The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health

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Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Calcium is an essential nutrient found in many foods, such as dairy products. The bones and teeth contain over 99% of all calcium in the human body.

Bones are always breaking down and rebuilding. Calcium is needed for this process, but the concentration of calcium in the body tends to decline with age. Taking extra calcium helps the bones rebuild and stay strong. The heart, nerves, and blood-clotting systems also need calcium.

People commonly take calcium by mouth for the treatment and prevention of low calcium levels, muscle cramps, osteoporosis, softening of the bones, and PMS. It is also used for high blood pressure, cancer, stroke, and many other conditions, but there is no good scientific evidence to support many of these other uses.

In the US and Canada, foods that contain calcium and vitamin D are allowed to state that they might reduce the risk of osteoporosis.

Uses & Effectiveness ?

Effective for

• Indigestion (dyspepsia). Taking calcium carbonate by mouth as an antacid is effective for treating indigestion.
• High levels of potassium in the blood (hyperkalemia). Giving calcium gluconate by IV can reverse heart problems caused by high potassium levels. IV products can only be given by a healthcare provider.
• Low levels of calcium in the blood (hypocalcemia). Taking calcium by mouth and by IV is effective for treating and preventing low calcium levels. IV products can only be given by a healthcare provider.
• Kidney failure. Taking calcium carbonate or calcium acetate by mouth is effective for controlling high phosphate levels in the blood in people with kidney failure. Taking calcium by mouth also seems to help reduce blood pressure in people with kidney failure.

Likely Effective for

• Bone loss in people taking drugs called corticosteroids. Taking calcium and vitamin D by mouth seems to reduce bone density loss in people using corticosteroid drugs long-term.
• Overactive parathyroid (hyperparathyroidism). Taking calcium by mouth reduces parathyroid hormone levels in people with kidney failure and parathyroid hormone levels that are too high.
• Weak and brittle bones (osteoporosis). Consuming adequate amounts of calcium, both from the diet and supplements, is effective for preventing bone loss and treating osteoporosis. Taking calcium by mouth, alone or with vitamin D, also helps prevent fractures in people with osteoporosis.
• Premenstrual syndrome (PMS). Consuming adequate amounts of calcium, both from the diet and supplements, seems to significantly reduce mood swings, bloating, food cravings, and pain.

Possibly Effective for

• Colon cancer, rectal cancer. Taking calcium supplements by mouth or increasing intake from the diet seems to reduces the risk of colorectal cancer. But people with low levels of vitamin D don’t seem to benefit from calcium supplements, nor do people who are overweight or obese.
• Increasing bone strength in the unborn baby. Taking calcium supplements by mouth during pregnancy increases the bone mineral density of the baby when calcium intake from the diet is low.
• High blood pressure. Taking calcium supplements by mouth seems to reduce blood pressure by a small amount in people with or without high blood pressure.
• Softening of the bones (osteomalacia). Taking calcium by mouth seems to help reverse softening of the bones caused by very low calcium intake.
• A pregnancy complication marked by high blood pressure and protein in the urine (pre-eclampsia). Taking 1-2 grams of calcium by mouth daily seems to reduce the risk of pregnancy-related high blood pressure. It seems to be most helpful in those who are high risk and have low calcium levels.
• Softening of bones in children, often due to vitamin D deficiency (rickets). Taking calcium by mouth seems to help reverse softening of the bones in children with very low calcium intake.
• Preventing tooth loss (tooth retention). Taking calcium and vitamin D by mouth appears to help prevent tooth loss in older people.

Possibly Ineffective for

• Breast cancer. Taking calcium by mouth doesn’t reduce the risk for breast cancer.
• Fractures. Taking calcium by mouth, alone or with vitamin D, doesn’t seem to prevent fractures in older people who do not have osteoporosis.
• Obesity. Taking calcium by mouth doesn’t seem to help with weight loss.
• Death from any cause. Taking calcium supplements by mouth doesn’t seem to reduce the overall risk of death.

Side Effects

When taken by mouth: Calcium is likely safe when used in recommended amounts of about 1000-1200 mg daily. Calcium can cause some minor side effects such as belching or gas. But calcium is possibly unsafe when taken in doses above the daily tolerable upper intake level (UL). The UL is 2500 mg for adults ages 19-50 years and 2000 mg for adults over 50 years. Taking more than this daily can increase the chance of having serious side effects.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Calcium is likely safe when taken by mouth in recommended amounts. But calcium is possibly unsafe when taken by mouth in doses above the daily tolerable upper intake level (UL). The UL is 3000 mg for those under 18 years of age and 2500 mg for those over 18 years of age. Higher doses might increase the risk of seizures in the infant. Be sure to consider total calcium intake from both dietary and supplemental sources of calcium. Avoid taking more than 1000-1200 mg of calcium from supplements daily unless prescribed by your doctor.

Children: Calcium is likely safe when taken by mouth in recommended amounts. But calcium is possibly unsafe when taken by mouth in doses above the daily tolerable upper intake level (UL). The UL is 1000 mg for those 0-6 months old, 1500 mg for those 6-12 months old, 2500 mg for those 1-8 years old, and 3000 mg for those 9-18 years old. Children should consume enough calcium to meet daily requirements, but should not consume extra calcium.

Low acid levels in the stomach (achlorhydria): People with low levels of gastric acid absorb less calcium if calcium is taken on an empty stomach. People with low acid levels should take calcium supplements with meals.

Too much calcium in the blood (as in parathyroid gland disorders and sarcoidosis): Calcium should be avoided if you have a condition that causes high calcium levels. Taking calcium supplements can cause calcium levels to increase even more.

Kidney disorders: In people with kidney disorders, taking calcium supplements can increase calcium levels too much. Speak with a healthcare provider before taking calcium supplements.

Smoking: People who smoke absorb less calcium from the stomach and might require calcium supplements.

Stroke: Taking calcium supplements for 5 or more years might increase the chance of developing dementia in people who have had a stroke. More research is needed to know if calcium supplements should be avoided after a stroke.

Special Precautions and Warnings

When taken by mouth: Calcium is likely safe when used in recommended amounts of about 1000-1200 mg daily. Calcium can cause some minor side effects such as belching or gas. But calcium is possibly unsafe when taken in doses above the daily tolerable upper intake level (UL). The UL is 2500 mg for adults ages 19-50 years and 2000 mg for adults over 50 years. Taking more than this daily can increase the chance of having serious side effects.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Calcium is likely safe when taken by mouth in recommended amounts. But calcium is possibly unsafe when taken by mouth in doses above the daily tolerable upper intake level (UL). The UL is 3000 mg for those under 18 years of age and 2500 mg for those over 18 years of age. Higher doses might increase the risk of seizures in the infant. Be sure to consider total calcium intake from both dietary and supplemental sources of calcium. Avoid taking more than 1000-1200 mg of calcium from supplements daily unless prescribed by your doctor.

Children: Calcium is likely safe when taken by mouth in recommended amounts. But calcium is possibly unsafe when taken by mouth in doses above the daily tolerable upper intake level (UL). The UL is 1000 mg for those 0-6 months old, 1500 mg for those 6-12 months old, 2500 mg for those 1-8 years old, and 3000 mg for those 9-18 years old. Children should consume enough calcium to meet daily requirements, but should not consume extra calcium.

Low acid levels in the stomach (achlorhydria): People with low levels of gastric acid absorb less calcium if calcium is taken on an empty stomach. People with low acid levels should take calcium supplements with meals.

Too much calcium in the blood (as in parathyroid gland disorders and sarcoidosis): Calcium should be avoided if you have a condition that causes high calcium levels. Taking calcium supplements can cause calcium levels to increase even more.

Kidney disorders: In people with kidney disorders, taking calcium supplements can increase calcium levels too much. Speak with a healthcare provider before taking calcium supplements.

Smoking: People who smoke absorb less calcium from the stomach and might require calcium supplements.

Stroke: Taking calcium supplements for 5 or more years might increase the chance of developing dementia in people who have had a stroke. More research is needed to know if calcium supplements should be avoided after a stroke.

Interactions ?

Major Interaction

Do not take this combination

• Administering intravenous ceftriaxone and calcium together can result in life-threatening damage to the lungs and kidneys. Calcium should not be administered intravenously within 48 hours of intravenous ceftriaxone. This interaction is not a concern when calcium is taken by mouth.

• Taking calcium along with dolutegravir can reduce blood levels of dolutegravir. This might decrease the effects of dolutegravir. To avoid this interaction, dolutegravir should be taken 2 hours before or 6 hours after taking calcium.

• Taking calcium along with elvitegravir can reduce blood levels of elvitegravir. This might decrease the effects of elvitegravir. To avoid this interaction, elvitegravir should be taken 2 hours before or 2 hours after taking calcium.

Moderate Interaction

Be cautious with this combination

• Calcium might decrease how well some antibiotics work. In the gut, calcium binds to antibiotics known as “quinolones.” This can decrease the amount of these drugs that the body absorbs. To avoid this interaction, take these drugs at least 2 hours before or 4 to 6 hours after calcium.

• Calcium might decrease how well some antibiotics work. In the gut, calcium binds to antibiotics known as “tetracyclines. ” This can decrease the amount of these drugs that the body absorbs. To avoid this interaction, take these drugs at least 2 hours before or 4 to 6 hours after calcium.

• Calcium can decrease how much bisphosphonate the body absorbs, which can decrease the effects of bisphosphonates. To avoid this interaction, take bisphosphonates at least 30 minutes before calcium or at a different time of day.

• Calcipotriene is a drug that is similar to vitamin D. Vitamin D helps the body absorb calcium. Taking calcium supplements along with calcipotriene might increase levels of calcium too much.

• Calcium can affect your heart. Digoxin is used to help your heart beat stronger. Taking calcium along with digoxin might increase the effects of digoxin and lead to an irregular heartbeat. If you are taking digoxin, talk to your doctor before taking calcium supplements.

• Taking large amounts of calcium along with diltiazem might decrease the effects of diltiazem.

• Calcium can decrease how much levothyroxine the body absorbs. Taking calcium along with levothyroxine might decrease the effects of levothyroxine. Levothyroxine and calcium should be taken at least 4 hours apart.

• Taking calcium with sotalol can decrease how much sotalol the body absorbs. Taking calcium along with sotalol might decrease the effects of sotalol. To avoid this interaction, take calcium at least 2 hours before or 4 hours after taking sotalol.

• Taking large amounts of calcium along with verapamil might decrease the effects of verapamil.

• Some “water pills” increase the amount of calcium in the body. Taking large amounts of calcium with some “water pills” might cause there to be too much calcium in the body. This could cause serious side effects, including kidney problems.

• Calcium citrate can increase how much aluminum the body absorbs from aluminum hydroxide. This increase in aluminum levels can cause serious side effects, especially in people with kidney disease. But not all forms of calcium have this effect. Calcium acetate does not appear to increase aluminum levels.

• Long-term lithium use can increase calcium levels in the blood. Taking lithium with calcium supplements might increase calcium levels too much.

• Taking calcium along with raltegravir for several months might reduce blood levels of raltegravir and decrease its effects. Taking a single dose of calcium along with raltegravir does not appear to affect blood levels of raltegravir.

Minor Interaction

Be watchful with this combination

• Calcium channel blockers are a type of medicine used for high blood pressure. Calcium may decrease the effects of calcium channel blockers when given by IV. But taking calcium supplements by mouth or consuming foods containing calcium does not seem to have this effect.

Dosing

Calcium is an essential nutrient found in many foods, including dairy products, kale, broccoli, and calcium-enriched citrus juices. The amount that should be consumed on a daily basis is called the recommended dietary allowance (RDA). For all adults 19-50 years of age and for males 51-70 years of age, the RDA is 1000 mg. For females 51 years and older, the RDA is 1200 mg. While pregnant and breast-feeding, the RDA is 1300 mg for those under 19 years of age and 1000 mg for those 19 years and older. In children, the RDA depends on age.

In supplements, calcium has most often been used by adults in doses of 500-1500 mg by mouth daily. Don’t take more than 2000-2500 mg daily unless under the supervision of a healthcare provider. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

Calcium-D3-MIC – instructions for use, doses, side effects, reviews of the drug: capsules, 166.7 mg + 66.7 IU

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Calcium-D3-MIC (capsules, 166.7 mg + 66.7 IU), instructions for medical use RU No. LSR-000019/09

Date last modified: 04/29/2021

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• Compound
• pharmachologic effect
• Description of the dosage form
• Pharmacokinetics
• Indications
• Contraindications
• Use during pregnancy and lactation
• Dosage and administration
• Side effects
• Interaction
• Overdose
• special instructions
• Release form
• Terms of dispensing from pharmacies
• Storage conditions
• Best before date
• Order in Moscow pharmacies
• Reviews

Active ingredient

Calcium carbonate + Colecalciferol (Calcium carbonate + Colecalciferol)

ATX

A12AX Calcium preparations in combination with vitamin D and/or other preparations

Nosological classification (ICD-10)

ICD-10 code list

• E55 Vitamin D deficiency
• E58 Nutritional calcium deficiency
• M80. 9 Osteoporosis with pathological fracture, unspecified
• M81.9Osteoporosis, unspecified

Pharmacological group

Bone and cartilage metabolism correctors in combinations

Vitamins and vitamin-like products in combinations

Dosage form

Capsules.

Composition

1
capsule contains:

Active ingredients:

Calcium
carbonate – 416.3 mg (in terms of calcium – 166.7 mg),
colecalciferol type 100 CWS – 0.667 mg (in terms of
colecalciferol – 0.001667 mg (66.7 IU)).

Composition
cholecalciferol type 100 CWS: cholecalciferol crystalline, α‑tocopherol,
soybean oil, corn starch, hydrolyzed gelatin, sucrose.

Excipient:

Starch
potato.

Composition of the gelatin capsule shell:

Composition
hard gelatin capsule bodies: gelatin, purified water, titanium dioxide
E171; composition of the cap of a hard gelatin capsule: gelatin, purified water,
titanium dioxide E171, alluring red dye E129, dye
quinoline yellow E104.

Combined
drug, the action of which is due to its constituent components.
Regulates the exchange of calcium and phosphate ions, reduces resorption and increases
bone density, compensates for the lack of calcium ions and vitamin D ₃
in the body, enhances the absorption of calcium ions in the intestine and reabsorption
phosphate in the kidneys, promotes bone mineralization.

Calcium
carbonate is involved in the formation of bone tissue, blood clotting,
in maintaining stable cardiac activity, in the implementation of processes
transmission of nerve impulses. Application of calcium and vitamin D ₃
prevents an increase in the production of parathyroid hormone, which is
stimulator of increased bone resorption.

Description of dosage form

Capsules
hard, gelatinous No. 0 cylindrical shape with hemispherical ends
with white body and orange lid.

Content
capsules – powder of white or almost white color.

Pharmacokinetics

Vitamin D ₃
absorbed in the small intestine. Calcium is absorbed in ionized form
in the proximal small intestine through active
transport mechanism.

Readings

–
Prevention and
treatment and deficiency of calcium and/or vitamin D ₃ .

–
With insufficient
intake of calcium and vitamin D ₃ into the body against the background
malnutrition.

–
With increased
body needs for calcium and vitamin D ₃
during pregnancy and breastfeeding, as well as in children over 12
years during a period of intensive growth.

–
Prevention and
as part of the complex therapy of osteoporosis (menopausal, senile,
“steroid”, idiopathic, etc. ).

Contraindications

–
Hypercalcemia
(increased concentration of calcium in the blood).

–
Hypercalciuria
(increased calcium in the urine).

–
Nephurolithiasis.

–
Hypervitaminosis
vitamin D ₃ .

–
Increased
sensitivity to the components of the drug.

–
severe renal
failure.

–
active form
tuberculosis.

–
Sarcoidosis.

–
Osteoporosis,
caused by immobilization.

–
Urolithiasis
disease.

–
Atherosclerosis.

–
Childhood
up to 12 years old.

With caution

Renal
insufficiency, benign granulomatosis, taking glycosides and thiazide
diuretics, pregnancy, lactation.

Use in pregnancy and lactation

Daily
the dose should not exceed 1500 mg calcium and 600 IU vitamin D ₃ .
Hypercalcemia developing against the background of an overdose during pregnancy
can cause defects in the mental and physical development of the child.

Vitamin D ₃
and its metabolites can pass into breast milk, therefore, it is necessary to take into account
intake of calcium and vitamin D ₃ from other sources in the mother
and child. An overdose during pregnancy may lead to
mental and physical development of the child.

Dosage and Administration

Information for healthcare professionals only.
Are you a healthcare professional?

Adults and children over 12:
2-3 capsules 2 times a day, morning and evening, mainly
while eating.

Side effects

Allergic
reactions, dysfunction of the gastrointestinal tract (constipation or diarrhea, flatulence,
nausea, abdominal pain), hypercalcemia and hypercalciuria (increased
calcium in blood or urine).

Interactions

Information for healthcare professionals only.
Are you a healthcare professional?

Activity
vitamin D ₃ may decrease when used simultaneously with phenytoin
or barbiturates.

At
simultaneous treatment with cardiac glycosides requires ECG monitoring and
clinical condition, since calcium preparations can potentiate
therapeutic and toxic effects of cardiac glycosides.

Preparations
calcium and vitamin D ³ may increase absorption
tetracyclines from the gastrointestinal tract. Therefore, the time interval
between taking a tetracycline drug and Calcium-D3-MIC should
be at least 3 hours.

For
to prevent a decrease in the absorption of bisphosphonates or sodium fluoride drugs,
it is recommended to take Calcium-D3-MIC not earlier than 2 hours later
after taking them.

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

Simultaneous
treatment with Kolestyramine preparations or laxatives based on
mineral or vegetable oils can reduce the absorption of vitamin D ₃ .

At
the simultaneous use of thiazide diuretics increases the risk
the occurrence of hypercalcemia, because they increase tubular
calcium reabsorption. Furosemide and other loop diuretics, on the other hand,
increase the excretion of calcium by the kidneys.

U
patients who are simultaneously taking cardiac glycosides and / or diuretics,
it is necessary to control the concentration of calcium and creatinine in the blood serum.

Overdose

Overdose symptoms:

Anorexia,
thirst, polyuria, decreased appetite, dizziness, fainting,
weakness, nausea, vomiting, hypercalciuria, hypercalcemia, hypercreatinemia.
With prolonged use, calcification of blood vessels and tissues.

Treatment:

Introduction
in the body of a large amount of fluid, the use of loop diuretics
(e.g. Furosemide), glucocorticosteroids, calcitonin, bisphosphonates. When
Seek medical attention if signs of overdose are detected.

Special instructions

B
during the treatment period, it is necessary to constantly monitor the excretion of calcium ions in the urine
and the concentration of calcium and creatinine ions in plasma (in case of development
calciuria exceeding 7. 5 mmol/day (300 mg/day)
reduce dose or stop taking).

Vo
to avoid overdose, additional intake must be taken into account
vitamin D ₃ from other sources.

Reception
foods containing oxalates (sorrel, spinach) and phytin (cereals) reduces
calcium absorption, so you should not take Calcium-D3-MIC for
two hours after taking sorrel, spinach, cereals.

Product form

Capsules.

By
10 capsules in a blister pack, 6 blister packs
together with instructions for use are placed in a pack of cardboard.

Terms of dispensing from pharmacies

Without
doctor’s prescription.

Storage conditions

Store
in a place protected from moisture and light at a temperature of 15 ° C
up to 25 °С.

Store
in a place inaccessible to children.

Expiry date

2
of the year.

Not
use after the expiration date.

Update date: 10/31/2022

Order in pharmacies

Region selection:
Altai TerritoryAmur RegionArkhangelsk RegionAstrakhan RegionBaikonurBelgorod RegionBryansk RegionVladimir RegionVolgograd RegionVologda RegionVoronezh RegionJewish Autonomous RegionTransbaikal TerritoryIvanovo RegionIrkutsk RegionKabardino-Balkar RepublicKaliningrad RegionKaluga RegionKamchatka TerritoryKarachay-Cherkess RepublicKemerovo RegionKirov RegionKostrom Krasnodar RegionKrasnoyarsk RegionKurgan RegionKurgan RegionLeningrad RegionLipetsk RegionMagadan RegionMoscowMoscow RegionMurmansk RegionNenets Autonomous OkrugNizhny Novgorod RegionNovgorod RegionNovosibirsk RegionOmsk RegionOrenburg RegionOryol RegionPenza RegionPerm RegionPrimorsky RegionPskov RegionRepublic of AdygeaRepublic Altai Republic of Bashkortostan Republic of Buryatia Republic of Dagestan Republic of Ingushetia Republic of Kalmykia Republic of Karelia Republic of Komi Republic of Crimea Republic of Mari El Republic of Mordovia Republic of Sakha (Yakutia) Republic of North Ossetia-Alania Tovskaya OblastSakhalin OblastSverdlovsk OblastSevastopolSmolensk OblastStavropol KraiTambov OblastTver OblastTomsk OblastTula OblastTyumen OblastUdmurt RepublicUlyanovsk OblastKhabarovsk KraiKhanty-Mansiysk Autonomous OkrugChelyabinsk OblastChechen RepublicChuvash RepublicChukotka Autonomous OkrugYamalo-Nenets Autonomous OkrugYaroslavl Region

The information provided on drug prices is not an offer to sell or buy goods.

The information is intended solely for comparing prices in stationary pharmacies operating in
in accordance with Article 55 of the Federal Law “On the Circulation of Medicines” dated April 12, 2010 No. 61-FZ.

Reviews

Read all reviews and leave your own.

Information for healthcare professionals only.
Are you a healthcare professional?

Calcium-D3-MIC – instructions for use, doses, side effects, reviews of the drug: capsules, 166.7 mg + 66.7 IU

Analogs

Order in pharmacies
Order
drug

All forms of release, dosages, registration certificates, drug manufacturers, drug characteristics

Calcium-D3-MIC (capsules, 166.7 mg + 66.7 IU), instructions for medical use RU No. LSR-000019/09

Date last modified: 04/29/2021

Contents

• Active substance
• ATX
• Nosological classification (ICD-10)
• Pharmacological group
• Dosage form
• Compound
• pharmachologic effect
• Description of the dosage form
• Pharmacokinetics
• Indications
• Contraindications
• Use during pregnancy and lactation
• Dosage and administration
• Side effects
• Interaction
• Overdose
• special instructions
• Release form
• Terms of dispensing from pharmacies
• Storage conditions
• Best before date
• Order in Moscow pharmacies
• Reviews

Active ingredient

Calcium carbonate + Colecalciferol (Calcium carbonate + Colecalciferol)

ATX

A12AX Calcium preparations in combination with vitamin D and/or other preparations

Nosological classification (ICD-10)

ICD-10 code list

• E55 Vitamin D deficiency
• E58 Nutritional calcium deficiency
• M80. 9 Osteoporosis with pathological fracture, unspecified
• M81.9Osteoporosis, unspecified

Pharmacological group

Bone and cartilage metabolism correctors in combinations

Vitamins and vitamin-like products in combinations

Dosage form

Capsules.

Composition

1
capsule contains:

Active ingredients:

Calcium
carbonate – 416.3 mg (in terms of calcium – 166.7 mg),
colecalciferol type 100 CWS – 0.667 mg (in terms of
colecalciferol – 0.001667 mg (66.7 IU)).

Composition
cholecalciferol type 100 CWS: cholecalciferol crystalline, α‑tocopherol,
soybean oil, corn starch, hydrolyzed gelatin, sucrose.

Excipient:

Starch
potato.

Composition of the gelatin capsule shell:

Composition
hard gelatin capsule bodies: gelatin, purified water, titanium dioxide
E171; composition of the cap of a hard gelatin capsule: gelatin, purified water,
titanium dioxide E171, alluring red dye E129, dye
quinoline yellow E104.

Combined
drug, the action of which is due to its constituent components.
Regulates the exchange of calcium and phosphate ions, reduces resorption and increases
bone density, compensates for the lack of calcium ions and vitamin D ₃
in the body, enhances the absorption of calcium ions in the intestine and reabsorption
phosphate in the kidneys, promotes bone mineralization.

Calcium
carbonate is involved in the formation of bone tissue, blood clotting,
in maintaining stable cardiac activity, in the implementation of processes
transmission of nerve impulses. Application of calcium and vitamin D ₃
prevents an increase in the production of parathyroid hormone, which is
stimulator of increased bone resorption.

Description of dosage form

Capsules
hard, gelatinous No. 0 cylindrical shape with hemispherical ends
with white body and orange lid.

Content
capsules – powder of white or almost white color.

Pharmacokinetics

Vitamin D ₃
absorbed in the small intestine. Calcium is absorbed in ionized form
in the proximal small intestine through active
transport mechanism.

Readings

–
Prevention and
treatment and deficiency of calcium and/or vitamin D ₃ .

–
With insufficient
intake of calcium and vitamin D ₃ into the body against the background
malnutrition.

–
With increased
body needs for calcium and vitamin D ₃
during pregnancy and breastfeeding, as well as in children over 12
years during a period of intensive growth.

–
Prevention and
as part of the complex therapy of osteoporosis (menopausal, senile,
“steroid”, idiopathic, etc. ).

Contraindications

–
Hypercalcemia
(increased concentration of calcium in the blood).

–
Hypercalciuria
(increased calcium in the urine).

–
Nephurolithiasis.

–
Hypervitaminosis
vitamin D ₃ .

–
Increased
sensitivity to the components of the drug.

–
severe renal
failure.

–
active form
tuberculosis.

–
Sarcoidosis.

–
Osteoporosis,
caused by immobilization.

–
Urolithiasis
disease.

–
Atherosclerosis.

–
Childhood
up to 12 years old.

With caution

Renal
insufficiency, benign granulomatosis, taking glycosides and thiazide
diuretics, pregnancy, lactation.

Use in pregnancy and lactation

Daily
the dose should not exceed 1500 mg calcium and 600 IU vitamin D ₃ .
Hypercalcemia developing against the background of an overdose during pregnancy
can cause defects in the mental and physical development of the child.

Vitamin D ₃
and its metabolites can pass into breast milk, therefore, it is necessary to take into account
intake of calcium and vitamin D ₃ from other sources in the mother
and child. An overdose during pregnancy may lead to
mental and physical development of the child.

Dosage and Administration

Information for healthcare professionals only.
Are you a healthcare professional?

Adults and children over 12:
2-3 capsules 2 times a day, morning and evening, mainly
while eating.

Side effects

Allergic
reactions, dysfunction of the gastrointestinal tract (constipation or diarrhea, flatulence,
nausea, abdominal pain), hypercalcemia and hypercalciuria (increased
calcium in blood or urine).

Interactions

Information for healthcare professionals only.
Are you a healthcare professional?

Activity
vitamin D ₃ may decrease when used simultaneously with phenytoin
or barbiturates.

At
simultaneous treatment with cardiac glycosides requires ECG monitoring and
clinical condition, since calcium preparations can potentiate
therapeutic and toxic effects of cardiac glycosides.

Preparations
calcium and vitamin D ³ may increase absorption
tetracyclines from the gastrointestinal tract. Therefore, the time interval
between taking a tetracycline drug and Calcium-D3-MIC should
be at least 3 hours.

For
to prevent a decrease in the absorption of bisphosphonates or sodium fluoride drugs,
it is recommended to take Calcium-D3-MIC not earlier than 2 hours later
after taking them.

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

Simultaneous
treatment with Kolestyramine preparations or laxatives based on
mineral or vegetable oils can reduce the absorption of vitamin D ₃ .

At
the simultaneous use of thiazide diuretics increases the risk
the occurrence of hypercalcemia, because they increase tubular
calcium reabsorption. Furosemide and other loop diuretics, on the other hand,
increase the excretion of calcium by the kidneys.

U
patients who are simultaneously taking cardiac glycosides and / or diuretics,
it is necessary to control the concentration of calcium and creatinine in the blood serum.

Overdose

Overdose symptoms:

Anorexia,
thirst, polyuria, decreased appetite, dizziness, fainting,
weakness, nausea, vomiting, hypercalciuria, hypercalcemia, hypercreatinemia.
With prolonged use, calcification of blood vessels and tissues.

Treatment:

Introduction
in the body of a large amount of fluid, the use of loop diuretics
(e.g. Furosemide), glucocorticosteroids, calcitonin, bisphosphonates. When
Seek medical attention if signs of overdose are detected.

Special instructions

B
during the treatment period, it is necessary to constantly monitor the excretion of calcium ions in the urine
and the concentration of calcium and creatinine ions in plasma (in case of development
calciuria exceeding 7. 5 mmol/day (300 mg/day)
reduce dose or stop taking).

Vo
to avoid overdose, additional intake must be taken into account
vitamin D ₃ from other sources.

Reception
foods containing oxalates (sorrel, spinach) and phytin (cereals) reduces
calcium absorption, so you should not take Calcium-D3-MIC for
two hours after taking sorrel, spinach, cereals.

Product form

Capsules.

By
10 capsules in a blister pack, 6 blister packs
together with instructions for use are placed in a pack of cardboard.

Terms of dispensing from pharmacies

Without
doctor’s prescription.

Storage conditions

Store
in a place protected from moisture and light at a temperature of 15 ° C
up to 25 °С.

Store
in a place inaccessible to children.

Expiry date

2
of the year.

Not
use after the expiration date.

Update date: 10/31/2022

Order in pharmacies

Region selection:
Altai TerritoryAmur RegionArkhangelsk RegionAstrakhan RegionBaikonurBelgorod RegionBryansk RegionVladimir RegionVolgograd RegionVologda RegionVoronezh RegionJewish Autonomous RegionTransbaikal TerritoryIvanovo RegionIrkutsk RegionKabardino-Balkar RepublicKaliningrad RegionKaluga RegionKamchatka TerritoryKarachay-Cherkess RepublicKemerovo RegionKirov RegionKostrom Krasnodar RegionKrasnoyarsk RegionKurgan RegionKurgan RegionLeningrad RegionLipetsk RegionMagadan RegionMoscowMoscow RegionMurmansk RegionNenets Autonomous OkrugNizhny Novgorod RegionNovgorod RegionNovosibirsk RegionOmsk RegionOrenburg RegionOryol RegionPenza RegionPerm RegionPrimorsky RegionPskov RegionRepublic of AdygeaRepublic Altai Republic of Bashkortostan Republic of Buryatia Republic of Dagestan Republic of Ingushetia Republic of Kalmykia Republic of Karelia Republic of Komi Republic of Crimea Republic of Mari El Republic of Mordovia Republic of Sakha (Yakutia) Republic of North Ossetia-Alania Tovskaya OblastSakhalin OblastSverdlovsk OblastSevastopolSmolensk OblastStavropol KraiTambov OblastTver OblastTomsk OblastTula OblastTyumen OblastUdmurt RepublicUlyanovsk OblastKhabarovsk KraiKhanty-Mansiysk Autonomous OkrugChelyabinsk OblastChechen RepublicChuvash RepublicChukotka Autonomous OkrugYamalo-Nenets Autonomous OkrugYaroslavl Region

The information provided on drug prices is not an offer to sell or buy goods.