This formulation is indicated for:

• Prevention and management of osteoporosis
• Maintaining strong and healthy bone growth
• Supporting proper functioning of the heart, muscles, and nervous system
• Use as a nutritional supplement
• Promoting bone formation and regeneration
• During pregnancy and breastfeeding
• Correction of deficiencies of Oracal, Vitamin D3, Magnesium, Zinc, Copper, Manganese, and Boron

Adequate nutrition plays a crucial role in preventing osteoporosis and other bone-related disorders. Calcium, Magnesium, and Vitamin D3 are essential macronutrients for maintaining bone health. In the absence of sufficient Vitamin D3, calcium absorption is significantly reduced. Magnesium, similar to calcium, contributes to bone strength and structural integrity. Recent epidemiological studies indicate that micronutrients such as Copper, Manganese, Zinc, and Boron are also vital for bone metabolism. Deficiencies of these micronutrients are commonly observed in individuals with osteoporosis.

Adult: 1 film-coated tablet twice daily, preferably 1 tablet in the morning and 1 tablet in the evening or as directed by physician. It is best taken with or just after main meals with a full glass of water.

Children 3-7 years: 1 effervescent tablet daily.

7 years to older: 1 to 2 effervescent tablet daily.

Absolute contraindications include hypercalcemia associated with myeloma, bone metastases, or other malignant bone diseases, sarcoidosis, primary hyperparathyroidism, and Vitamin D3 overdose. Severe renal impairment is also a contraindication. Hypersensitivity to any component of the formulation is another contraindication. Relative contraindications include osteoporosis due to prolonged immobilization, renal calculi, and severe hypercalciuria.

Calcium supplementation is generally well tolerated but may occasionally cause mild gastrointestinal disturbances such as constipation, flatulence, nausea, abdominal discomfort, or diarrhea. Long-term use of Vitamin D3 may rarely lead to skin rash. Hypercalciuria and, in rare cases, hypercalcemia have been reported with prolonged use at high doses.

Use during pregnancy and lactation should be under medical supervision. Requirements for calcium and Vitamin D3 increase during these periods; however, total intake should consider other dietary and supplemental sources. If both calcium and iron supplements are needed, they should be taken at different times. Animal studies have shown teratogenic effects with excessive Vitamin D3. In humans, long-term hypercalcemia may lead to physical and mental developmental issues, aortic stenosis, and retinopathy in newborns. Vitamin D3 and its metabolites are excreted into breast milk.

Patients with mild to moderate renal impairment or mild hypercalciuria should be monitored carefully. Regular assessment of plasma calcium levels and urinary calcium excretion is recommended. Urinary calcium should also be measured in patients with a history of kidney stones to exclude hypercalciuria. During long-term therapy, monitoring of serum and urinary calcium levels, as well as renal function, is advised. Treatment should be reduced or temporarily discontinued if urinary calcium exceeds 7.5 mmol/24 hours. Intake from other calcium and Vitamin D3 sources should also be considered.

Symptoms of overdose may include nausea, vomiting, excessive drowsiness, dry mouth, reduced appetite, metallic taste, abdominal cramps, diarrhea, headache, and constipation.

Specific mineral & vitamin combined preparations

Store in a dry place, protected from light and heat. Keep out of reach of children.