Calcium and Vitamin- D3 is used for the treatment of osteoporosis, osteomalacia, rickets, tetany, disorders of osteogenesis and tooth formation (addition to specific treatment) and parathyroid disease. Also used in raised Calcium requirement for children and adolescents at times of rapid growth and during pregnancy and lactation. It is also used as routine supplement and phosphate binder in chronic renal failure.

Adults and Elderly : The usual doses are two tablets daily at morning and evening. Higher doses should not be used unless recommended by the physician. Tablet must be swallowed.

It is contraindicated in case of hypercalcaemia, hyperthyroidism, renal calculi & nephrolithiasis, Zoliinger-Elison syndrome and in concomitant digoxin therapy.

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 mild to moderate renal failure or mild hypercalciuria. Urinary calcium excretion should also be measured. In patients with a history of renal stones urinary calcium excretion should be measured to exclude 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 urinary calcium exceeds 7.5mmol/24 hours. Allowances should be made for calcium and vitamin D supplements from other sources.

Orally administered Calcium Carbonate may be irritating to the GI tract. It may also cause constipation. Hypercalcaemia is rarely produced by administration of Calcium alone, but may occur when large doses are given to patients with chronic renal failure. Also there may be occasional allergic reactions, irregular heartbeats, nausea, vomiting, decreased appetite, dry mouth and drowsiness. Following the administration of Vitamin D3 supplements occasional skin rash has been reported.

The risk of hypercalcaemia should be considered in patients taking thiazide diuretics since these drugs can reduce urinary calcium excretion. Hypercalcaemia must be avoided in digitalized patients. Certain foods (e.g. those containing oxalic acid, phosphate or phytinic) may reduce the absorption of calcium. Concomitant treatment with phenytoin or barbiturates can decrease the effect of vitamin D because of metabolic activation. Concomitant use of glucocorticoids can decrease the effect of vitamin D. The effects of digitalis and other cardiac glycosides may be accentuated with the oral administration of calcium combined with vitamin D. Strict medical supervision is needed and, if necessary monitoring of ECG and calcium. Calcium salts may reduce the absorption of thyroxine, biphosphonates, sodium fluoride, quinolone or tetracycline antibiotics or iron. It is advisable to allow a minimum period of four hours before taking the calcium.

During pregnancy and lactation treatment should always be under the direction of a physician. During pregnancy and lactation, requirements for calcium and vitamin D are increased but in deciding on the required supplementation allowances should be made for availability of these agents from other sources. If calcium iron supplements are both required to be administered to the patient, they should be taken at different times. Overdoses of vitamin D have shown teratogenic effects in pregnant animals. In humans, long term hypercalcaemia can lead to physical and mental retardation, aortic stenosis and retinopathy in a new born child. Vitamin D and its metabolites pass into the breast milk. children.

Symptoms of overdose may include nausea and vomiting, severe drowsiness, dry mouth, loss of appetite, metallic taste, stomach cramps, unconsciousness, diarrhea, weakness, headache, constipation, dizziness or irritability.

Onecal-D Tablet: Each box containing 3x10’s tablets of Alu-PVC blister. Each Pot contains 30 tablets