Calcemin tablets p / o No. 60 No. 1

DescriptionOval tablets of white color, with a notch on one side. Release form Tablets Pharmacological properties Combined preparation containing vitamins, macro-/microelements. The action is due to the properties of the ingredients included in the composition. Indications for use Replenishment of calcium, vitamin D and micronutrient deficiencies (zinc, copper, manganese, boron) when the need for them cannot be met by an appropriate diet, especially in case of prolonged deficiency, irregular and unbalanced nutrition and increased needs for these nutrients, in particular : prevention and complex treatment of osteoporosis of various origins; during pregnancy and the period of breastfeeding; in children from 6 years of age during a period of intensive growth. Dosage and administration For children from 6 to 12 years old, take 1 tablet 1 time per day with meals. Adults and children over 12 years old – 1 tablet 2 times a day with meals. From the 20th week of pregnancy and the entire period of lactation – 1 tablet 2 times a day. Duration of treatment When used for prevention and in the complex therapy of osteoporosis, the duration of treatment is determined by the doctor individually. When used to compensate for the deficiency of calcium and vitamin D3, the average duration of the course of treatment is at least 4-6 weeks. The number of repeated courses during the year is determined individually. Patients with impaired liver function: dose adjustment is not required. Patients with impaired renal function: Calcemin 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 lactationCalcemin can be used during pregnancy and lactation at the recommended doses. The daily dose for pregnant women should not exceed 1500 mg of calcium and 600 IU of vitamin D, since chronic overdose of calcium and vitamin D 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. In lactating women, it should be borne in mind that vitamin D and calcium pass into breast milk. This should be taken into account when additionally prescribing calcium and vitamin D to a child. Precautions In long-term therapy, calcium levels in the blood serum and urine should be monitored. Observation is especially important in elderly patients with simultaneous treatment with cardiac glycosides and diuretics (see the section “Interaction with other medicinal products and other forms of interaction”) and in patients with an increased tendency to form kidney stones. In cases of hypercalcemia or signs of impaired renal function, reduce the dose or stop treatment. Vitamin D should be taken with caution in patients with renal insufficiency. In this case, it is necessary to control the content of calcium and phosphates in the blood serum. It is also necessary to take into account the risk of soft tissue calcification. In patients with severe renal insufficiency, vitamin D in the form of cholecalciferol is not normally metabolized, so other forms of vitamin D should be used. Additional vitamin D and calcium from other sources must be taken into account to avoid overdose. In such cases, serum and urine calcium levels should be regularly monitored. Calcium and vitamin D3 should be used with caution in immobilized patients with osteoporosis due to the risk of hypercalcemia. Vitamin D should be taken with caution in patients with sarcoidosis, as they have abnormal vitamin D metabolism and may develop hypercalcemia, kidney stones, and kidney failure. The concentration of calcium in the blood and urine should be checked regularly in such patients. Simultaneous use with antibiotics of the tetracycline or quinolone group is usually not recommended or should be carried out with caution (see the section “Interaction with other drugs and other types of interactions”). The use of large doses of vitamin D3 is impractical, since the vitamin in these cases inhibits the formation of biologically active compounds of vitamin D3. At the same time, the percentage of unconverted vitamin D3 in the body increases, which undergoes oxidation, and thereby increases the risk of hypervitaminosis D. The combined use of the drug with other sources of vitamin D and calcium (for example, drugs, dairy products) can lead to the development of hypercalcemia and milk-alkaline syndrome with alkalosis, impaired renal function, and soft tissue calcification. Therefore, in these cases, the level of calcium in the blood serum and urine and kidney function should be monitored. One tablet of Calcemin contains less than 1 mmol (23 mg) of sodium, i.e. the preparation practically does not contain sodium. Interaction with other drugs Phenytoin, barbiturates, carbamazepine, rifampicin: may reduce the effect of vitamin D3 by increasing its metabolism to inactive metabolites. Bisphosphonates, fluorides: May reduce the absorption of bisphosphonates and sodium fluoride in the gastrointestinal tract. It is recommended to take at least 1-2 hours before or after taking Calcemin. Preferably, bisphosphonates and calcium preparations are used at different times of the day. Tetracycline: may reduce the absorption of tetracycline in the gastrointestinal tract. It is recommended to take at least 2-3 hours before or 4-6 hours after taking Calcemin. Cardiac glycosides, calcium channel blockers: possible increase in the toxicity of cardiac glycosides (danger of lethal arrhythmias). It is recommended to monitor the ECG and the concentration of calcium in the blood. The effectiveness of calcium channel blockers, such as verapamil, is reduced in atrial fibrillation. Co-administration is not recommended. Levothyroxine, ketoconazole, quinolones, certain cephalosporins, iron, zinc, magnesium preparations, estramustine, thyroid hormones, strontium ranelate, eltrombopag, phosphates, bisphosphonates and fluorides: absorption may be impaired. If necessary, joint use is recommended to observe an interval of at least 2 hours before or 4-6 hours after taking this drug. Thiazide diuretics: Thiazide diuretics decrease urinary calcium excretion. Due to the increased risk of hypercalcemia with the simultaneous use of thiazide diuretics and calcium preparations, it is recommended to regularly check the level of calcium in the blood serum in case of long-term treatment. Glucocorticoids, hormonal contraceptives: reduce calcium absorption, possibly reducing the effect of vitamin D3. Dose adjustment of Calcemin may be required. Ion exchange resins such as cholestyramine, laxatives, orlistat: Concomitant use with this drug may reduce the absorption of vitamin D3 in the gastrointestinal tract. It is recommended to take 2 hours before or 4-6 hours after taking vitamin D. Foods: interactions with certain foods (eg, those containing oxalic acid, phosphates, phytic acids, or foods high in fiber) are possible. Due to the risk of reduced calcium absorption, it is recommended that an interval of at least 2 hours be observed between taking calcium supplements and these foods. Contraindications Hypersensitivity to the substances that make up the drug (see section “Composition”); severe hypercalciuria and hypercalcemia, as well as diseases and / or conditions that can lead to hypercalcemia and / or hypercalciuria (for example, sarcoidosis, myeloma, bone metastases, primary hyperparathyroidism); nephrocalcinosis, nephrolithiasis; hypervitaminosis D; severe renal failure (creatinine clearance < 30 ml / min); children under 6 years old. Active ingredients: calcium (calcium citrate and calcium carbonate) 250 mg, Vitamin D3 50 ME, zinc (zinc oxide) 2 mg, copper (copper oxide) 0.5 mg, manganese (manganese sulfate) 0.5 mg, boron (borate sodium) 50 mcg. Excipients: soy polysaccharide, sodium lauryl sulfate, colloidal silicon dioxide, sodium croscarmellose, microcrystalline cellulose, stearic acid, magnesium stearate. Shell: hypromellose, triacetin, mineral oil, sodium lauryl sulfate, titanium dioxide, magnesium silicate. Overdose Acute or prolonged overdose of calcium and vitamin D, especially in predisposed patients, can cause hypervitaminosis D, hypercalcemia, hypercalciuria and hyperphosphatemia. Consequences include renal failure, milk-alkali syndrome, vascular and soft tissue calcification, including calcification leading to nephrolithiasis. Signs of acute overdose may be sudden headache, confusion, gastrointestinal disorders (constipation, diarrhea, nausea and vomiting). Laboratory and clinical manifestations of toxicity and hypercalcemia are varied and depend on the susceptibility of the patient and the accompanying circumstances. Symptoms may include anorexia, weight loss, thirst, polyuria, and malabsorption of other minerals. Changes in laboratory parameters are possible: an increase in the concentration of aspartate aminotransferase and alanine aminotransferase in blood plasma. Chronic overdose can lead to calcification of vessels and organs caused by hypercalcemia. Extremely high hypercalcemia can cause coma and death. Treatment: rehydration, the use of loop diuretics (eg, furosemide), glucocorticosteroids, calcitonin, bisphosphonates, in severe cases, hemodialysis. Side effects Like all medicines, Calcemin can cause side effects, although not everybody gets them. The following adverse reactions have been reported, the frequency of which is unknown (based on the available data, the frequency of occurrence cannot be determined): disorders of the immune system: allergic reactions (rash, urticaria, swelling, itching), anaphylactic reactions, anaphylactic shock, hypersensitivity reactions, including asthmatic syndrome , mild to moderate reactions from the skin and / or respiratory system, gastrointestinal tract and / or cardiovascular system (symptoms may include respiratory distress syndrome); gastrointestinal disorders: constipation, bloating, abdominal pain, diarrhea, nausea, vomiting; metabolic and nutritional disorders: hypercalcemia, hypercalciuria, hyperphosphatemia (in patients with impaired renal function), milk-alkaline syndrome (usually in case of overdose); disorders of the kidneys and urinary tract: nephrocalcinosis, nephrolithiasis (in patients with impaired renal function). 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 tablets p / o No. 60 No. 1 Price for Calcemin tablets p / o No. 60 No. 1