Calcium 600 mg + Vitamin D 400 IU

Calcium 600 mg + Vitamin D 400 IU is a combination tablet used to supplement calcium and vitamin D deficiency. Each tablet contains: Calcium Carbonate USP 1250 mg (Coral source, equivalent to 500 mg elemental Calcium) and Vitamin D USP 200 IU (DX tablet contains 1500 mg Calcium and 400 IU Vitamin D; effervescent tablet contains 1500 mg Calcium and 400 IU Vitamin D3).

Calcium is the primary mineral component of bones, providing strength and rigidity, and is essential for nerve and muscle function. Vitamin D enhances intestinal calcium absorption and stimulates bone formation. Calcium and vitamin D have synergistic effects on bone growth, osteoporosis, and fracture prevention. The calcium carbonate in this preparation is sourced from coral origin, which has a chemical structure very similar to human bone and ensures better absorption.

• Osteoporosis
• Osteomalacia
• Tetany
• Hypoparathyroidism
• Disorders of osteogenesis
• Inadequate calcium intake in childhood diet
• Rickets
• Pregnancy and lactation
• Elderly patients
• Pancreatitis
• Phosphate binder in chronic renal failure

Adults: 1-2 tablets daily (one each morning and evening) or as directed by a physician.

Effervescent tablet: Dissolve 1 tablet in a glass of water and drink orally. Stir the solution with a spoon before drinking.

Note: Taking on a full stomach ensures better absorption. Take with plenty of water.

Common side effects: Constipation, flatulence, nausea, vomiting, diarrhea, headache, drowsiness, dry mouth, anorexia, abdominal pain.

Rare: Hypercalcemia, hypophosphatemia, acid rebound, milk-alkali syndrome, allergic reactions, irregular heartbeats, decreased appetite.

Occasional skin rash has been reported with vitamin D supplements.

• When hypercalcemia occurs, discontinuation of the drug is usually sufficient to return serum calcium to normal.
• Use cautiously in patients with sarcoidosis, renal or cardiac disease, and patients receiving cardiac glycosides.
• Patients with a history of stone formation should increase their fluid intake.
• During long-term treatment, monitor serum calcium levels and renal function (serum creatinine).
• In severe renal insufficiency, vitamin D (cholecalciferol) is not metabolized normally; other forms of vitamin D should be used.
• Use with caution in immobilized patients with osteoporosis due to increased risk of hypercalcemia.

• Hypercalcemia and hyperparathyroidism
• Hypercalciuria and nephrolithiasis
• Hypersensitivity to any ingredient
• Severe renal insufficiency
• Concomitant digoxin therapy (requires careful monitoring of serum calcium levels)

• Thiazide diuretics: Reduce urinary calcium excretion; monitor serum calcium regularly during concomitant use.
• Systemic corticosteroids: Reduce calcium absorption; dose increase may be necessary.
• Ion-exchange resins (cholestyramine) and laxatives (paraffin oil): May reduce GI absorption of vitamin D.
• Tetracyclines: Calcium interferes with tetracycline absorption; administer tetracycline at least 2 hours before or 4-6 hours after calcium.
• Cardiac glycosides (digitalis): Hypercalcemia may increase toxicity; monitor ECG and serum calcium levels.
• Bisphosphonates or sodium fluoride: Administer at least 3 hours before calcium (GI absorption may be reduced).
• Oxalic acid (spinach, rhubarb) and phytic acid (whole cereals): Form insoluble calcium salts, inhibiting absorption; do not take calcium products within 2 hours of eating foods high in these acids.