Cavic-C Plus

Indication

Nutritional Supplements in Osteoporosis, Calcium deficiency, Rickets, Hypocalcaemia, Calcium supplement, Osteomalacia

Adult Dose

Dosage should be individualized based on the demands of age, sex, and various physiological (pregnancy & lactation) & disease conditions. In general, the dosage is- Adults: 1 effervescent tablet daily

Child Dose

Dosage should be individualized based on the demands of age, sex, and various physiological (pregnancy & lactation) & disease conditions. In general, the dosage is as- Children above 7 years: 1 effervescent tablet daily Children 3-7 years: Half effervescent tablet daily

Contraindication

Absolute contraindications are hypercalcemia resulting from myeloma, bone metastases or another malignant bone disease, sarcoidosis; primary hyperparathyroidism, and Vitamin-D overdosage. It is also contraindicated in severe renal failure and hypersensitivity to any of the tablet ingredients.

Mode of Action

Calcium carbonate/vitamin D3 prevents or treats negative Ca balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function. Bone mineral component; cofactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways. Vitamins and minerals are essential for normal metabolic functions including hematopoiesis. Vitamin D3 is a fat-soluble sterol. It is necessary for the regulation and regulation of calcium and phosphate homeostasis and bone mineralization. Vitamin D is also essential for healthy bones as it aids in Calcium absorption from the GI tract. Vitamin C is necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in the conversion of folic acid to folinic acid.

Precaution

Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma Calcium levels and urinary Calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria. In patients with a history of renal stones urinary Calcium excretion should be measured to exclude hypercalciuria. With long-term treatment, it is advisable to monitor serum and urinary Calcium levels and kidney function and reduce or stop treatment temporarily if urinary Calcium exceeds 7.5 mmol/24 hours. Allowances should be made for Calcium and Vitamin-D supplements from other sources. Lactation: Calcium enters human milk; use with caution

Side Effect

Calcium Anorexia, Constipation, Flatulence, Nausea, Vomiting, Hypercalcemia, Hypophosphatemia, Xerostomia, Acid rebound, Milk-alkali syndrome Vitamin D Hypercalcemia, Muscle/bone pain, Metallic taste, Headache, Nausea, Vomiting, Dry mouth, Constipation, Arrhythmias

Interaction

Calcium Carbonate: Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn, and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication. Calcium Lactate: This may reduce the efficacy of calcium-channel blockers. Concurrent admin of IV calcium salt with cardiac glycosides may lead to serious adverse events. Increased risk of hypercalcemia when used with thiazide diuretics. May reduce the absorption of tetracycline, alendronate, atenolol, iron, quinolone antibiotics, sodium fluoride, and zinc. Calcium Gluconate: Co-admin of high calcium doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcemia. May potentiate digoxin toxicity. Decreases effects of calcium-channel blockers. Enhanced absorption with calcitriol (a vitamin D metabolite). Vit D3: Increased risk of hypercalcaemia if given with thiazide diuretics, calcium or phosphate. Antiepileptics (e.g. carbamazepine, phenobarbitone, phenytoin & primidone) may increase vitamin D requirements. Rifampicin & isoniazid may reduce the efficacy of vitamin D. Corticosteroids may counteract the effect of vitamin D. Digoxin or any cardiac glycoside. Reduced absorption when taken with cholestyramine, colestipol, mineral oil, or orlistat. Ketoconazole. Vit C: Deferroxamine, hormonal contraceptives, fluphenazine, warfarin, elemental iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine, vitamin B12.