The drug is usually well tolerated, but in rare cases the following effects may occur:

• Diarrhea;
• Lack of appetite;
• Nausea, vomiting;
• Stomach ache;
• The development of allergic reactions, which manifest themselves in the form of rashes and itching on the skin.

Drug price

The approximate price in the Russian Federation for the drug Calcium D3 Nycomed is:

• Tablets in a package of 30 pieces - 239 rubles;
• 50 pieces per package – 317 rubles;
• 100 pieces each – 522 rubles;
• 20 pieces each – 171 rubles.

The cost of the drug may vary in different pharmacies. The drug is produced in Norway and has a pleasant taste and is quite easy to use.

Reviews about the drug

Combination tablets are in great demand among patients and doctors. Patients note that the tablets are convenient to take, they are tasty and do not cause heartburn.

In a short period Pain in joints and teeth ceases to bother you, which is characteristic of osteoparosis. Reviews from doctors are also highly rated. In the former, calcium and vitamin D3 in combination have a more pronounced effect.

Pharmacokinetic features, positive effects and quick results allow us to call This remedy is one of the best among the other drugs in the group.

Calcium D3 Nycomed - cheaper analogues

Pharmaceutical companies produce cheaper analogues of the drug Calcium D3 Nycomed:

• Complivit calcium D3;
• Calcide;
• Calcium is an asset;
• Calcium gluconate.

All of them are used to treat osteoporosis and prevent it.

Complivit calcium D3

Available in the form of chewable tablets with orange and mint flavors.

The drug contains the following substances:

• Calcium 500 mg;
• Vitamin D3 400 IU.

Refers to calcium-phosphate metabolic regulators. The medicine has a round, slightly rough shape with a white or slightly creamy color.

Restores calcium and phosphate metabolism, reduces bone and joint wasting and increases bone density. Complements the lack of calcium and vitamin D3 in the body.

Calcium is necessary for the functioning of the following systems:

• Forms bone tissue;
• Increases blood clotting;
• Carries out the transmission of nerve impulses;
• Supports the stability of the heart and blood vessels.

Indications:

• Prevention and treatment of osteoporosis and its complications during menopause, taking hormones;
• Replenishment of vitamin D3 and calcium deficiency.

Vitamin D3 helps:

• Helps calcium to be well absorbed in the intestines;
• Participates in the mineralization of bone tissue and teeth.

The drug Complivit calcium D3 is prescribed for the prevention and treatment of osteoporosis.

Price:

• The price for 30 tablets is 249 rubles;
• The cost of 100 tablets is 403 rubles.

The medicine is produced by Pharmstandard in the Russian Federation.

Calcide

The biologically active supplement is produced in the form of capsules and tablets. The medicine contains eggshell calcium, vitamins B, C, PP, E, A and D.

Eggshells contain large amounts of calcium and trace elements, which provide metabolic processes in the human body. The dietary supplement Calcide is produced by processing eggshells, which allows it to retain all its beneficial properties.

Additional vitamins are added to the drug. Therefore the remedy considered a source of natural calcium with a high content of vitamins.

Indications:

• Replenishment of calcium and vitamin D3 deficiency;
• Prevention and treatment of osteoporosis;
• Increased immunity;
• Strengthening the blood vessels of the heart;
• Normalizes the functioning of the nervous and endocrine systems.

The cost for a package of 100 tablets in Russia is approximately 141 rubles. The medicine is produced in the Russian Federation by the company Comfort Complex.

Calcium-active

Available in tablet form and used as a dietary supplement to food. The medicine contains 50 mg of calcium and 50 IU of vitamin D3. Tablets are packaged in plastic containers 40 and 80 pieces each in each.

The drug contains a calcium metabolism regulator. Normalizes the normal functioning of the structure and destruction of bone tissue. Calcium in the drug is easily and quickly absorbed. His made from the amaranth plant where calcium is available in large quantities. This allows you to replenish calcium deficiency in the body. Vitamin D3 and phosphorus improve the absorption of calcium, which enters the body with food. It is prescribed for various pathologies of the musculoskeletal system.

Indications:

• As an additional source of calcium and vitamin D3;
• Comprehensive treatment and prevention of osteoporosis;
• Patients with diseases of the gums and teeth;
• For teenagers to improve growth;
• Frequent fractures and joint problems.

The price of tablets in Russia is 146 rubles for 80 tablets, which are packaged in plastic containers.

Calcium gluconate

The medicine is available in powder, tablets and ampoules with solution.

The product includes:

• Calcium salt of gluconic acid;
• A white granular powder that dissolves quickly in hot water and slowly in cold.

Action:

• Replenishes calcium deficiency in the body, which is involved in the transmission of nerve impulses, in the formation of bone tissue and teeth, and blood clotting;
• Also prescribed to relieve intoxication;
• Is an anti-inflammatory agent;
• Antiallergic;
• Hemostatic.

Belongs to the group of macro- and microelements. Its approximate cost in Russia is from 4 to 398 rubles depending on the release form and packaging.

Indications:

• Allergy of unknown etiology;
• Hepatitis;
• Dermatological pathologies;
• Bleeding;
• Liver damage.

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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.

For a complete list of excipients, see the “List of excipients” section.

Description

Round, biconvex, white, uncoated tablets. May have small inclusions and uneven edges. There may be a small amount of powder at the bottom of the bottle.

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Indications for use

Prevention and treatment of vitamin D and calcium deficiency.

Meeting vitamin D and calcium requirements as an adjunct to specific osteoporosis therapy in patients at risk of vitamin D and calcium deficiency.

Directions for use and doses

Dosage regimen

Adults, including elderly patients

Complementary therapy for osteoporosis

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 the active substances or to any of the excipients listed in the “List of excipients” section. - Severe renal failure (glomerular filtration rate< 30 мл/мин/1,73 м 2). - Заболевания и/или состояния, приводящие к гиперкальциемии и/или гиперкальциурии. - Почечнокаменная болезнь (нефролитиаз). - Гипервитаминоз D.

Special instructions and precautions

During long-term treatment, it is necessary to monitor serum calcium levels and monitor renal function by determining serum creatinine. Monitoring is especially important for elderly patients receiving concomitant treatment with 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.

When used concomitantly with other sources of vitamin D and/or drugs or nutrients (such as milk) containing calcium, there is a risk of developing hypercalcemia and milk-alkali syndrome with subsequent impairment of renal function. 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 the increased risk of hypercalcemia.

Calcium-D3 Nycomed contains isomalt (E953) and sucrose. Patients suffering from rare hereditary disorders such as fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not take this drug. With long-term use, sucrose can have a negative effect on tooth enamel.

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 medications should be administered at least two hours before or 4 to 6 hours after oral calcium intake.

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 the absorption of fat-soluble vitamins (eg 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 pass 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.

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; persistent headache; prolonged loss of appetite; nausea or vomiting; unusual fatigue 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 of developing hyperphosphatemia, nephrolithiasis and nephrocalcinosis (see section "Special instructions and precautions").

Reporting suspected adverse reactions

It is important to report suspected adverse reactions after registration of a medicinal product to ensure continuous monitoring of the benefit-risk relationship of the medicinal product.

If an undesirable reaction occurs, either listed or not mentioned in these instructions for medical use, patients are advised to consult their doctor.

Medical professionals and patients are recommended to report any suspected adverse reactions of the drug to the Republican Unitary Enterprise “Center for Expertise and Testing in Healthcare” (see section “Send information about adverse reactions to the address”).

Overdose

Symptoms

Overdose can lead to hypercalcemia and hypervitaminosis of vitamin D. 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. Persistently high calcium levels can lead to 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, renal function and diuresis is mandatory. In severe cases, ECG and central venous pressure should be monitored.

Pharmacotherapeutic group

Mineral supplements. Combinations of calcium with vitamin D and/or other agents.

ATX code: A12AX

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. A clinical study in patients suffering from vitamin D deficiency showed that taking two daily calcium 500 mg/vitamin D 400 IU tablets for 6 months normalized 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 the 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 of fatty acids

Chewable tablets 500 mg/200M.E. with tasteorange.

20, 50 or 100 tablets in a bottle made of high-density polyethylene, sealed with a screw cap, under which there is a ring for tearing off the sealing gasket, ensuring first opening control.

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.