Calcium-D3 Nycomed forte chewable tablets lemon 500 + 400mg / IU, No. 60

- For the prevention and complex therapy of osteoporosis and its complications (bone fractures).

- To replenish the deficiency of calcium and / or vitamin D3.

Adults: for the prevention of osteoporosis - 1 tablet 2 times a day; in the complex therapy of osteoporosis - 1 tablet 2-3 times a day. To replenish calcium and vitamin D deficiencies:

- Adults and children over 12 years old - 2 tablets per day.

- Children from 3 to 12 years old - 1 tablet a day or as directed by a doctor.
Tablets can be chewed or sucked and taken with meals.

Active ingredients: calcium carbonate - 1250 mg (equivalent to elemental calcium - 500 mg) colecalciferol (vitamin D3) - 10mkg (400 ME) in the form of colecalciferol concentrate 4 mg.
Auxiliary components: sorbitol, isomalt, povidone, magnesium stearate, aspartame, lemon oil, mono- and diglycerides of fatty acids.

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

- Hypercalciuria (increased calcium in the urine).

- Nephrolithiasis.

- Vitamin D hypervitaminosis.

- Hypersensitivity to the components of the drug.

- Severe renal failure.

- Active tuberculosis.

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

Use with caution: pregnancy, lactation.

Application during pregnancy and lactation
The daily dose should not exceed 1500 mg of calcium and 600 IU of vitamin D3. Hypercalcemia that develops against the background of an overdose during pregnancy can cause defects in the mental and physical development of the child. Vitamin D and its metabolites can pass into breast milk, therefore it is necessary to take into account the intake of calcium and vitamin D from other sources in the mother and child.

Trade name of the drug:
Calcium-D3 Nycomed Forte

Dosage form
Chewable tablets (lemon).

Composition per tablet
Active ingredients: calcium carbonate - 1250 mg (equivalent to elemental calcium - 500 mg) colecalciferol (vitamin D3) - 10mkg (400 ME) in the form of colecalciferol concentrate 4 mg.
Auxiliary components: sorbitol, isomalt, povidone, magnesium stearate, aspartame, lemon oil, mono- and diglycerides of fatty acids.

Description:
Round, biconvex, white, uncoated tablets with lemon aroma. May have small blotches and uneven edges.

Pharmacotherapeutic group
Calcium-phosphorus metabolism regulator.

ATX code: A12AX

Pharmacological properties
A combined preparation that regulates the exchange of calcium and phosphorus in the body (bones, teeth, nails, hair, muscles). Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium and vitamin D3 in the body, which is necessary for the mineralization of teeth. Calcium is involved in the regulation of nerve conduction, muscle contractions and is a component of the blood coagulation system.
Vitamin D increases the absorption of calcium in the intestine.
The use of calcium and vitamin D3 prevents an increase in the production of parathyroid hormone (PTH), which is a stimulator of increased bone resorption (leaching of calcium from the bones).
Vitamin D3 is absorbed in the small intestine. Calcium is absorbed in ionized form in the proximal small intestine through an active, D-vitamin dependent transport mechanism

Indications for use

- For the prevention and complex therapy of osteoporosis and its complications (bone fractures).

- To replenish the deficiency of calcium and / or vitamin D3.

Contraindications

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

- Hypercalciuria (increased calcium in the urine).

- Nephrolithiasis.

- Vitamin D hypervitaminosis.

- Hypersensitivity to the components of the drug.

- Severe renal failure.

- Active tuberculosis.

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

Use with caution: pregnancy, lactation.

Application during pregnancy and lactation
The daily dose should not exceed 1500 mg of calcium and 600 IU of vitamin D3. Hypercalcemia that develops against the background of an overdose during pregnancy can cause defects in the mental and physical development of the child. Vitamin D and its metabolites can pass into breast milk, therefore it is necessary to take into account the intake of calcium and vitamin D from other sources in the mother and child.

Dosing and
Administration Adults: for the prevention of osteoporosis - 1 tablet 2 times a day; in the complex therapy of osteoporosis - 1 tablet 2-3 times a day. To replenish calcium and vitamin D deficiencies:

- Adults and children over 12 years old - 2 tablets per day.

- Children from 3 to 12 years old - 1 tablet a day or as directed by a doctor.
Tablets can be chewed or sucked and taken with meals.

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

Overdose Overdose
symptoms: anorexia, thirst, polyuria, decreased appetite, dizziness, fainting, weakness, nausea, vomiting, hypercalciuria, hypercalcemia, hypercreatinemia. With prolonged use of excessive doses, vascular and tissue calcification.
Treatment: the introduction of a large amount of fluid into the body, the use of loop diuretics (for example, Furosemide), glucocorticosteroids, calcitonin, bisphosphonates.
If you find signs of an overdose, seek help.
In the case of the development of clinical symptoms of an overdose, the concentration of calcium and creatinine in the blood should be determined. In the case of an increased concentration of calcium or creatinine in the blood serum, the dose of the drug should be reduced or the treatment should be temporarily discontinued.
In case of hypercalciuria exceeding 7.5 mmol / day (300 mg / day), it is necessary to reduce the dose or stop taking it.

Interaction with other medicinal products

- The activity of vitamin D3 may decrease when used simultaneously with phenytoin or barbiturates.

- With simultaneous treatment with cardiac glycosides, it is necessary to monitor the ECG and the clinical condition, because calcium preparations can potentiate the therapeutic and toxic effects of cardiac glycosides.

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

- To prevent a decrease in the absorption of bisphosphonates or sodium fluoride preparations, it is recommended to take Calcium-D3 Nycomed Forte no earlier than 2 hours after taking them.

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

- Simultaneous treatment with cholestyramine preparations or laxatives based on mineral or vegetable oil can reduce the absorption of vitamin D3.

- With the simultaneous use of thiazide diuretics, the risk of hypercalcemia increases, because they increase tubular calcium reabsorption. Furosemide and other loop diuretics, on the other hand, increase renal excretion of calcium.

- In 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.

special instructions

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

- To avoid overdose, it is necessary to take into account the additional intake of vitamin D3 from other sources.

- Consumption of foods containing oxalates (sorrel, spinach) and phytin (cereals) reduces the absorption of calcium, so you should not take Calcium-D3 Nycomed Forte within two hours after taking sorrel, spinach, cereals.

- Calcium-D3 Nycomed Forte should be used with caution in immobilized patients with osteoporosis due to the risk of hypercalcemia.

Release form
Chewable tablets (lemon).
30, 60 or 120 tablets per vial made of high density polyethylene, sealed with a screw cap, under which there is a ring for tearing off the sealing gasket, which provides control of the first opening. Part of the label is attached to the bottle with a special adhesive tape that allows the label to be lifted. The instructions for use in the form of a folding sheet are placed under the movable part of the label.

Shelf life
3 years
Do not use after the expiration date.

Storage
conditions Store the bottle tightly closed at a temperature not exceeding 25 ? C in a dry place.
Keep out of the reach of children!