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Increased demand for Calcium and Vitamin-C, e.g. pregnancy, lactation, periods of rapid growth (childhood, adolescence), in old age
Calcium is used as a pharmacological agent in humans almost entirely to remedy deficiency. Adequate calcium in the blood is so vital to a wide variety of bodily functions that our internal biochemistry will not tolerate a deficiency even for short periods. Vitamin-C is an essential component of the diet as humans cannot synthesize Vitamin-C. It is a very powerful reducing agent and plays an important part in the response of the body to stress. It is important in the defense against infections. Vitamin-D is also essential for healthy bones as it aids in calcium absorption from the GI tract. In addition to this it stimulates bone formation. Clinical studies show that calcium and vitamin-D has synergistic effects on bone growth as well as in osteoporosis and fracture prevention.
Adults and children above 7 years: 1 effervescent tablet daily
Children 3 to 7 years: 1/2 effervescent tablet daily
The risk of hypercalcemia should be considered in patients taking thiazide diuretics since these drugs can reduce urinary calcium excretion. Hypercalcemia must be avoided in digitalised patients. Certain foods (e.g. those containing oxalic acid, phosphate or phytinic acid) may reduce the absorption of calcium. Concomitant therapy with phenytoin or barbiturates can decrease the effect of vitamin-D because of metabolic activation. The effect of digitalis and other cardiac glycosides may be accentuated with the oral administration of calcium combined with vitamin-D. Calcium salts may reduce the absorption of thyroxine, bisphosphonates, sodium fluoride, quinolone or tetracycline antibiotics or iron. It is advisable to allow a minimum period of 4 hours before taking the calcium.
For patients with mild hypercalciuria (exceeding 300 mg = 7.5 mmol/24 hours), with mild or moderate impairment of renal function or with a history of urinary concrements, monitoring of calcium excretion in the urine is required. If necessary, the dosage should be reduced or therapy should be discontinued. Since citrate salts have been reported to increase aluminium absorption, this preparation which contains citric acid as a constituent, should be used with caution in patients with severely impaired renal function, especially those receiving aluminium-containing preparations.
In rare cases, mild gastrointestinal disturbances (bloating, diarrhoea) can occur. In predisposed patients prolonged treatment with high doses may promote the formation of calculi in the urinary tract.
Epidemiological studies with oral calcium have shown no increase in the teratogenic hazard to the fetus. Although supplemental calcium may be excreted in breast milk, the concentration is unlikely to be sufficient to produce any adverse effect on the neonate.
Vitamin-C may be taken safely during pregnancy and lactation.
Acute overdosage has not been reported. It would be expected to cause gastrointestinal disturbances but not to result in hypercalcemia, except in patients treated with a very high dosage of vitamin-D and derivatives.
Store at a cool and dry place. Protect from light and moisture. Keep out of reach of children. Keep the container tightly closed.
Each effervescent tablet contains Calcium lactate gluconate 1000 mg, Calcium carbonate BP 327 mg & Ascorbic acid (Vitamin-C) BP 500 mg.