Calcium carbonate + Calcium lactogluconate (Calcii carbonas + Calcii lactogluconas)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
Read on
Clinical and pharmacological group: & nbsp

Macro and microelements

Included in the formulation
  • Calcium Sandoz® Forte
    pills inwards 
    Sandoz d.     Slovenia
    • АТХ:

    A.12.A.A.20   The combination of different calcium salts

    Pharmacodynamics:

    Calcium is a vital mineral element necessary to maintain the balance of electrolytes in the body and the adequate functioning of numerous regulatory mechanisms. Replenishes Ca deficiency2+ in the body, is involved in phosphate-calcium metabolism, has a vitamin, anti-cancer, anti-inflammatory and anti-allergic effect.

    Two calcium salts (calcium lactogluconate and calcium carbonate) are converted into an active ionized form of calcium, which is easily digested.

    Pharmacokinetics:

    About 25-50% of calcium is absorbed into the intestine. Approximately 50% of the total calcium content in the blood is present in a physiologically active ionized form, about 5% forms complexes with citrate, phosphate and other anions. The remaining 45% of calcium in the serum binds to proteins, mainly albumin. About 20% of calcium is excreted through the kidneys and 80% through the intestine. The level of excretion through the kidneys depends on the glomerular filtration and tubular reabsorption. Through the intestine, both unabsorbed calcium and its absorbed part are excreted, which is secreted with bile and pancreatic secretion.

    Indications:

    Prevention and treatment of calcium deficiency (including pregnancy, lactation, a period of intensive growth in children); addition of calcium to specific therapy in the prevention and treatment of osteoporosis; allergic reactions (maintenance therapy); osteomalacia (as an adjunct to the main therapy, including vitamin D3).

    ICD-10

    IV.E50-E64.E58   Alimentary calcium deficiency

    XIII.M80-M85.M81.0   Postmenopausal osteoporosis

    XIII.M80-M85.M81.1   Osteoporosis after removal of ovaries

    XIII.M80-M85.M81.4   Medicinal osteoporosis

    XIII.M80-M85.M81.5   Idiopathic osteoporosis

    XIII.M80-M85.M81.8   Other osteoporosis

    XIII.M80-M85.M82.8 *   Osteoporosis in other diseases classified elsewhere

    XIII.M80-M85.M83.9   Osteomalacia in adults, unspecified

    XV.O20-O29.O25   Malnutrition in pregnancy

    Contraindications:

    Hypercalcemia; hypercalciuria; chronic renal failure; nefroourolithiasis; nephrocalcinosis; phenylketonuria; deficiency of sugar / isomaltase; intolerance to fructose, glucose-galactose malabsorption; children's age up to 3 years.

    Carefully:

    Appendicitis or suspicion of it, bleeding - gastrointestinal, rectal or unspecified localization, ulcerative colitis, colostomy, ileostomy, diverticulitis, chronic diarrhea,constipation, hemorrhoids, hypoparathyroidism, sarcoidosis.

    Pregnancy and lactation:

    The drug can be administered during pregnancy and breastfeeding on the recommendation of a doctor. Calcium enters the breast milk.

    In pregnancy, the daily dose of calcium should not exceed 1500 mg. Hypercalcemia in pregnancy can cause disturbances in the development of the fetus.

    The category of FDA recommendations is not defined.

    Dosing and Administration:

    Children from 3 to 9 years old - 500 mg per day.

    Adults and children from 10 years, 1000 mg per day.

    Side effects:

    Allergic reactions, including rash, itching, hives, facial swelling, angioedema, edema; hypercalcemia, flatulence, constipation, diarrhea, nausea, vomiting, epigastric pain.

    When taken in high doses (2000 mg per day with daily intake for several months), there may be headache, fatigue, thirst, polyuria.

    Overdose:

    Symptoms hypercalcemia: nausea, vomiting, thirst, polydipsia, polyuria, dehydration and constipation.

    Chronic overdose in the development of hypercalcemia can lead to liming vessels and organs. The threshold of calcium intoxication - with the intake of calcium preparations for several months in a dose exceeding 2000 mg per day.

    Therapy in case of an overdose

    In case of intoxication, immediately stop therapy and restore the water-electrolyte balance.

    In chronic overdose, if there is evidence of hypercalcemia at the initial stage, hydration is performed with the help of 0.9% sodium chloride solution. To increase the excretion of calcium, as well as to avoid edema in the tissues (for example, with congestive heart failure), loop diuretics can be used, for example, furosemide. In this case, one should refrain from the use of thiazide diuretics.

    In patients with renal insufficiency, hydration is ineffective, such patients are shown dialysis. In the case of persistent hypercalcemia, other factors contributing to its development should be excluded, including vitamin A or D hypervitaminosis, primary hyperparathyroidism, malignant tumors, renal failure, stiffness of movements.

    Interaction:

    Combination calcium carbonate + calcium lactogluconate can reduce the absorption of estramustine, etidronate, and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics, and fluoride preparations. The interval between the reception of a combination calcium carbonate + calcium lactogluconate and the above preparations should be at least 3 hours.

    Simultaneous administration of vitamin D and its derivatives increases the absorption of calcium. When administered in high doses along with vitamin D and its derivatives, calcium can reduce the action of calcium channel blockers.

    If the combination is applied simultaneously calcium carbonate + calcium lactogluconate and tetracycline drugs, absorption of the latter may be impaired. For this reason, tetracycline drugs should be taken at least 2 hours before or 4-6 hours after ingestion.

    Thiazide diuretics reduce the excretion of calcium in the urine, so when they are used together with a combination of calcium carbonate + calcium lactogluconate Serum calcium should be monitored regularly, as there is a risk of developing hypercalcemia.

    Systemic corticosteroids reduce absorption of calcium. If they are used simultaneously, an increase in the dose of the combination may be required calcium carbonate + calcium lactogluconate.

    When administered in combination calcium carbonate + calcium lactogluconate together with cardiac glycosides, an increase in the toxicity of cardiac glycosides is possible. Patients taking cardiac glycosides should regularly take ECG and monitor the level of calcium in the blood serum.

    With the simultaneous ingestion of bisphosphonate or sodium fluoride, these drugs should be taken at least 3 hours before taking medications containing a combination calcium carbonate + calcium lactogluconate, as absorption from the gastrointestinal tract bisphosphonate or sodium fluoride can decrease.

    Absorption from the gastrointestinal tract may decrease with the simultaneous intake of certain foods containing oxalic acid (for example, spinach, rhubarb) or phytic acid (in all cereals), in connection with the formation of insoluble complexes with calcium ions. Patients should not take drugs containing calcium carbonate + calcium lactogluconate 2 hours before or after a meal rich in oxalic or phytic acid.

    Special instructions:No data.
    Instructions
    Up