Natekal 1000 dispersible tablets 600mg + 1000ME, No. 30

Treatment and prevention of calcium and vitamin D3 deficiency: osteoporosis, incl. menopausal, senile, 'steroid', idiopathic (prevention and addition to specific treatment); osteomalacia (associated with impaired mineral metabolism in patients over 45 years old); hypocalcemia (including after adherence to diets with refusal to take milk and dairy products); with increased need during pregnancy and lactation, as well as in children over 12 years of age during the period of intensive growth.

Inside, chewed or swallowed whole. Adults and children over 12 years old - 1 single dose 2 times / day.

colecalciferol (vit. D3) 400 IU?

which corresponds to dry vitamin D3 * 4 mg

calcium carbonate 1.5 g?

which corresponds to a calcium content of 600 mg

Hypersensitivity; hypercalcemia (including as a result of primary or secondary hyperparathyroidism); hypercalciuria; calcium nephrourolithiasis; hypervitaminosis D; sarcoidosis; osteoporosis due to immobilization; phenylketonuria (contains aspartame); pulmonary tuberculosis (active form).

With care

With renal failure, benign granulomatosis, during pregnancy, during lactation, simultaneously with the intake of glycosides and thiazide diuretics, in childhood (up to 12 years).

pharmachologic effect

Combined drug that regulates the exchange of calcium and phosphorus in the body (bones, teeth, nails, hair, muscles). Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium and vitamin D3 in the body, enhances the absorption of calcium in the intestine and reabsorption of phosphates in the kidneys, promotes the mineralization of bone and dental tissue.

Calcium is involved in the formation of bone tissue, in maintaining stable cardiac activity, in the regulation of nerve conduction, muscle contractions, hormone production and is a component of the blood coagulation system. Adequate calcium intake is especially important during growth, pregnancy and breastfeeding.

Vitamin D3 (colecalciferol) increases the absorption of calcium in the intestine, promotes the formation and mineralization of bone and dental tissue.

The use of calcium and vitamin D3 prevents an increase in the production of PTH, which is a stimulant of increased bone resorption (leaching of calcium from the bones).

Pharmacokinetics

Colecalciferol

Vitamin D3 is easily absorbed from the small intestine (about 80% of the dose taken). Colecalciferol and its metabolites circulate in the blood associated with specific globulin. Colecalciferol is converted in the liver by hydroxylation to 25-hydroxycalciferol. Then it is converted in the kidneys to the active form of 1,25-hydroxycalciferol. 1,25-hydroxycalciferol is a metabolite responsible for increasing calcium absorption. Unmetabolized vitamin D3 is deposited in adipose and muscle tissue. It is excreted through the intestines and kidneys.

Calcium

Calcium is absorbed in ionized form from the proximal small intestine through an active, D-vitamin dependent transport mechanism. Typically, the amount of calcium absorbed from the gastrointestinal tract is about 30% of the dose taken. 99% of the calcium in the body is concentrated in the hard tissues of the teeth and bones. The remaining 1% is in intra- and extracellular fluids. About 50% of the total calcium content in the blood is in a physiologically active ionized form, of which about 10% in a complex with citrate, phosphate or other anions, the remaining 40% are associated with proteins, primarily with albumin. Calcium is excreted by the intestines, kidneys and sweat glands. Renal excretion depends on glomerular filtration and tubular calcium reabsorption.

Indications of active substances of the drug Natekal D3

Treatment and prevention of calcium and vitamin D3 deficiency: osteoporosis, incl. menopausal, senile, 'steroid', idiopathic (prevention and addition to specific treatment); osteomalacia (associated with impaired mineral metabolism in patients over 45 years old); hypocalcemia (including after adherence to diets with refusal to take milk and dairy products); with increased need during pregnancy and lactation, as well as in children over 12 years of age during the period of intensive growth.

Dosage regimen

Inside, chewed or swallowed whole. Adults and children over 12 years old - 1 single dose 2 times / day.

Side effect

From the digestive system: constipation, flatulence, nausea, stomach pain, diarrhea.

On the part of laboratory parameters: hypercalcemia and hypercalciuria.

Others: allergic reactions.

Contraindications for use

Hypersensitivity; hypercalcemia (including as a result of primary or secondary hyperparathyroidism); hypercalciuria; calcium nephrourolithiasis; hypervitaminosis D; sarcoidosis; osteoporosis due to immobilization; phenylketonuria (contains aspartame); pulmonary tuberculosis (active form).

With care

With renal failure, benign granulomatosis, during pregnancy, during lactation, simultaneously with the intake of glycosides and thiazide diuretics, in childhood (up to 12 years).

Application during pregnancy and lactation

Use with caution during pregnancy, lactation. During pregnancy, the daily dose should not exceed 1500 mg of calcium and 600 IU of vitamin D3.

Overdose during pregnancy can lead to impaired mental and physical development of the child.

Calcium and vitamin D3 pass into breast milk.

Application for impaired renal function

Use with caution in renal failure.

Application in children

Use with caution in children (up to 12 years).

special instructions

During the period of treatment, it is necessary to constantly monitor the excretion of calcium in the urine and the concentration of calcium and creatinine in the plasma (in case of the appearance of calciuria exceeding 7.5 mmol / day (300 mg / day), it is necessary to reduce the dose or stop taking it).

To avoid overdose, additional intake of vitamin D3 from other sources must be considered. Do not use simultaneously with vitamin complexes containing calcium and vitamin D3.

In older people, the need for calcium is 1.5 g / day, for vitamin D3 - 0.5-1 thousand IU / day.

Drug interactions

Reduces the absorption of bisphosphonates, sodium fluoride and tetracyclines (the interval between doses is at least 2-3 hours).

Increases the risk of developing toxicity of cardiac glycosides (monitoring of the ECG and the patient's condition is necessary).

Phenytoin, barbiturates, GCS reduce the effect of vitamin D3, vitamin A - toxicity.

GCS reduce calcium absorption.

Cholestyramine, laxatives (liquid paraffin) reduce the absorption of vitamin D.

Thiazide diuretics increase the risk of developing hypercalcemia.

Furosemide and other loop diuretics increase renal excretion of calcium.