Calcium-D3 Nycomed Forte is a mineral additive that regulates the exchange of calcium and phosphorus.
Release form and composition
Calcium-D3 Nycomed Forte is available in the form of chewable tablets with lemon flavor (in bottles of high-density polyethylene of 30, 60 or 120 pcs., 1 bottle in a cardboard box).
- Calcium carbonate - 1250 mg (equivalent to 500 mg of elemental calcium);
- Colecalciferol (vitamin D3) - 10 micrograms (400 IU).
Excipients: povidone, sorbitol, isomalt, aspartame, magnesium stearate, mono-and diglycerides of fatty acids, lemon oil.
Indications for use
- Prevention of deficiency and treatment of calcium deficiency and / or vitamin D3;
- Treatment (as part of combination therapy) and prevention of osteoporosis and its complications.
- Hypervitaminosis D;
- The active form of tuberculosis;
- Severe renal failure;
- Children's age up to 3 years;
- Hypersensitivity to any component, as well as to soy and / or peanuts.
Due to the content of aspartame, which in the human body is transformed into phenylalanine, Calcium-D3 Nycomed Forte is contraindicated in patients with phenylketonuria.
Also, the tablets contain sucrose, isomalt and sorbitol, so they are not recommended to be taken with sucrose-isomalta deficiency, glucose-galactose malabsorption and hereditary fructose intolerance.
Special observation during treatment is required for pregnant and lactating women, patients who have been diagnosed with renal failure.
Dosing and Administration
The drug should be taken with food, dissolving or chewing the tablets until dissolved.
Recommended doses of Calcium-D3 Nycomed Forte:
- To compensate for the lack of calcium and vitamin D: children over 12 years old and adults - 2 tablets per day, children 3-12 years old - 1 tablet per day or as directed by a doctor;
- For the prevention of osteoporosis: for adults - 1 tablet 2 times a day or 2 tablets 1 time a day;
- As part of the complex treatment of osteoporosis: adults - 1 tablet 2-3 times a day.
When prescribing Calcium-D3 Nycomed Forte for prophylaxis or as part of the complex therapy of osteoporosis, the duration of therapy is determined individually.
To compensate for the lack of calcium and / or vitamin D3, the drug is taken for at least 4-6 weeks. The need for and the number of repeated courses the doctor determines individually.
Calcium-D3 Nycomed Forte has rare side effects. In some cases, noted:
- On the part of the digestive system: flatulence, abdominal pain, nausea, diarrhea or constipation, dyspepsia;
- From the skin and subcutaneous tissue: rash, urticaria, itching;
- Metabolism: hypercalciuria and hypercalcemia.
Calcium overdose is manifested by hypercalcemia: abdominal pain, nausea, vomiting, thirst, constipation, anorexia, fatigue, muscle weakness, polyuria, urolithiasis, nephrocalcinosis, bone pain, mental disorders, in severe cases - more and heart arrhythmias. With prolonged use in excess doses (more than 2500 mg of calcium) there is a possibility of soft tissue calcification and kidney damage.
If you have any symptoms of an overdose, you should stop taking Calcium-D3 Nicomed Forte, as well as cardiac glycosides and thiazide diuretics (if used) and consult a doctor. Treatment involves gastric lavage in the first place, then - to replace fluid loss, taking loop diuretics, bisphosphonates, calcitonin and glucocorticosteroids. It is necessary to control diuresis, kidney function and the content of electrolytes in the blood plasma. In severe cases, ECG monitoring and measurement of central venous pressure is required.
Hypercalcemia as a result of overdose, developed during pregnancy, can have an adverse effect on the fetus.
Foods containing oxalates and phytin (rhubarb, spinach, sorrel, grains) reduce calcium absorption, so you should not take Calcium-D3 Nycomed Forte for 2 hours after eating.
When selecting the dose, you must consider the intake of calcium and vitamin D3 from other sources.
With long-term use of Calcium-D3 Nycomed Forte, it is necessary to control the concentration of creatinine and calcium in the blood, especially in patients who are at risk of kidney stones and in elderly people who receive cardiac glycosides and diuretics. In the case of renal dysfunction or signs of hypercalcemia, a dose reduction is required, and sometimes complete withdrawal of the drug.
In patients with renal insufficiency, the risk of soft tissue calcification increases, therefore during treatment it is necessary to control the content of calcium and phosphate in the blood serum.
The maximum daily doses for pregnant women: calcium - 1500 mg, vitamin D3 - 600 IU.
The drug can be used during lactation, but in this case, take into account the intake of calcium and vitamin D3 from other sources should not only the mother but also the child.
The risk of hypercalcemia increases in immobilized patients with osteoporosis, so Calcium-D3 Nycomed Forte is prescribed with caution.
The mineral supplement does not adversely affect the speed of psychophysical reactions and the ability to concentrate.
Hypercalcemia can cause the potentiation of the toxic effects of cardiac glycosides, taken simultaneously with Calcium-D3 Nicomedes Forte. It is necessary to monitor the concentration of calcium in the serum and ECG values.
Calcium absorption reduces glucocorticosteroids, which may require an increase in the dose of Calcium-D3 Nycomed Forte.
When calcium is taken, absorption of tetracyclines and bisphosphonates from the gastrointestinal tract is reduced. For this reason, it is recommended to take the first not less than 2 hours before or 4-6 hours after taking the mineral supplement, and the second not less than 1 hour before taking Calcium-D3 Nicomed. Due to a decrease in absorption and a decrease in the effectiveness of levothyroxine between the intake of drugs, at least 4-hour intervals should be maintained. For the same reason, antibiotics of the quinolone group must be taken 2 hours before or 6 hours after the calcium supplement.
The risk of hypercalcemia increases with simultaneous use of thiazide diuretics, therefore, control of calcium in blood serum is necessary.
Terms and conditions of storage
Store in a tightly closed vial in a dry place inaccessible to children at a temperature up to 25 ºC.
Shelf life - 3 years.