Calcium carbonate with colecalciferol oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations of calcium carbonate and colecalciferol.
Drugs List
Therapeutic Indications
Uses
Calcium and vitamin D deficiency
Dosage
Adults
Tablets
1250mg to 3750mg of calcium carbonate (500mg to 1500mg elemental calcium) and 400units to 1000units of colecalciferol (10micrograms to 25micrograms vitamin D3) per day. Some products should be taken in divided doses (preferably morning and evening).
Granules
1250mg to 2500mg of calcium carbonate (500mg to 1000mg elemental calcium) and 440units to 880units of colecalciferol (11micrograms to 22micrograms vitamin D3) per day.
Children
Not all brands are licensed in children under 18 years of age.
Some brands may differ in their dosage recommendations for children. See product literature for full guidance.
Children aged 12 to 18 years
1250mg to 3000mg of calcium carbonate (500mg to 1200mg elemental calcium) and 200units to 800units of colecalciferol (5micrograms to 20micrograms vitamin D3).
Children aged 1 month to 12 years
1250mg to 2500mg of calcium carbonate (500mg to 1000mg elemental calcium) and 200units to 400units of colecalciferol (5micrograms to 10micrograms vitamin D3)
Contraindications
Hypervitaminosis D
Neonates under 1 month
Hereditary fructose intolerance
Hypercalcaemia
Hypercalciuria
Hyperparathyroidism
Metastatic calcification
Myeloma
Nephrocalcinosis
Nephrolithiasis
Prolonged immobilisation with hypercalciuria and/or hypercalcaemia
Severe renal impairment
Skeletal metastasis
Precautions and Warnings
Children 1 month to 18 years
Breastfeeding
Galactosaemia
Glucose-galactose malabsorption syndrome
History of nephrolithiasis
Lactose intolerance
Mild renal impairment
Phenylketonuria
Pregnancy
Sarcoidosis
Some formulations contain aspartame - caution in phenylketonuria
Allow for calcium and vitamin D intake from other sources
Not all available brands/formulations are licensed for use in children
Preparation contains sucrose
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some forms contain isomalt: unsuitable in hereditary fructose intolerance
Some formulations contain glucose
Some formulations contain lactose
Some formulations contain propylene glycol
Some products may contain soya or soya derivative
Breastfeeding: Hypercalcaemia of infant possible if mother taking vitamin D
Check serum calcium level if nausea and vomiting occur
Monitor renal function in elderly patients
Monitor renal function on long term therapy
Monitor serum and urinary calcium in patients with sarcoidosis
Monitor serum calcium levels in patients with renal impairment
Monitor serum calcium levels on prolonged use
Monitor serum phosphate levels in patients with renal impairment
Monitor urinary calcium in patients with a history of renal stones
Reduce dose or discontinue if urinary calcium exceeds 7.5mmol/24 hours
Advise to avoid iron, zinc and strontium 2 hours before or after dose
Pregnancy and Lactation
Pregnancy
Use calcium carbonate with colecalciferol with caution during pregnancy.
Manufacturers advise that calcium carbonate with colecalciferol can be used during pregnancy. Some manufacturers reccomend maximum doses. Refer to specific product literature for more information.
During pregnancy, requirements for calcium and vitamin D are increased.
In pregnant women, overdoses of calcium and vitamin D should be avoided as permanent hypercalcaemia has been related to adverse effects on the developing foetus. Long term hypercalcaemia can lead to physical and mental retardation, aortic stenosis and retinopathy in the new-born child.
Studies in animals have shown reproductive toxicity with high doses of vitamin D.
Lactation
Use calcium carbonate with colecalciferol with caution during breastfeeding.
Manufacturers advise that calcium carbonate with colecalciferol can be used during breastfeeding.
Calcium and vitamin D pass into breast milk. This should be taken into consideration when giving additional vitamin D to the child.
Breast milk from women taking pharmacological doses of vitamin D may cause hypercalcaemia if given to an infant. Serum calcium concentrations should be monitored in the breastfeeding neonate.
The Specialist Pharmacy Service (SPS) states that low dose vitamin D (up to 10micrograms a day) is considered safe with breastfeeding.
Side Effects
Abdominal distension
Abdominal pain
Angioedema
Constipation
Diarrhoea
Dyspepsia
Flatulence
Hypercalcaemia
Hypercalciuria
Hyperphosphataemia
Hypersensitivity reactions
Laryngeal oedema
Milk-alkali syndrome
Nausea
Nephrocalcinosis
Nephrolithiasis
Pruritus
Rash
Urticaria
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: September 2019
Reference Sources
Summary of Product Characteristics: Accrete D3 film-coated tablets. Internis Pharmaceutical Ltd. Revised August 2016.
Summary of Product Characteristics: Accrete D3 One A Day 1000mg/880IU chewable tablets. Sandoz Limited. Revised September 2018.
Summary of Product Characteristics: Adcal-D3 Caplets. Kyowa Kirin Ltd. Revised February 2017.
Summary of Product Characteristics: Adcal-D3 Chewable Tablets. Kyowa Kirin Ltd. Revised February 2017.
Summary of Product Characteristics: Adcal-D3 Lemon Chewable Tablets. Kyowa Kirin Ltd. Revised February 2017.
Summary of Product Characteristics: Adcal-D3 Dissolve 1500mg/400IU Effervescent Tablets. Kyowa Kirin Ltd. Revised February 2017.
Summary of Product Characteristics: Cacit D3 500mg/440IU, effervescent granules for oral solution in sachet. Theramex Ireland Limited. Revised March 2019.
Summary of Product Characteristics: Calceos 500mg/400IU Chewable Tablets. Galen Ltd. Revised March 2015.
Summary of Product Characteristics: Calcichew-D3 Forte 500mg/400IU film coated tablets. Takeda UK Ltd. Revised May 2019.
Summary of Product Characteristics: Calcichew-D3 1000mg/800 IU Once Daily chewable tablets. Takeda UK Ltd. Revised May 2019.
Summary of Product Characteristics: Calcichew-D3 Chewable Tablets. Takeda UK Ltd. Revised December 2016.
Summary of Product Characteristics: Calcichew-D3 Forte Chewable Tablets. Takeda UK Ltd. Revised December 2016.
Summary of Product Characteristics: Calci-D 1000mg/1000 IU Chewable Tablets. Consilient Health Ltd. Revised September 2015.
Summary of Product Characteristics: Evacal D3 1500 mg/400 IU Chewable tablets. Teva UK Ltd. Revised May 2019.
Summary of Product Characteristics: Natecal D3 Chewable Tablets. Chiesi Limited. Revised October 2015.
Summary of Product Characteristics: Kalcipos-D 500mg/800IU Chewable Tablets. Mylan Products Ltd. Revised December 2018.
Summary of Product Characteristics: TheiCal-D3 1000mg/880 IU chewable tablets. Stirling Anglian Pharmaceuticals Ltd. Revised December 2015.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 27 August 2019.
Specialist Pharmacy Service (SPS)
Available at: https://www.sps.nhs.uk/
Colecalciferol Last revised: 19 April 2016
Last accessed: 27 August 2019.
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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