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 Calcium, Vitamin D3, Magnesium, Zinc, Copper, Manganese, and Boron

Each film-coated tablet contains:

• Calcium Carbonate BP equivalent to 600 mg elemental Calcium
• Vitamin D3 BP (as Cholecalciferol) 200 IU
• Magnesium Oxide BP equivalent to 40 mg Magnesium
• Manganese Sulfate Monohydrate BP equivalent to 1.8 mg Manganese
• Cupric Oxide equivalent to 1 mg Copper
• Boron Citrate equivalent to 250 mcg Boron
• Zinc Oxide BP equivalent to 7.5 mg Zinc

Each effervescent tablet contains:

• Calcium Carbonate BP equivalent to 600 mg elemental Calcium
• Vitamin D3 BP (as Cholecalciferol) 400 IU
• Magnesium Oxide BP equivalent to 40 mg Magnesium
• Manganese Sulfate Monohydrate BP equivalent to 1.8 mg Manganese
• Cupric Oxide equivalent to 1 mg Copper
• Boron Citrate equivalent to 250 mcg Boron
• Zinc Oxide BP equivalent to 7.5 mg Zinc

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.

The possibility of hypercalcemia should be considered in patients using thiazide diuretics, as these drugs can decrease urinary calcium excretion. Hypocalcemia should be avoided in patients receiving digitalis therapy. Certain foods (such as those containing oxalic acid, phosphate, or phytic acid) may reduce calcium absorption. Concurrent use of phenytoin or barbiturates may decrease the effectiveness of Vitamin D3 due to increased metabolic activation. The effect of Vitamin D3 may also be reduced when used with glucocorticoids. Calcium combined with Vitamin D3 may diminish the effects of digitalis and other cardiac glycosides; therefore, careful medical supervision is required, including ECG monitoring if necessary. Calcium salts may interfere with the absorption of thyroxine, bisphosphonates, sodium fluoride, quinolones, tetracycline antibiotics, and iron. It is recommended to maintain at least a four-hour interval before taking calcium with these medications.

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.