Calcium d3 Sandoz instructions. Calcium Sandoz Forte instructions for use, contraindications, side effects, reviews. This is interesting - practical experience of application

Description of the dosage form

Round, flat tablets with a beveled edge, white to almost white in color, with a slight specific odor. The tablets have a slightly rough surface.

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 2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and anti-allergic effects.

Calcium Sandoz ® Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into the active form of calcium, which is easily absorbed. This dosage form ensures an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic calcium deficiency in the body, as well as for the treatment of various types of metabolic disorders in bone tissue.

Pharmacokinetics

Suction. Approximately 25–50% of an ingested dose of calcium is absorbed primarily in the proximal small intestine and enters the metabolic calcium depots.

Distribution and metabolism. 99% of calcium reserves in the body are contained in bones and teeth, 1% is found in intra- and extracellular fluid. Approximately 50% of the total calcium content in the blood is present in the physiologically active ionized form, approximately 5% forms complexes with citrate, phosphate and other anions. The remaining 45% of serum calcium is bound to proteins, mainly albumin.

Excretion. About 20% of calcium is excreted through the kidneys and 80% through the intestines. The level of excretion through the kidneys depends on glomerular filtration and tubular reabsorption. Both unabsorbed calcium and the absorbed part of it, which is excreted in bile and pancreatic secretions, are excreted through the intestines.

Calcium Sandoz Forte: Indications

prevention and treatment of calcium deficiency (including pregnancy, lactation, period of intensive growth in children);

adding calcium to specific therapy for the prevention and treatment of osteoporosis;

allergic reactions (maintenance therapy);

osteomalacia (as an addition to the main therapy, including vitamin D3).

Calcium Sandoz Forte: Contraindications

hypersensitivity to the components of the drug;

increased concentration of calcium in the blood and urine (hypercalcemia, hypercalciuria);

chronic renal failure;

nephrourolithiasis, nephrocalcinosis;

phenylketonuria and sucrose/isomaltose deficiency, fructose intolerance, glucose-galactose malabsorption.

Use during pregnancy and breastfeeding

The drug can be prescribed during pregnancy and breastfeeding on the recommendation of a doctor. Calcium passes into breast milk. During pregnancy, the daily dose of calcium should not exceed 1500 mg. Hypercalcemia during pregnancy can cause disturbances in fetal development.

Directions for use and doses

Inside, regardless of food intake. Before taking the tablet, dissolve it in a glass of water.

In severe cases or with an increased need for calcium (for example, treatment with bisphosphonates), the dose may be increased to 2000 mg/day.

Prevention and treatment of osteoporosis

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

Adults and children over 10 years old - 1000 mg/day.

Duration of therapy: when used to replenish calcium deficiency, the average duration of treatment is at least 4–6 weeks.

When used for prevention in complex therapy of osteoporosis, the duration of treatment is determined individually.

Calcium Sandoz Forte: Side effects

Very rarely (<1/10000) - реакции повышенной чувствительности, в т.ч. сыпь, зуд, крапивница, гиперкальциемия. В единичных случаях сообщалось о системных аллергических реакциях (анафилактическая реакция, отек лица, ангионевротический отек). В отдельных медицинских публикациях сообщалось о развитии гиперкальциурии на фоне приема кальциевых добавок.

Rarely (>1/10000,<1/1000) - метеоризм, запор, диарея, тошнота, рвота, эпигастральная боль. При приеме в высоких дозах (2000 мг/сут ежедневно в течение нескольких месяцев) может наблюдаться головная боль, повышенная утомляемость, жажда, полиурия.

Overdose

Overdose leads to the development of hypercalciuria and hypercalcemia.

Symptoms of hypercalcemia: nausea, vomiting, thirst, polydipsia, polyuria, dehydration and constipation. Chronic overdose with the development of hypercalcemia can lead to liming of blood vessels and organs. The threshold for calcium intoxication is when taking calcium supplements for several months at a dose exceeding 2000 mg/day.

Treatment: in case of intoxication, therapy should be stopped immediately and water and electrolyte balance should be restored. In case of chronic overdose, if signs of hypercalcemia are detected, hydration is carried out initially with a 0.9% sodium chloride solution. To enhance the excretion of calcium, as well as to avoid the formation of edema in the tissues (for example, in congestive heart failure), loop diuretics, such as furosemide, can be used. In this case, you should refrain from using thiazide diuretics.

In patients with renal failure, hydration is ineffective; dialysis is indicated for such patients. In the case of persistent hypercalcemia, other factors contributing to its development should be excluded, incl. hypervitaminosis A or D, primary hyperparathyroidism, malignant tumors, renal failure, stiffness.

Interaction

The combination of calcium carbonate + calcium lactogluconate may reduce the absorption of estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones and fluoride preparations. The interval between taking effervescent calcium carbonate + calcium lactogluconate tablets and the above drugs should be at least 3 hours.

The simultaneous administration of vitamin D and its derivatives increases calcium absorption. When prescribed in high doses along with vitamin D and its derivatives, calcium may reduce the effect of verapamil and possibly other CCBs.

With the simultaneous use of effervescent calcium carbonate + calcium lactogluconate tablets and tetracycline drugs, the absorption of the latter may be impaired. For this reason, tetracycline preparations should be taken at least 2 hours before or 4-6 hours after oral calcium supplements.

Thiazide diuretics reduce urinary calcium excretion, therefore, when used concomitantly with calcium carbonate + calcium lactogluconate effervescent tablets, regular monitoring of serum calcium concentrations should be carried out, as there is a risk of developing hypercalcemia.

Systemic corticosteroids reduce calcium absorption. If they are used simultaneously, it may be necessary to increase the dose of effervescent calcium carbonate + calcium lactogluconate tablets.

When ingesting effervescent calcium carbonate + calcium lactogluconate tablets in patients receiving cardiac glycosides, the toxicity of cardiac glycosides may increase due to the development of hypercalcemia. Such patients should regularly take an ECG and monitor the level of calcium in the blood serum.

When taking a bisphosphonate or sodium fluoride orally at the same time, these drugs should be taken at least 3 hours before taking calcium carbonate + calcium lactogluconate effervescent tablets, since absorption from the gastrointestinal tract of the bisphosphonate or sodium fluoride may be reduced.

Calcium absorption from the gastrointestinal tract may be reduced by concomitant intake of certain foods containing oxalic acid (eg spinach, rhubarb) or phytic acid (in all grains) due to the formation of insoluble complexes with calcium ions. Patients should not take effervescent tablets calcium carbonate + calcium lactogluconate 2 hours before or after meals, with a high content of oxalic or phytic acid.

Latin name

Calcium-Sandoz forte

Release form

Effervescent tablets.

1 effervescent tablet 1000 mg contains:
Active ingredients: calcium lactogluconate 2263.00 mg and calcium carbonate 1750.00 mg, which is equivalent to 1000 mg or 25 mmol of ionized calcium.
Excipients: citric acid macrogol-6000, orange flavor (orange flavor contains sulfur dioxide (E220), butylated hydroxyanisole (E320), sorbitol), aspartame, sodium bicarbonate.

Package

20 tablets in a polypropylene case, sealed with a polypropylene lid containing silica gel and equipped with a first-opening control system. The pencil case along with instructions for use are placed in a cardboard box.

pharmachologic effect

Calcium Sandoz forte is a regulator of calcium-phosphorus metabolism.

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 Ca2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and antiallergic effects.

Calcium Sandoz Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into an active ionized form of calcium, which is easily absorbed. This dosage form ensures an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic calcium deficiency in the body, as well as for the treatment of various types of metabolic disorders in bone tissue.

Indications

Osteoporosis of various origins (postmenopausal, senile, caused by long-term therapy with glucocorticosteroids, immobilization, gastrectomy, etc.) as part of combination therapy (for example, with vitamin D3 and bisphosphonates).
- Conditions accompanied by an increased need for calcium, including pregnancy, lactation, periods of intensive growth in children.
- Prevention of osteoporosis.
- Osteomalacia (as an addition to the main therapy, including vitamin D3).
- Latent tetany, accompanied by hypocalcemia (an injection solution of calcium should be used to treat acute tetany).
- Allergic reactions (maintenance therapy).

Contraindications

Hypersensitivity to the components of the drug, increased concentration of calcium in the blood and urine (hypercalcemia, hypercalciuria), chronic renal failure, nephrourolithiasis, nephrocalcinosis, phenylketonuria and sucrose/isomaltose deficiency, fructose intolerance, glucose-galactose malabsorption.

Use during pregnancy and breastfeeding

The drug can be prescribed during pregnancy and breastfeeding on the recommendation of a doctor. Calcium passes into breast milk. During pregnancy, the daily dose of calcium should not exceed 1500 mg. Hypercalcemia during pregnancy can cause disturbances in fetal development.

Directions for use and doses

Inside, regardless of food intake. Before taking the tablet, dissolve it in a glass of water.

Children from 3 to 9 years: 500 mg per day.
Adults and children over 10 years of age: 1000 mg per day.

In severe cases or with an increased need for calcium (for example, during treatment with bisphosphonates), the dose may be increased to 2000 mg per day.

Side effects

Very rare (less than 1/10,000): hypersensitivity reactions, incl. rash, itching, urticaria, hypercalcemia. In isolated cases, systemic allergic reactions (anaphylactic reactions, facial edema, angioedema) have been reported. Some medical publications have reported the development of hypercalciuria while taking calcium supplements.

Rarely (more than 1/10,000, less than 1/1,000): flatulence, constipation, diarrhea, nausea, vomiting, epigastric pain. When taken in high doses (2000 mg/day when taken daily for several months), headache, fatigue, thirst, and polyuria may occur.

special instructions

In patients with slight hypercalciuria (exceeding 300 mg/24 hours or 7.5 mmol/day), with mild or moderate renal dysfunction, as well as in the presence of anamnestic indications of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or discontinue it. Patients with a tendency to form stones in the urinary tract are advised to increase their fluid intake.

In patients with impaired renal function, calcium salts should be taken under medical supervision. Monitoring of serum calcium and phosphate levels is necessary.

When treating with calcium preparations, it is necessary to avoid taking large doses of vitamin D or its derivatives, unless there are special indications for this.

Patients on a low-salt diet should take into account the sodium content in 1 tablet of effervescent Calcium Sandoz Forte:
2.976 mmol (corresponding to 68.45 mg) sodium in one 500 mg tablet;
5.95 mmol (corresponds to 136.90 mg) sodium in one 1000 mg tablet.

Information for patients with diabetes:
One tablet of Calcium Sandoz forte contains 0.002 bread units, so the drug can be used in patients with diabetes.

Drug interactions

The combination of calcium carbonate + calcium lactogluconate may reduce the absorption of estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics and fluoride preparations. The interval between taking effervescent calcium carbonate + calcium lactogluconate tablets and the above drugs should be at least 3 hours. Simultaneous administration of vitamin D and its derivatives increases calcium absorption. When prescribed in high doses along with vitamin D and its derivatives, calcium may reduce the effect of verapamil and possibly other calcium channel blockers.

With the simultaneous use of Calcium Sandoz forte effervescent tablets and tetracycline drugs, the absorption of the latter may be impaired. For this reason, tetracycline preparations should be taken at least 2 hours before or 4-6 hours after ingesting calcium preparations. Thiazide diuretics reduce urinary calcium excretion, therefore, when used concomitantly with Calcium Sandoz Forte effervescent tablets, regular monitoring of serum calcium concentrations should be carried out, as there is a risk of developing hypercalcemia.

Systemic corticosteroids reduce calcium absorption. If they are used simultaneously, it may be necessary to increase the dose of Sandoz Forte Calcium tablets.

When taking Calcium Sandoz Forte tablets orally in patients receiving cardiac glycosides, the toxicity of cardiac glycosides may increase due to the development of hypercalcemia. Such patients should regularly take an ECG and monitor the level of calcium in the blood serum.

Storage conditions

At a temperature not exceeding 30°C in a tightly closed container. Keep out of the reach of children.

which corresponds to a calcium content of 500 mg

Release form

Effervescent tablets 20 pieces in a polypropylene case in a cardboard pack.

pharmachologic effect

Calcium preparation for oral administration. 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 Ca2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and antiallergic effects.

Calcium-Sandoz Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into an active ionized form of calcium, which is easily absorbed. This dosage form ensures an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic calcium deficiency in the body, as well as for the treatment of various types of metabolic disorders in bone tissue.

Indications for use

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

Directions for use and doses

Inside, regardless of food intake. Before taking the tablet, dissolve it in a glass of water.

Children aged 3 to 9 years- 500 mg/day, adults and children over 10 years old- 1000 mg/day.

In severe cases or with an increased need for calcium (for example, during treatment with bisphosphonates), the dose may be increased to 2000 mg/day.

Prevention and treatment of osteoporosis: children aged 3 to 9 years- 500 mg/day, adults and children over 10 years old- 1000 mg/day.

Duration of therapy: when used to replenish calcium deficiency, the average duration of treatment is at least 4-6 weeks. When used for prevention as part of complex therapy for osteoporosis, the duration of treatment is determined individually.

Contraindications

• hypercalcemia;
• hypercalciuria;
• chronic renal failure;
• nephrourolithiasis;
• nephrocalcinosis;
• phenylketonuria;
• sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;
• hypersensitivity to the components of the drug.
• Calcium Sandoz Forte is not recommended for use in children under 3 years of age due to the lack of data on effectiveness and safety in this category of patients.

Storage conditions

The drug should be stored in a tightly closed container at a temperature not exceeding 30°C.

Suction

Approximately 25-50% of the dose of calcium taken orally is absorbed mainly in the proximal small intestine and enters the metabolic calcium depots.

Distribution and metabolism

99% of calcium reserves in the body are contained in bones and teeth, 1% is found in intra- and extracellular fluid. Approximately 50% of the total calcium content in the blood is present in the physiologically active ionized form, approximately 5% forms complexes with citrate, phosphate and other anions. The remaining 45% of serum calcium is bound to proteins, mainly albumin.

Removal

About 20% of calcium is excreted through the kidneys and 80% through the intestines. The level of excretion through the kidneys depends on glomerular filtration and tubular reabsorption. Both unabsorbed calcium and the absorbed part of it, which is excreted in bile and pancreatic secretions, are excreted through the intestines.

Overdose

Overdose leads to the development of hypercalciuria and hypercalcemia. Symptoms of hypercalcemia: nausea, vomiting, thirst, polydipsia, polyuria, dehydration and constipation.

Chronic overdose with the development of hypercalcemia can lead to liming of blood vessels and organs. The threshold for calcium intoxication is when taking calcium supplements for several months at a dose exceeding 2000 mg/day.

Therapy in case of overdose

In case of intoxication, therapy should be stopped immediately and water and electrolyte balance should be restored.

In case of chronic overdose, if signs of hypercalcemia are detected, hydration is carried out at the initial stage with a 0.9% sodium chloride solution. To enhance the excretion of calcium, as well as to avoid the formation of edema in the tissues (for example, in congestive heart failure), loop diuretics, for example, furosemide, can be used. In this case, you should refrain from using thiazide diuretics.

In patients with renal failure, hydration is ineffective; dialysis is indicated for such patients. In the case of persistent hypercalcemia, other factors contributing to its development should be excluded, incl. hypervitaminosis of vitamin A or D, primary hyperparathyroidism, malignant tumors, renal failure, stiffness of movement.

Storage conditions

The drug should be stored in a tightly closed container at a temperature not exceeding 30°C.

Interaction with other drugs

The combination of calcium carbonate + calcium lactogluconate may reduce the absorption of estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics and fluoride preparations. The interval between taking effervescent calcium carbonate + calcium lactogluconate tablets and the above drugs should be at least 3 hours.

The simultaneous administration of vitamin D and its derivatives increases calcium absorption. When prescribed in high doses along with vitamin D and its derivatives, calcium may reduce the effect of verapamil and possibly other calcium channel blockers.

With the simultaneous use of effervescent tablets calcium carbonate + calcium lactogluconate and tetracycline drugs, the absorption of the latter may be impaired. For this reason, tetracycline preparations should be taken at least 2 hours before or 4-6 hours after ingesting calcium preparations.

Thiazide diuretics reduce urinary calcium excretion, therefore, when used simultaneously with calcium carbonate + calcium lactogluconate effervescent tablets, regular monitoring of serum calcium concentrations should be carried out, as there is a risk of developing hypercalcemia.

Systemic corticosteroids reduce calcium absorption. When used simultaneously, it may be necessary to increase the dose of effervescent calcium carbonate + calcium lactogluconate tablets.

When ingesting effervescent calcium carbonate + calcium lactogluconate tablets in patients receiving cardiac glycosides, the toxicity of cardiac glycosides may increase due to the development of hypercalcemia. Such patients should regularly take an ECG and monitor the level of calcium in the blood serum.

When taking a bisphosphonate or sodium fluoride orally at the same time, these drugs should be taken at least 3 hours before taking effervescent calcium carbonate + calcium lactogluconate tablets, since absorption from the gastrointestinal tract of the bisphosphonate or sodium fluoride may be reduced.

Calcium absorption from the gastrointestinal tract may be reduced by concomitant intake of certain foods containing oxalic acid (eg, spinach, rhubarb) or phytic acid (in all grains), due to the formation of insoluble complexes with calcium ions. Patients should not take calcium carbonate + calcium lactogluconate effervescent tablets 2 hours before or after a meal rich in oxalic or phytic acid.

Side effect

Very rarely (
Rarely (>1/10,000,
When taken in high doses (2000 mg/day when taken daily for several months), headache, fatigue, thirst, and polyuria may occur.

Compound

calcium carbonate 1750 mg

calcium lactogluconate 2263 mg,

Which corresponds to a Ca2+ content of 1000 mg (25 mmol)

Excipients: citric acid - 3323 mg, macrogol 6000 - 250 mg, orange flavor - 30 mg (orange flavor contains sulfur dioxide (E220), butylated hydroxyanisole (E320), sorbitol), aspartame - 30 mg, sodium bicarbonate - 500 mg.

Directions for use and doses

Inside, regardless of food intake. Before taking the tablet, dissolve it in a glass of water.

Children aged 3 to 9 years - 500 mg/day, adults and children over 10 years old - 1000 mg/day.

In severe cases or with an increased need for calcium (for example, during treatment with bisphosphonates), the dose may be increased to 2000 mg/day.

Prevention and treatment of osteoporosis: children aged 3 to 9 years - 500 mg/day, adults and children over 10 years old - 1000 mg/day.

Duration of therapy: when used to replenish calcium deficiency, the average duration of treatment is at least 4-6 weeks. When used for prevention as part of complex therapy for osteoporosis, the duration of treatment is determined individually.

Product description

Effervescent tablets are round, flat, with a beveled edge, from white to almost white in color, with a slight specific odor; tablets have a slightly rough surface.

With caution (Precautions)

In patients with mild or moderately severe renal dysfunction, as well as in the presence of a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or discontinue it.

special instructions

In patients with mild hypercalciuria (exceeding 300 mg or 7.5 mmol/day), with mild or moderate renal dysfunction, as well as a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or discontinue it. In patients with a tendency to form stones in the urinary tract, increased fluid intake is recommended.

In patients with impaired renal function, calcium salts should be taken under medical supervision. Monitoring of serum calcium and phosphate levels is necessary.

When treating with calcium supplements, it is necessary to avoid taking vitamin D or its derivatives in high doses, unless there are special indications for this.

Patients on a salt-restricted diet should take into account the sodium content of effervescent tablets:

1 effervescent 500 mg tablet contains 2.976 mmol (corresponding to 68.45 mg) sodium;

1 effervescent tablet 1000 mg contains 5.95 mmol (corresponding to 136.90 mg) sodium.

Information for patients with diabetes

1 effervescent tablet contains 0.002 XE, so the drug can be used in patients with diabetes.

Special precautions when disposing of unused drug

There is no need for special precautions when disposing of unused Calcium Sandoz® Forte.

Impact on the ability to drive vehicles and operate machinery

Calcium Sandoz® Forte does not affect the ability to drive a car or operate machinery.

Use during pregnancy and lactation

The drug can be prescribed during pregnancy and breastfeeding on the recommendation of a doctor. Calcium passes into breast milk.

During pregnancy, the daily dose of calcium should not exceed 1500 mg. Hypercalcemia during pregnancy can cause disturbances in fetal development.

Release form

Effervescent tablets are round, flat, with a beveled edge, from white to almost white in color, with a slight specific odor; tablets have a slightly rough surface.
1 tab.
calcium carbonate 1750 mg
calcium lactogluconate 2263 mg,
what soo

Expiration date from date of manufacture

Indications for use

Prevention and treatment of calcium deficiency (including pregnancy, lactation, 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 addition to basic therapy, including vitamin D3).

Contraindications

Hypercalcemia;

Hypercalciuria;

Chronic renal failure;

Nephrourolithiasis;

Nephrocalcinosis;

Phenylketonuria;

Sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;

Hypersensitivity to the components of the drug.

pharmachologic effect

Calcium preparation for oral administration. 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 Ca2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and antiallergic effects.

Calcium-Sandoz® Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into an active ionized form of calcium, which is easily absorbed. This dosage form ensures an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic calcium deficiency in the body, as well as for the treatment of various types of metabolic disorders in bone tissue.

Calcium Sandoz Forte: instructions for use and reviews

Latin name: Calcium Sandoz forte

ATX code: A12AA20

Active substance: calcium carbonate (calcium carbonate) + calcium lactogluconate (calcium lactogluconate)

Manufacturer: Famar Orleans (France)

Updating the description and photo: 09.09.2019