INDICATIONS
Prevention and treatment of osteoporosis and fractures (both vertebral and non-vertebral); treatment of osteomalacia, rickets, tetany, hypoparathyroidism and secondary hyperparathyroidism; in kidney disease, pancreatitis, hyperoxaluria; as phosphate binder to reduce phosphate absorption in patients with hyperphosphatemia; during therapy with antiseizure medications, bisphosphonates in paget’s disease; for healthy bone formation and maintenance; in disorders of osteogenesis and tooth formation (in addition to specific treatment); in pregnancy and lactation due to increased demand; in raised calcium requirement for children and adolescents at times of rapid growth; to prevent and cure calcium deficiency and/or vitamin D deficiency
especially in the household people who do not get direct sunlight.
DOSAGE AND ADMINISTRATION
Adults, Elderly and children: 1 tablet twice daily.
SIDE EFFECTS
The use of calcium supplements may cause constipation, and headache; mild hypercalcemia associated with anorexia, nausea and vomiting; more severe hypercalcemia associated with confusion, delirium, stupor and coma. The use of vitamin D may cause weakness, headache, somnolence, nausea, vomiting, dry mouth, constipation, muscle pain, bone pain, metallic taste, polyuria, polydipsia, anorexia, weight loss, nocturia and mild acidosis.
PRECAUTIONS
Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma calcium levels and urinary calcium excretion should be made in patients with a history of renal stones or in patients with mild to moderate renal failure or mild hypercalciuria. With long term treatment it is advisable to monitor serum and urinary calcium levels and kidney function and reduce or stop treatment temporarily if serum calcium level exceeds 12 mg/dl. Calcium salt should be used cautiously in patients with sarcoidosis, history of nephrolithiasis, cardiac disease and in patients receiving cardiac glycosides.
CONTRAINDICATIONS
It is contraindicated in patients having hypercalcaemia and severe hypercalciurea, ventricular fibrillation, hypervitaminosis, severe renal failure, kidney stones and hypersensitivity to any of the ingredients of the product.
DRUG INTERACTION
A-CAL D should not be used with the following medications because of possible interactions – Iron; digoxin; verapamil; calcium, aluminium or magnesium containing antacids; other calcium or vitamin D supplements (e.g., calcitriol). Bran decreases the gastrointestinal absorption of calcium and may therefore decrease the efficacy of calcium supplements. Concurrent administration of thiazide diuretics may increase the risk of hypercalcemia. Co-administration of calcium
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