Generic
Calcitriol + Calcium
5 brands available in the market
At a glance
Calcitriol + Calcium is a combination tablet used in the treatment of osteoporosis, hypoparathyroidism, hypocalcaemia, osteomalacia, rickets, renal osteodystrophy, and chronic kidney dialysis. It replenishes calcium deficiency and improves bone health.
Description
Calcitriol + Calcium is a combination tablet that increases blood calcium levels and improves bone health. 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 is normally formed in the kidneys from 25-hydroxycholecalciferol. In physiological amounts, it augments intestinal absorption of calcium and phosphate and plays a significant role in the regulation of bone mineralization.
Indications
- Osteoporosis
- Hypoparathyroidism
- Hypocalcaemia
- Osteomalacia
- Rickets
- Renal osteodystrophy
- Chronic kidney dialysis
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. The biological effects of calcitriol are mediated by the vitamin D receptor, functioning as a ligand-activated transcription factor that modifies expression of target genes.
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.
Hyperparathyroidism in renal failure: 0.25 mcg/day or alternate day; may increase slowly.
Hypoparathyroidism/Pseudohypoparathyroidism: 0.5-2 mcg once daily.
Vitamin D-dependent rickets: 0.015-0.02 mcg/kg/day (initial); 0.03-0.06 mcg/kg/day (maintenance). Max: 2 mcg/day.
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 idiopathic hypercalcemia.
- Caution in coronary disease, renal impairment, and arteriosclerosis (especially in elderly).
- Caution in hypoparathyroidism.
- Pediatric doses must be individualized and monitored under close medical supervision.
- Caution in hypercalcemia, malabsorption syndrome, heart disease, kidney disease, kidney stones, sarcoidosis, liver disease, Crohn's disease.
- Risk of hypercalcemia with thiazide diuretics or excessive vitamin D.
Contraindications
- Hypercalcemia
- Hypercalciuria
- Hypophosphatemia
- Evidence of vitamin D toxicity
- Pregnancy (doses exceeding RDA)
- Lactation
- Hypersensitivity to any ingredient
Drug interactions
- Tetracyclines, quinolones, oral bisphosphonates: Reduced absorption with concurrent calcium use.
- Corticosteroids: Reduce calcium absorption.
- Thiazide diuretics: Increased risk of hypercalcemia and metabolic alkalosis.
- Cardiac glycosides (digitalis): High blood calcium may increase cardiac glycoside effects and precipitate digitalis intoxication.
- 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
Calcium enters breast milk; not recommended during lactation. Use only as directed by a registered physician.
Pediatric use
Pediatric doses must be individualized and monitored under close medical supervision.
Geriatric use
Caution required in elderly patients due to coronary disease, renal impairment, and arteriosclerosis.
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