Generic
Calcium Citrate + Calcitriol
5 brands available in the market
At a glance
Calcium Citrate + Calcitriol is a combination tablet used to prevent or treat low blood calcium levels, osteoporosis, osteomalacia, rickets, hypoparathyroidism, and latent tetany. It improves bone health and helps maintain calcium balance.
Description
Calcium Citrate + Calcitriol is a combination tablet used to supplement calcium and vitamin D deficiency. Each tablet contains Calcium Citrate USP 1200 mg (equivalent to Calcium 252 mg) and Calcitriol EP 0.25 mcg.
Calcium plays a very important role in the body for normal functioning of nerves, cells, muscle, and bone. Calcium citrate is well absorbed on an empty stomach and does not constipate. Calcitriol is the most active known form of vitamin D3 in stimulating intestinal calcium transport. It augments intestinal absorption of calcium and phosphate and plays a significant role in the regulation of bone mineralization.
Indications
- Calcium deficiency
- Osteoporosis
- Osteomalacia
- Rickets
- Hypoparathyroidism
- Latent tetany
- Postmenopausal calcium supplementation
Therapeutic class
Specific mineral & vitamin combined preparations
Pharmacological class
Calcium + Vitamin D Analog Combination
Pharmacology
Calcium citrate is a good source of calcium that is well absorbed on an empty stomach and does not cause constipation. Calcitriol is the active form of vitamin D3 that increases intestinal calcium and phosphate absorption and regulates bone mineralization. In chronic renal failure, calcitriol production is impaired, contributing to mineral metabolism abnormalities. Oral calcitriol administration compensates for this deficiency and reverses signs and symptoms of bone disease.
Mechanism of action
Calcitriol promotes intestinal calcium absorption and renal calcium retention, increasing serum calcium levels. It also increases renal tubule phosphate resorption, decreasing serum phosphatase and PTH levels. Calcium provides the essential mineral for bone mineralization and nerve/muscle function.
Dosage
Adults: 1-4 tablets daily (depending on clinical condition), with or without food, or as directed by the registered physician.
Note: Dose must be individualized based on serum calcium levels.
Administration
Take as advised by your physician, with or without food. Swallow tablets whole; do not chew or crush. Monitor serum calcium levels regularly.
Missed dose
If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not double the dose.
Side effects
Calcium-related side effects: Anorexia, constipation, flatulence, nausea, vomiting, hypercalcemia, hypophosphatemia, xerostomia, acid rebound, milk-alkali syndrome, coma, confusion, delirium, headache, lethargy.
Calcitriol-related side effects: Abdominal pain, apathy, increased BUN/creatinine, cardiac arrhythmia, constipation, dry mouth, dehydration, growth suppression, headache, hyperthermia, hypercalcemia, hypercholesterolemia, hypermagnesemia, hyperphosphatemia, hypertension, decreased libido, metallic taste, muscle/bone pain, nocturia, pruritus, psychosis, somnolence, weakness.
Precautions & warnings
- Caution in hypercalcemia, malabsorption syndrome, heart disease, kidney disease, kidney stones, sarcoidosis, liver disease, Crohn's disease.
- Impaired calcium absorption in achlorhydria (common in elderly).
- Increased risk of hypercalcemia and hypercalciuria in hypoparathyroid patients on high doses of vitamin D.
- Caution in history of kidney stones and renal impairment.
- Risk of hypercalcemia with thiazide diuretics or excessive vitamin D.
Contraindications
- Hypercalcemia
- Hypercalciuria
- Hypophosphatemia
- Nephrolithiasis (kidney stones)
- Hypervitaminosis D
- Hypersensitivity to any ingredient
Drug interactions
- Tetracyclines, quinolones, oral bisphosphonates: Reduced absorption with concurrent calcium use.
- Corticosteroids: May reduce calcium absorption.
- Thiazide diuretics: Increased risk of hypercalcemia and metabolic alkalosis.
- Cardiac glycosides (digitalis): High blood calcium may increase cardiac glycoside effects.
- Erlotinib: Reduced efficacy with calcium.
- Paricalcitol: Increased risk of hypercalcemia.
- Enzyme-inducing antiepileptics: Increase vitamin D metabolism.
- Calcium citrate with aluminium products: Fatal encephalopathy in renal failure patients due to marked rise in aluminium levels.
Food interactions
No specific food restrictions (may be taken with or without food).
Use in pregnancy
May be unsafe during pregnancy (Category C). Use only as directed by a registered physician during pregnancy.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Adequate information on use during lactation is not available; use only as directed by a registered physician.
Pediatric use
Use in children under medical supervision.
Geriatric use
Elderly patients may have impaired calcium absorption due to achlorhydria; caution required.
Renal / hepatic impairment
Hepatic impairment: Caution required; dose adjustment may be needed.
Overdose effects
Overdose may cause hypercalcemia, hypercalciuria, hyperphosphatemia, milk-alkali syndrome. Symptoms: nausea, vomiting, constipation, confusion, coma. Consult your doctor immediately if overdose is suspected.
Storage conditions
Store in a cool and dry place below 25°C, protected from light and moisture. Keep out of reach of children.
Chemical structure
Calcium Citrate 1200 mg (equiv. Calcium 252 mg) + Calcitriol 0.25 mcg