Detailed Product Description

COMPOSITION:

Each chewable tablet contains:

Calcium Carbonate                   BP       500 mg.

Eq. to Elemental Calcium

DESCRIPTION: It is essential for the functional integrity of the nervous system and muscular system, where it has a major influence ion the integrity and excitability of these tissues. It is necessary for normal cardiac function, and is one of the factor that operates in the mechanisms involved in the coagulation of the blood.

ADVERSE EFFECTS: Calcium carbonate may occasionally cause constipation. Flatulence from released carbon dioxide may occur in some patients. High doses or prolonged use may lead to gastric hypersecretion and acid rebound. Like other calcium salts. Calcium carbonate can cause hypercalcaemia, particularly in patient withy renal impairment or after high doses. Alkalosis may also occur as a result of the carbonate anion. There have been rare reports of the milk-alkali syndrome and tissue calcification.

CONTRAINDICATIONS: Renal calculi, hypophosphataemia.

SPECIAL PRECAUTIONS : End stage renal failure, hypoparathyroid patients, prolonged intake of therapeutic amounts.

DRUG INTERACTIONS : Thiazide diuretics : Hypercalcaemia.

Atenolol : Decreased peak plasma levels of atenolol.

Iron salts : Gl absorption of iron reduced.

Quinolones : Reduced bioavailability of Norfloxacin.

Tetracyclines : Absorption and serum levels of tetracyclines reduced.

Verapamil : Clinical effects and toxicities of verapamil reversed.

INDICATIONS : Calcium & Vitamin D deficiency state, Rickets. During pregnancy & lactation. Postmenopausal woman. Chronic renal failure.

Calcium acetate : Control of phosphataemia in chronic renal failure and end stage renal disease; does not promote aluminum absorption.

PHARMACOKINETICS: Calcium is absorbed predominantly from the small intestine by active transport and passive diffusion. About one-third of ingested calcium is absorbed although this can vary depending upon dietary factors and the state of the small intestine; also absorption is increased in calcium deficiency and during periods of high physiological requirement such as during childhood or pregnancy and lactation. 1, 25-Dihydroxychloecalciferol (calcitriol), a metabolite of vitamin D, enhances the active phase of absorption. Excess calcium is predominantly excreted really. Unabsorbed calcium is secreted in the bile and pancreatic juice. Minor amounts are lost in the sweat, skin, hair, and nails. Calcium crosses the placenta and is distributed into breast milk.

Human Requirements: Calcium is the most abundant mineral in the body and is an essential body electrolyte. However, defining individual calcium requirements has proved difficult and guidelines very widely by country and culture. Some authorities have adopted a factorial approach. For example, in the UK the dietary reference value of healthy people under the prevailing dietary circumstances. The amount of calcium absorbed varies according to several factors including the requirements of the body, but is normally only about 30 to 40% of the dietary intake.

The richest dietary sources of calcium are milk and milk products. Significant amounts can also be consumed in green leafy vegetables, fortified flour, and hard water.

DOSES: Doses may be expressed in terms of mmol or mEq of calcium, mass(mg) of calcium, or mass of calcium salt. In simple deficiency states calcium salts may be given by mouth, usually in dose of 10 to 50 mmol (400 mg to 2 g) of calcium daily adjusted to the individual patients requirements.

In severe acute hypocalcaemia or hypocalcaemia tetany parenteral administration is necessary, generally by slow intravenous injection or continuous infusion of calcium chloride or calcium gluconate. A typical dose is 2.25 mmol of calcium by slow intravenous injection, either repeated as required, or followed by continuous intravenous infusion of about 9 mmol daily. 2.25 mmol of calcium is provided by 10 ml. of calcium gluconate 10%. Calcium gluceptate and calcium glycerophosphate with calcium lactate have been given by the intramuscular route; the chloride and gluconate are unsuitable for this route because of their irritancy. The intravenous route is used in children. Intravenous calcium salts are also used to reverse the toxic cardiac effects of potassium in the emergency treatment of severe hyperkalaemia, and as an antidote to magnesium is severe hypermagnesaemia. For these indications, 2.25 to 4.5 mmol of calcium (10 to 20 ml. of calcium gluconate 10%) is commonly used.

Individual calcium salts have specific uses. Calcium carbonate or acetate are effective phosphate binders and are given by mouth to reduce phosphate absorption from the gut in patients with hypophosphataemia: this is particularly relevant to patients with chromic renal failure in order to prevent the development of renal osteodystrophy. The initial dose of calcium carbonate is 2.5 g daily titrated to a maximum of 17 g daily. The initial doses of calcium acetate is 3 or 4 g daily; most patients require 6 to 12 g daily.

Storage           :           Store in a well-closed, light-resistant containers in a cool, dry &

dark place

Packing           :           Elis Calcium carbonate generally found in blister pack of 10 tablet, 10                                        blister strip packed in a carton

Keep the Medicine out of the reach of children