This combination tablet is indicated for the prevention and treatment of low blood calcium levels in individuals with inadequate dietary calcium intake. It is also used in conditions related to calcium deficiency such as osteoporosis, osteomalacia, rickets, hypoparathyroidism, and latent tetany. Additionally, it may be prescribed for certain individuals, including postmenopausal women, to ensure adequate calcium intake.

Each tablet contains:

• Calcium Citrate USP 1200 mg equivalent to Calcium 252 mg
• Calcitriol EP 0.25 mcg

Calcium is essential for the proper functioning of nerves, muscles, cells, and bones. When blood calcium levels are low, the body compensates by drawing calcium from bones, leading to bone weakening. Adequate calcium intake is necessary for maintaining strong and healthy bones. Calcium citrate is well absorbed even on an empty stomach and is less dependent on gastric acid for absorption, with a lower likelihood of causing constipation.

Calcitriol is the active form of vitamin D3 and plays a key role in enhancing intestinal absorption of calcium and phosphate. It is normally produced in the kidneys from its precursor, 25-hydroxycholecalciferol. In physiological amounts, calcitriol helps regulate bone mineralization and maintains calcium balance. In chronic renal failure, reduced production of calcitriol contributes to disturbances in mineral metabolism.

The biological effects of calcitriol are mediated through vitamin D receptors present in many tissues. These receptors act as transcription factors that regulate gene expression. In patients with chronic renal failure, oral calcitriol helps compensate for reduced endogenous production when kidney function declines. This improves calcium and phosphate absorption and corrects hypocalcemia, thereby reducing the symptoms of bone disease.

In patients with established postmenopausal osteoporosis, calcitriol enhances calcium absorption, increases circulating calcitriol levels, and reduces the incidence of vertebral fractures.

1-4 tablets daily with or without food depending on clinical situation or as directed by the registered physician.

Concurrent use of calcium may reduce the absorption of tetracyclines, quinolones, and oral bisphosphonates. Corticosteroids may decrease calcium absorption. Thiazide diuretics can increase the risk of hypercalcemia and metabolic alkalosis. Elevated calcium levels may enhance the effects of cardiac glycosides. Calcium may reduce the effectiveness of erlotinib. The risk of hypercalcemia may increase when used with paricalcitol. Enzyme-inducing antiepileptic drugs may increase the metabolism of vitamin D. In patients with renal impairment, concurrent use of calcium citrate with aluminum-containing products may lead to a significant increase in aluminum levels, potentially causing encephalopathy.

This medication is contraindicated in patients with hypercalcemia, hypercalciuria, and hypophosphatemia.

Possible adverse effects include constipation, nausea, abdominal pain, hypercalcemia, hypercalciuria, headache, and muscle weakness.

Pregnancy Category C. This medication should be used during pregnancy and lactation only under the supervision of a registered physician.

This medication should be used with caution in the following conditions: hypercalcemia, malabsorption syndrome, heart disease, kidney disease, kidney stones, immune-related disorders (such as sarcoidosis), liver disease, and certain bowel diseases (e.g., Crohn’s disease).

Specific mineral & vitamin combined preparations

Store below 25°C in a cool and dry place, protected from light and moisture. Keep out of the reach of children.