This preparation is indicated for the treatment of osteoporosis, osteomalacia, rickets, tetany, and parathyroid disorders. It is also used in conditions requiring increased calcium intake in children and adolescents during periods of rapid growth, inadequate calcium intake due to malnutrition, prevention and treatment of osteoporosis, disorders of osteogenesis and tooth formation (as an adjunct to specific therapy), latent tetany, and during pregnancy and lactation. Additionally, it may be used as a routine nutritional supplement and as a phosphate binder in chronic renal failure.

Ascorbic acid (Vitamin C) and Folic acid (Vitamin B9) are water-soluble vitamins, whereas Vitamin D is fat-soluble. Ascorbic acid supports the formation and integrity of connective tissue through collagen synthesis and acts as a potent antioxidant in aqueous environments. Vitamin D, often referred to as the sunshine vitamin, functions similarly to a hormone (pro-hormone). It enhances calcium absorption and reduces calcium excretion, thereby helping maintain calcium balance in the body. Vitamin D is essential for proper brain function and contributes to mental and emotional well-being. Folic acid is involved in DNA and RNA synthesis and plays a vital role during periods of rapid growth such as infancy, adolescence, and pregnancy. It also helps regulate blood levels of homocysteine, elevated levels of which are associated with cardiovascular disease. This combination may be used in deficiency states of Vitamin C, Vitamin D, and Folic acid associated with cardiovascular disorders. Vitamin C deficiency conditions include scurvy, generalized weakness, bleeding gums, post-infectious states, alcoholism, postoperative recovery, wound healing, and prevention of cold, flu, and influenza. Folic acid deficiency may result in megaloblastic anemia and nutritional anemia. Vitamin D deficiency conditions include intestinal malabsorption, chronic liver disease, osteomalacia, osteopenia, rickets, hypocalcemia, institutionalized patients, individuals using sunscreen regularly, people with darker skin, and persons covering most of the body surface for cultural or religious reasons. It is also indicated in familial hypophosphatemia, hypoparathyroidism, prevention of osteoporosis and fractures, either alone or in combination with calcium supplementation. This preparation may also be beneficial in situations where the requirement for Vitamin C, Vitamin D, and Folic acid is increased, such as pregnancy, lactation, smoking, advanced age, and living in polluted environments.

One tablet twice daily with food or as directed by the physician.

Concurrent use of thiazide diuretics may increase the risk of hypercalcemia. Calcium salts may reduce the absorption of several medications including bisphosphonates, fluoride, certain fluoroquinolones, and tetracyclines.

• Hypercalcemia and hyperparathyroidism
• Hypercalciuria and nephrolithiasis
• Hypersensitivity to any component of this preparation
• Severe renal insufficiency
• Concurrent digoxin therapy (requires careful monitoring of serum calcium levels)

Vitamin C, Vitamin D3, and Folic acid combination is generally well tolerated. Mild gastrointestinal disturbances may occasionally occur.

Pregnancy: There is no contraindication to the use of this preparation during pregnancy.

Lactation: There is no contraindication to the use of this preparation during lactation.

Contraindications: This combination should not be used in patients with hypercalcemia, hyperparathyroidism, renal calculi, nephrolithiasis, Zollinger-Ellison syndrome, or in patients receiving concurrent digoxin therapy, unless serum calcium levels are carefully monitored.

Caution is advised in patients with renal impairment, sarcoidosis, hypercalcemia, hypercalciuria, and cardiac disease.

In cases of overdose, therapy should be discontinued immediately.

Specific combined vitamin preparations