Natekal D3 - instructions for use, dose, side effects, contraindications

sorbitol - 565.25 mg, maltodextrin 166 mg, croscarmellose sodium - 30 mg, aspartame - 5 mg, sodium saccharinate - 5 mg, lactose monohydrate - 67 mg, flavor anise - 15 mg, flavoring mint - 11,25 mg, the flavor is molasses - 7,5 mg, magnesium stearate - 60 mg; * - alpha-tocopherol acetate 0.008 mg, soy bean oil hydrogenated 0.3 mg, gelatin 1.52 mg, sucrose 1.52 mg, corn starch 0.642 mg.

Description:

round flat tablets of white or almost white color, with bevelled edges and a specific odor, on one side of the tablet the marking "D".

Pharmacotherapeutic group:calcium-phosphorus exchange regulator

ATX: & nbsp

A.12.A.X Calcium preparations in combination with other drugs

Pharmacodynamics:

Combined drug regulating the exchange of calcium and phosphorus in the body.

Reduces resorption (resorption) and increases the density of bone tissue, filling the lack of calcium and vitamin Dz in organism.

Vitamin D3 increases calcium absorption in the gastrointestinal tract and its binding in bone tissue.

The use of calcium and vitamin Dz prevents the increase in the production of parathyroid hormone (PTH), which is a stimulator of increased bone resorption (leaching calcium from the bones).

Pharmacokinetics:

Vitamin Dz absorbed in the small intestine. Calcium is absorbed in ionized form in the proximal part of the small intestine through an active, D-vitamin dependent transport mechanism.

Indications:

It is used as a therapeutic and prophylactic drug:

- for prevention and complex therapy of osteoporosis;

- replenishment of calcium and vitamin deficiency Dz in the elderly.

Contraindications:

- Hypersensitivity to one of the components of the drug (including peanuts or soybeans);

- intolerance of some types of sugars: lactose, sucrose, sorbitol, fructose;

- phenylketonuria;

- pulmonary tuberculosis in active form;

- hypercalcemia (elevated calcium in the blood - in individuals with increased function of parathyroid glands);

- hypercalciuria (increased excretion of calcium with urine)

- urolithiasis (formation of calcareous stones);

- sarcoidosis and metastasis of tumors in the bone;

- osteoporosis caused by prolonged immobilization;

- an overdose of a vitamin Dz.

Carefully:

With caution, take the drug to people with kidney failure, benign granulomatosis.

Pregnancy and lactation:

During pregnancy and lactation, the daily dose of the drug should not exceed 1500 mg of calcium and 600 ME vitamin A Dz. Overdose during pregnancy can lead to disruption of the child's mental and physical development. Calcium and Vitamin Dz penetrates into breast milk. During pregnancy and lactation should be taken Natekal Dz not more than 1 tablet per day.

Dosing and Administration:

Before use, consult a doctor. Only for adults. The tablet should be chewed or sucked, but not swallowed whole.

As a preventive agent: 1 to 2 chewable tablets per day, preferably during meals.

For the therapy of osteoporosis and for the replacement of calcium and vitamin D3 deficiency in the elderly: course and dosage according to the recommendations of the doctor.

Side effects:

There may be: constipation, diarrhea, flatulence, nausea, pain in the stomach. Hypercalcemia and hypercalciuria. Allergic reactions.

Interaction:

- Vitamin activity Dz can decrease with simultaneous application with phenytoin or barbiturates;

- while simultaneous treatment with cardiac glycosides, ECG monitoring and the clinical state of the patient are necessary, calcium increases the risk of developing cardiac glycoside toxicity;

- with the simultaneous use of the drug and antibiotics from the tetracycline and fluoroquinolone group, the interval between admission should be at least 3 hours, because calcium and vitamin Dz increase the absorption of tetracyclines and fluoroquinolones from the gastrointestinal tract;

- the absorption of bisphosphonate or sodium fluoride decreases with simultaneous use with the drug;

- corticosteroids reduce the absorption of calcium;

- with the simultaneous use of diuretics from the group of thiazides, the risk of hypercalcemia increases due to an increase in the reverse absorption of calcium from the lumen of the renal tubules. Furosemide and other "loop" diuretics, on the contrary, increase the excretion of calcium by the kidneys;

- simultaneous treatment with colestyramine preparations or laxatives based on mineral or vegetable oil can reduce the absorption of vitamin A D3;

- the acid reaction of food products increases, and the slightly alkaline reaction of the products reduces the absorption of calcium.

Special instructions:

During the treatment with the drug, it is necessary to constantly monitor the excretion of calcium in the urine and the concentration of calcium and creatinine in the blood plasma. The dose should be reduced or temporarily discontinued if the concentration of calcium or serum creatinine is increased, or if the urinary calcium level exceeds 7.5 mmol / 24 hours (300 mg / 24 hours).

In order to avoid an overdose, it is necessary to take into account the supplementary intake of the vitamin Dz from other sources. Do not apply simultaneously with vitamin-mineral complexes containing calcium and vitamin Dz.

Have older people, the need for calcium is 1,5 g / day, in vitamin D3 - 500 -1000 IU / day.

To prevent a decrease in the absorption of bisphosphonate or sodium fluoride, it is recommended to take NATEKAL Dz not earlier than 3 hours after their admission. Corticosteroids reduce the absorption of calcium, so treatment with corticosteroids may require an increase in the dose of NATEKAL Dz.

Effect on the ability to drive transp. cf. and fur:

Form release / dosage:

Tablets, chewing.

Packaging:

For 60 or 12 tablets per vial of high-density polyethylene with lid of the same material with control of the first autopsy. On inside the lid (in cap made of high-density polyethylene density) is a disk of silica gel or without silica gel. Each bottle together with instructions for use placed in a cardboard box.

Storage conditions:

Store at a temperature not exceeding 30 ° C.

Keep out of the reach of children.

Shelf life:

2 years.Do not use after expiry date.

Terms of leave from pharmacies:Without recipe

Registration number:П N013811 / 01

Date of registration:14.03.2008

The owner of the registration certificate:Italfarmaco SpAItalfarmaco SpA Italy

Manufacturer: & nbsp

ITALFARMACO, S.p.A. Italy

Representation: & nbspITALFARMAKO SpA ITALFARMAKO SpA Italy

Information update date: & nbsp27.01.2014

Illustrated instructions

Instructions

Natekal D3 (Natecal D3)