Calcemin Silver tablets p / o No. 120 No. 1

Name:
Calcemin Silver tab. p/o in vial No. 120 in pack No. 1
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Oval tablets of light gray color, with a notch on one of the sides. Release form Tablets Pharmacological properties Calcium is an important structural component of bone tissue. Vitamin D3 (cholecalciferol) increases the absorption of calcium in the small intestine, activates the processes of restructuring (remodeling) of bone tissue by increasing the formation of the synthesis of type I collagen and osteoblasts. Improves bone quality by inhibiting osteoclast activity. The intake of calcium and vitamin D prevents the increase in parathyroid hormone (PTH) secretion, which is caused by calcium deficiency and is one of the causes of osteoporosis (bone resorption). Magnesium is involved in bone metabolism. Zinc is a cofactor for over 200 enzymes involved in the synthesis of proteins and nucleic acids responsible for cell growth and repair. Copper takes part in the construction of the most important connective tissue proteins collagen and elastin, which form the matrix of bone and cartilage tissue. Manganese normalizes the synthesis of glycosaminoglycans necessary for the formation of bone and cartilage tissue, Boron regulates the activity of parathyroid hormone and through it the exchange of calcium, magnesium, phosphorus and vitamin D. Indications for use Prevention of osteoporosis and other calcium-deficient conditions. In the complex treatment of osteoporosis, when calcium and vitamin D deficiency are diagnosed. Risk reduction and complex treatment of fractures of various localization in calcium-deficient conditions in people over 50 years of age. Dosage and administration Adults and children over 12 years old: 1 tablet 1-2 times a day with meals. The duration of use is determined by the doctor. If necessary, repeat courses of treatment are carried out. Patients with impaired liver function: dose adjustment is not required. Patients with impaired renal function: Calcemin Silver should not be used in severe renal insufficiency. Elderly patients: the dose is the same as for adults. A possible decrease in kidney function should be taken into account. Use during pregnancy and lactation It is not recommended to use the drug during pregnancy and lactation. Chronic overdose may be harmful to the fetus and newborn. Hypercalcemia during pregnancy due to the use of high doses of vitamin D can lead to the development of side effects in the fetus: parathyroid hormone suppression, hypocalcemia, tetany, epileptic seizures and aortic stenosis syndrome, the symptoms of which may be retinopathy, mental retardation or growth failure, as well as lead to to the development of hypercalcemia in newborns. Vitamin D and calcium are excreted into breast milk. Precautions In order not to exceed the total dose of calcium 2500 mg and vitamin D 4000 IU / day, which can lead to toxic effects, it is recommended to take into account the intake of elements from other sources (eg, with food). During treatment, it is recommended to check the level of calcium in the blood serum and in the urine. With long-term treatment with drugs containing calcium in combination with vitamin D, it is necessary to monitor the concentration of serum calcium and kidney function by determining the level of creatinine in the blood serum. Especially in elderly patients with simultaneous use of cardiac glycosides, calcium channel blockers and / or thiazide diuretics, as well as in patients with a tendency to form stones. If there are signs of hypercalcemia, impaired renal function, calciuria exceeding 7.5 mmol / day (300 mg / day), the dose should be reduced or the drug should be discontinued. Combined drugs should be used with caution in immobilized patients due to the increased risk of hypercalcemia. The drug contains sodium, which is taken into account in a sodium-controlled diet. Interactions with other drugs Calcium may lead to a decrease in the absorption of other drugs (including antibiotics (eg, tetracyclines, quinolones, some cephalosporins) and antivirals, protease inhibitors, eltrombopag) in the gastrointestinal tract. Calcium absorption may also decrease. Therefore, an interval between the use of these drugs should be observed, at least 2 hours before or 4-6 hours after calcium intake, unless otherwise indicated. Levothyroxine should be taken at least 4 hours before or 4 hours after calcium intake; fluoroquinolones – 2 hours before or 6 hours after; phosphates, bisphosphonates – 1 hour before, fluorides and iron preparations – 3 hours before the use of calcium. It is not recommended to take the drug simultaneously with antacids containing aluminum, due to a decrease in their effectiveness. Thiazide diuretics reduce urinary calcium excretion. Due to the increased risk of hypercalcemia with the simultaneous use of thiazide diuretics, it is necessary to regularly check the level of calcium in the blood serum. With simultaneous use with furosemide and other “loop” diuretics, calcium excretion by the kidneys increases. Cardiac glycosides and calcium channel blockers: Hypercalcemia increases the risk of lethal arrhythmia with cardiac glycosides such as digoxin and reduces the effectiveness of calcium channel blockers such as verapamil and atrial fibrillation. It is recommended to monitor the concentration of calcium in the blood serum, ECG and the clinical condition of the patient. Glucocorticoids, hormonal contraceptives impair the absorption of calcium ions. Ion exchange resins (eg, cholestyramine), laxatives, orlistat may reduce the absorption of vitamin D from the gastrointestinal tract. In order to minimize the interaction, it is necessary to use at least 2 hours before or 4-6 hours after taking vitamin D. Carbamazepine, rifampicin, phenytoin or barbiturates increase the metabolism of vitamin D to its inactive metabolites and thus reduce its effect . With the simultaneous use of the drug Calcemin Silver with vitamin A, the toxicity of vitamin D3 decreases. Interaction with food and nutritional supplements. Oxalic acid, found in spinach and rhubarb, and phytic acid (found in whole grains) can inhibit calcium absorption. Therefore, it is not recommended to consume preparations containing calcium within two hours after eating a meal rich in oxalic and phytic acid. Calcium may decrease the absorption of iron, zinc, and magnesium from food. This should be considered in patients at high risk for deficiency of these minerals. In order to avoid inhibition of minerals from food, these patients are better off taking calcium at bedtime rather than with meals. Contraindications Hypersensitivity to any of the components of the drug; hypercalcemia and / or conditions leading to hypercalcemia (eg, sarcoidosis, malignant neoplasms, primary hyperparathyroidism), hypercalciuria, impaired renal function, urolithiasis; hypervitaminosis D; age up to 12 years. Active ingredients: calcium (calcium citrate and calcium carbonate) 500 mg, vitamin D3 400 ME, magnesium (magnesium oxide) 40 mg, zinc (zinc oxide) 7.5 mg, copper (copper oxide) 1 mg, manganese (manganese sulfate) 1.8 mg, boron (sodium borate) 250 mcg. Excipients: microcrystalline cellulose (E460), stearic acid (E570), croscarmellose sodium, soy polysaccharide, sodium lauryl sulfate, magnesium stearate (E572). Shell: hypromellose, magnesium silicate (E553a), titanium dioxide (E171), triacetin (E1518), mineral oil (E905), FD&C Blue No. 2 Lacquer (E132), FD&C Yellow No. 6 Lacquer (E110). OverdoseOverdose may be accompanied by symptoms similar to side effects. Intake of calcium and vitamin D in doses exceeding 2500 mg calcium and 4000 IU/day of vitamin D may lead to toxic effects. In patients with hypercalcemia or conditions associated with hypercalcemia, renal insufficiency and / or a tendency to nephrolithiasis, toxic effects of calcium and vitamin D may occur when using low doses of the drug. Acute or chronic overdose of calcium and vitamin D can cause hypervitaminosis D, hypercalcemia, hypercalciuria, and hyperphosphatemia. The consequences are renal failure, “milk-alkaline syndrome”, calcification of blood vessels and soft tissues, including calcification, which leads to nephrocalcinosis and nephrolithiasis. Non-specific primary symptoms such as sudden onset of headache, muscle weakness, mental depression and gastrointestinal disturbances (abdominal pain, constipation, diarrhea, nausea and vomiting) may indicate an acute overdose. If such symptoms occur, the drug should be discontinued. Laboratory and clinical manifestations of poisoning and hypercalcemia may also include the following symptoms: anorexia, weight loss, fatigue, thirst, polyuria, bone pain, muscle weakness, cardiac arrhythmias, mental disorders, polydipsia, polyuria and impaired absorption of other minerals, increased aspartate aminotransferase and alanine aminotransferase in blood plasma. Chronic overdose can cause calcification of vessels and organs due to hypercalcemia. Extremely high hypercalcemia can lead to irreversible kidney damage and soft tissue calcification, coma and death. In case of accidental overdose, symptomatic treatment is recommended: gastric lavage, fluids, low calcium diet, rehydration, loop diuretics, bisphosphonates, calcitonin, and corticosteroids. It is necessary to control the concentration of electrolytes in the serum, kidney function and diuresis. In severe cases, monitor the ECG and CVP. Side effects The following adverse reactions have been registered, the frequency of which is unknown (based on the available data, the frequency of occurrence cannot be determined): On the part of the gastrointestinal tract: abdominal pain, dyspepsia, constipation, diarrhea, flatulence, nausea, vomiting. From the immune system: allergic reactions, including anaphylactic reactions, anaphylactic shock. Rarely, hypersensitivity reactions have been reported, accompanied by relevant laboratory and clinical manifestations, including asthma syndrome, mild to moderate reactions from the skin and / or respiratory system, gastrointestinal tract and / or cardiovascular system. Symptoms may include rash, urticaria, edema, skin redness, itching, non-cardiogenic pulmonary edema. Very rarely, severe reactions, including anaphylactic shock, have been reported. On the part of laboratory parameters: hypercalcemia, hypercalciuria, hypervitaminosis D (with prolonged use in high doses). Reporting Adverse Reactions If you experience any adverse reactions, please consult your physician. This recommendation applies to any possible adverse reactions, including those not listed in the package insert. You can also report adverse reactions to the adverse drug reactions (actions) information database, including reports of drug failures. By reporting adverse reactions, you help to get more information about the safety of the drug. Storage conditions At a temperature not exceeding 25 ° C, out of the reach of children. Buy Calcemin Silver tablets p / o No. 120 No. 1 Price for Calcemin Silver tablets p / o No. 120 No. 1 one