Calcium d3 nycomed plus instructions. Calcium D3 Nycomed: instructions and cheaper analogues

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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.

Directions for use

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, serum calcium levels should be regularly monitored during the use of thiazide diuretics.

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.

Breastfeeding

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

Uncommon: 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. tastefullyorange.

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.

Chewable orange tablets 1 table.
active substance:
calcium carbonate 1250 mg

excipients: sorbitol - 390 mg; povidone - 36.4 mg; magnesium stearate - 6 mg; aspartame - 1 mg; orange flavor granulate - 63 mg

Chewable mint tablets 1 table.
active substance:
calcium carbonate 1250 mg
(equivalent to elemental calcium - 500 mg)
colecalciferol (vitamin D3) 5 mcg (200 IU)
(as colecalciferol concentrate - 2 mg)
excipients: sorbitol - 390 mg; povidone - 36.4 mg; magnesium stearate - 6 mg; aspartame - 1 mg; mint flavor granulate - 31.8 mg

Chewable tablets with strawberry-watermelon flavor 1 tablet.
active substance:
calcium carbonate 1250 mg
(equivalent to elemental calcium - 500 mg)
colecalciferol (vitamin D3) 5 mcg (200 IU)
(as colecalciferol concentrate - 2 mg)
excipients: sorbitol - 390 mg; povidone - 36.4 mg; magnesium stearate - 6 mg; aspartame - 1 mg; strawberry-watermelon flavor granules - 10.2 mg

Pharmacological action

A combined drug that regulates the exchange of calcium and phosphorus in the body (in bones, teeth, nails, hair, muscles).
Reduces resorption (resorption) and increases 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 a component of the blood coagulation system. Adequate calcium intake is especially important during growth, pregnancy and lactation.
Vitamin D3 increases calcium absorption in the intestines.
The use of calcium and vitamin D3 prevents an increase in the production of parathyroid hormone, which is a stimulator of increased bone resorption (leaching of calcium from the bones).

Pharmacokinetics

Calcium
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 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 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.

Indications for use Calcium-d3 nycomed

• prevention and treatment of calcium and/or vitamin D3 deficiency;
• prevention and complex therapy of osteoporosis and its complications (bone fractures).

Contraindications to the use of Calcium-d3 nycomed

• increased levels of calcium in the blood;
• urolithiasis;
• hypersensitivity to the drug.

Calcium-d3 nikomed Use during pregnancy and children

During pregnancy and lactation, treatment should be carried out under the supervision of a physician.

Drug interactions

The activity of vitamin D3 may be decreased when used concomitantly with phenytoin or barbiturates. With simultaneous treatment with cardiac glycosides, monitoring of the ECG and clinical condition is necessary, because Calcium preparations can potentiate the therapeutic and toxic effects of cardiac glycosides. Calcium and vitamin D3 preparations can increase the absorption of tetracyclines from the gastrointestinal tract, so Calcium-D3 Nycomed tablets should be taken 3 hours before or after taking tetracyclines. To prevent decreased absorption of bisphosphonate drugs or sodium fluoride, it is recommended to take Calcium-D3 Nycomed no earlier than 2 hours after taking them. GCS reduce calcium absorption, so treatment with these drugs may require an increase in the dose of Calcium-D3 Nycomed. Simultaneous treatment with cholestyramine preparations or laxatives based on mineral or vegetable oil may reduce the absorption of vitamin D3. With simultaneous use of thiazide diuretics, the risk of hypercalcemia increases, because they increase tubular reabsorption of calcium. Furosemide and other loop diuretics, on the contrary, increase the excretion of calcium by the kidneys. In patients taking cardiac glycosides and/or diuretics simultaneously, the concentration of calcium and creatinine in the blood serum should be monitored.

Dosage of Calcium-d3 nycomed

Prevention and treatment of calcium and/or vitamin D3 deficiency: adults and children over 12 years old - 1 table. 2 times a day; children from 5 to 12 years old - 1–2 tablets. per day; 3–5 years - dosage in accordance with doctor’s recommendations.
Addition to specific therapy and prevention of osteoporosis and its complications (bone fractures): adults - 1 table. 2–3 times a day.
Special patient groups
Patients with impaired liver function. The drug Calcium-D3 Nycomed should not be used in case of severe renal failure.
Patients with impaired renal function. The drug Calcium-D3 Nycomed should not be used in case of severe renal failure.
Elderly patients. The dose 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 treatment of calcium and/or 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.
When used to complement specific therapy and prevent osteoporosis and its complications (bone fractures), the duration of treatment is determined by the doctor individually.

Precautions

Calcium-D3 Nycomed tablets contain aspartame and should not be taken if you have phenylketonuria. To avoid overdose, additional vitamin D3 intake from other sources must be taken into account. Eating foods containing oxalates (sorrel, spinach) and phytin (cereals) reduces calcium absorption, so you should not take Calcium-D3 Nycomed within 2 hours after eating sorrel, spinach, or cereal products. The drug should be used with caution in immobilized patients with osteoporosis due to the risk of developing hypercalcemia.

Calcium-D3 Nycomed is a mineral and vitamin preparation that regulates metabolism and replenishes the deficiency of calcium (Ca) and vitamin D3 in the body. The drug is sold over-the-counter and has a reputation as a useful remedy not only for diseases and diseases, but also as a general tonic, improving the condition of nails, teeth and hair. However, the drug has side effects and contraindications, so before purchasing it at the pharmacy, it will be useful to read the instructions for use. Being informed about the price, as well as about cheaper analogues, will help you make the right choice.

The drug is available in the form of chewable tablets. They are round, white, have yellowish-gray inclusions and a light fruity smell.

There are 4 types of tastes (aromas):

1. mint;
2. citric;
3. orange;
4. strawberry-watermelon.

Tablets of 20, 30, 50, 100 and 120 pieces are packaged in high-density white polyethylene bottles, which, together with instructions, are placed in cardboard packaging.

The manufacturer in Russia is the Yaroslavl Pharmaceutical Plant, part of the largest Japanese pharmaceutical company Takeda Pharmaceutical.

Pharmacological action

The main active ingredients of lemon chewable tablets are:

1. calcium carbonate – 1250 mg, which corresponds to 500 mg of elemental Ca;
2. colecalciferol (vitamin D3) – 10 mcg (400 IU).

In mint, strawberry-watermelon and orange tablets with the same amount of Ca, the content of vitamin D3 is 2 times less - 5 mcg (200 IU).

The combined effect of the active ingredients of the drug - calcium and D3 - is as follows:

• the level of calcium needed for health in our body is restored;
• the processes of bone tissue resorption stop, that is, the leaching of mineral salts from it, which helps to increase its density;
• Due to the presence of vitamin D3, the intensity of calcium absorption increases.

Indications for use

Calcium is necessary to ensure the vital functions of the body along with other macroelements: oxygen, carbon, nitrogen, hydrogen, iron, phosphorus, potassium, magnesium, etc. Normally, its content in the human body is 2%.

Ca is part of bone tissue, plays an important role in the transmission of nerve impulses, and takes part in the contraction of striated and smooth muscles. With a lack of calcium, normal heart function and hormone production are impossible, and the blood clotting system ceases to function.

The drug is used:

1. For bone injuries.
2. With different etiologies.
3. As part of drug therapy and bones.
4. If Ca deficiency occurs due to food poisoning, dysbiosis, past intestinal infections, chronic enterocolitis.
5. With an increased need for calcium:
   • during periods of accelerated growth in children,
   • under significant physical or mental stress,
   • for women, these are periods of pregnancy, lactation, menopause and postmenopause.
6. With obvious external signs of calcium deficiency:
   • brittle nails,
   • deterioration of dental condition,
   • dry skin and hair,
   • increased bleeding,
   • convulsions,
   • general weakness.

Dosage, method of application

The tablets are chewed or dissolved and taken with meals. On the day you can use:

1. children from 3 to 5 years old - strictly in accordance with the doctor’s prescription;
2. from 6 to 12 years – 1-2 tablets;
3. over 12 years old and adults – 2 tablets
   (1 piece 2 times a day, or 2 pieces once a day).

The product is effective only with a course of use - from 4 to 6 weeks.

The specific duration should be determined by the attending physician, who, if necessary, will adjust the dosage, taking into account the age and data of the patient’s biochemical blood parameters.

Calcium D3 Nycomed is used with caution during pregnancy in women and subsequent breastfeeding.

Contraindications

• Excess vitamin D in the body is called hypervitaminosis if it is taken as part of other medications.
• Hypercalcemia and hypercalciuria detected by laboratory tests.
• Hypersensitivity to the active or excipients of chewable tablets, as well as to peanuts and soy.
• Nephrolithiasis and a number of other severe kidney diseases.
• Tuberculosis in the active phase.
• Phenylketonuria.

The drug is contraindicated for people with hereditary fructose intolerance, in cases of sucrase-isomaltase deficiency and glucose-galactose malabsorption due to the presence of sorbitol, isomalt and sucrose in its composition as excipients.

Chewable tablets are not used to treat children under three years of age.

Side effects

Specific manifestations of impaired metabolism: hypercalcemia and (or) hypercalciuria.

From the digestive system: pain in the abdomen, constipation or diarrhea, nausea, vomiting.

Skin reactions: redness, burning, itching.

Overdose

If the doses indicated in the instructions or prescribed by the doctor are not observed, signs of hypercalcemia may occur:

• arrhythmia, cardiac dysfunction;
• severe fatigue, feeling of weakness in different muscle groups;
• bone pain;
• anorexia (exhaustion), accompanied by increased thirst;
• polyuria (significant increase in urine production);
• nausea and vomiting;
• general weakness, fainting.

Excessive doses and long-term use of the drug are fraught with such a serious complication as calcification of blood vessels and tissues, which become fragile, and with calcification of cerebral vessels, dementia or mental disorders may even occur.

Price

Prices for the drug in Moscow pharmacies depend on the number of tablets in the bottle:

• packages of 20 and 30 pieces - from 165 to 290 rubles;
• 50 pieces from 287 to 517 rubles;
• 100 and 120 pieces - from 587 to 820 rubles.

Cheaper analogues of the drug Calcium-D3 Nycomed

Russia produces many medicines that are a source of calcium and vitamins. Among the more affordable analogues of Calcium D3 Nycomed are:

• Complivit Calcium D3.
  A Russian drug with a similar composition (calcium carbonate and colecalciferol), but at a slightly lower price.
  A package of 20 tablets costs from 108 to 135 rubles, and a package containing 100 tablets can be bought for 350-395 rubles.
• Calcium-Active.
  Calcium-Active tablets contain organic, easily digestible calcium, extracted from the leaves of the medicinal plant amaranth, as well as phosphorus and vitamin D3. This drug is even more affordable: 40 tablets cost from 82 to 101 rubles, and 80 tablets cost 148-190 rubles.
• Calcide.
  Calcide is a biologically active food additive obtained from eggshells. The use of modern biotechnologies allows us to completely preserve the natural set of various microelements contained in the shell. In addition to Ca, the drug contains vitamins D, C, and group B. The price for 100 tablets is about 130 rubles.

chewable tablets

Owner/Registrar

NYCOMED PHARMA, AS

International Classification of Diseases (ICD-10)

E55 Vitamin d deficiency E58 Nutritional calcium deficiency M80 Osteoporosis with pathological fracture M81.0 Postmenopausal osteoporosis M81.1 Osteoporosis after oophorectomy M81.2 Osteoporosis caused by immobility M81.4 Drug-induced osteoporosis M81.5 Idiopathic osteoporosis M81.8 Other osteoporosis M82 Osteoporosis with diseases classified elsewhere

Pharmacological group

A drug that regulates the metabolism of calcium and phosphorus

Pharmacological action

A combined drug that regulates the exchange of calcium and phosphorus in the body (in bones, teeth, nails, hair, muscles).

Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium and vitamin D 3 in the body, 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

Calcium

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 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 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.

Prevention and treatment of calcium and/or vitamin D 3 deficiency;

Prevention and complex therapy of osteoporosis and its complications (bone fractures).

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.

The frequency of side effects of the drug is assessed as follows: very common (>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.

Overdose

Symptoms: manifestations of 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 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 is necessary.

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 content of calcium and phosphate 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 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 work with technically complex mechanisms.

For renal failure

The drug is contraindicated in severe renal failure.

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.

Drug interactions

Hypercalcemia can potentiate the toxic effects of cardiac glycosides when used simultaneously with calcium and vitamin D preparations. 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 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.

Eating foods containing oxalates (sorrel, rhubarb, spinach) and phytin (cereals) reduces the absorption of calcium, so you should not take Calcium-D 3 Nycomed within 2 hours after eating sorrel, rhubarb, spinach, cereals.

The tablets can be chewed or dissolved and taken with meals.

Calcium-D 3 Nycomed

For adults For prevention of osteoporosis- 1 tab. 2 times/day; V - 1 tab. 2-3 times/day.

For - 1 tab. 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 the doctor’s recommendations.

Calcium-D 3 Nycomed Forte

For adults For prevention of osteoporosis- 1 tab. 2 times/day or 2 tablets 1 time/day; V complex therapy of osteoporosis- 1 tab. 2-3 times/day.

For replenishment of calcium and vitamin D deficiencyadults and children over 12 years old- 2 tablets/day, children from 3 to 12 years old- 1 tablet/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 no dose adjustment is required.

Should not be used when severe renal failure.

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

Storage conditions and shelf life

The drug should be stored in a tightly closed bottle, in a dry place, out of reach of children, at a temperature not exceeding 25°C. Shelf life - 3 years. Do not use after expiration date.

Release from pharmacies

The drug is approved for use as an over-the-counter product.

Photo of the drug

Latin name: Calcium-D3 Nycomed

ATX code: A12AX

Active ingredient: Calcium carbonate + Cholecalciferol

Manufacturer: Nycomed Pharma (Switzerland)

Description is valid on: 12.10.17

Calcium D3 Nycomed is a combination drug with a high content of vitamin D3 and calcium. It is intended to replenish calcium and vitamin D3 deficiency in the body. Helps regulate calcium and phosphorus metabolism.

Active ingredient

Calcium carbonate + Colecalciferol.

Indications for use

It is used to treat and prevent deficiency of calcium and vitamin D3 in the body in the following cases:

• For osteoporosis (menopausal, senile, steroid, idiopathic, etc.).
• For hypocalcemia.
• With osteomalacia (softening of bones due to impaired mineral metabolism).
• When the body's need for the active substances of the drug is increased.

Contraindications

Contraindicated for the following diseases and conditions:

hypervitaminosis d3, severe renal failure, hypersensitivity to the components of the drug, soy and peanuts, hypercalciuria, active form of tuberculosis, hypercalcemia, hereditary fructose intolerance, phenylketonuria, sucrase-isomaltase deficiency, nephrolithiasis, glucose-galactose malabsorption, sarcoidosis.

Elderly people, immobile patients and children under 12 years of age should take it with caution.

Instructions for use Calcium D3 Nycomed (method and dosage)

The tablets must be dissolved or chewed during meals.

To compensate for the lack of calcium and vitamin D, children over 12 years of age and adult patients take 1 tablet twice a day, children 5-12 years old are given 1-2 tablets per day, and for children aged 3-5 years, the dosage of the drug is determined by the pediatrician. To prevent osteoporosis, adult patients are prescribed 1 tablet twice a day, and when treating this disease - 1 tablet 2-3 times a day.

Calcium D3 Nycomed Forte for the prevention of osteoporosis, adults should take 1 tablet twice a day or 2 tablets once a day, and for complex treatment of osteoporosis - 1 tablet twice or three times a day. To compensate for the deficiency of vitamin D3 and calcium, adult patients and children over 12 years of age take 2 tablets of the drug per day, and children aged 3-12 years take 1 tablet per day.

Side effects

Possible side effects include nausea, stomach pain, flatulence, constipation and diarrhea. Sometimes uncontrolled use of this drug causes hypercalciuria and hypercalcemia.

Overdose

In case of significant overdose, it can cause polyuria, nausea, thirst, headache, loss of appetite, weakness, constipation, dizziness, fainting and vomiting.

Analogs

Analogs by ATC code: Vitrum Osteomag, Kalcemin, Complivit Calcium D3, Natekal D3.

Do not decide to change the drug on your own; consult your doctor.

Release form and composition

Available in the form of round chewable tablets in different flavors:

Pharmacological action

The effect of this combination drug is due to the properties of its constituent components. It replenishes vitamin D3 and calcium deficiency, regulates calcium and phosphate metabolism, reduces resorption and increases bone density, promotes bone mineralization, and also improves calcium absorption in the intestines.

Calcium carbonate takes an active part in the formation of bone tissue, the process of blood clotting, the transmission of nerve impulses and the normalization of cardiac activity. The use of calcium and vitamin D3 prevents the body from overproducing parathyroid hormone, which stimulates increased bone resorption.

Vitamin D3 helps improve the absorption and distribution of calcium in organs and tissues.

Special instructions

• Vitamin D should be taken with caution in patients with renal failure. In this case, it is necessary to monitor the content of calcium and phosphate 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 D3 should be used with caution in immobilized patients with osteoporosis due to the risk of hypercalcemia.
• The simultaneous use of Calcium D3 Nycomed with tetracycline or quinolone antibiotics is usually not recommended, or should be done with caution.
• Does not affect the ability to drive vehicles or work with technically complex mechanisms.

During pregnancy and breastfeeding

It can be taken during lactation, but it should be remembered that its components can pass into breast milk. To calculate the daily dosage of the drug, other sources of these components entering the woman’s body should also be taken into account.

In childhood

The dosage form of the tablet is not used in children under 3 years of age.

In old age

Monitoring is required during simultaneous treatment with cardiac glycosides and diuretics.

For impaired renal function

With long-term therapy, it is necessary to monitor the levels of calcium and creatinine in the blood serum. Monitoring is especially important 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.

Drug interactions

• Preparations containing calcium and vitamin D3 can increase the absorption of tetracycline antibiotics from the gastrointestinal tract, and therefore the interval between doses of these drugs should be at least three hours.
• When using the drug together with thiazide diuretics, the risk of developing hypercalcemia increases, and “loop” diuretics, on the contrary, improve calcium excretion by the kidneys.
• GCS can reduce calcium absorption, so patients taking GCS may require an increase in the dosage of calcium supplements.
• When using calcium supplements together with sodium fluoride or bisphosphonates, their absorption may be reduced, so it is recommended to take calcium 2 hours after taking these medications.