D-Cure 25000iu SMB solution and vitamin D deficiency treatment (1 blister x 4 tubes)

Dosage form Box of 1 blister x 4 tubes
Specifications Cholecalciferol
Ingredient Osteoporosis, fracture, rickets

Ingredient

Thành phần cho 1ml

Composition information	Content
Cholecalciferol	0.625mg/ml

Uses

Indication

drug D - Cure 25000 IU is indicated in the following cases:

Prophylaxis and treatment of vitamin D deficiency.

ATC code: A11CC05.

The biological activity of vitamin D enhances the absorption of calcium in the intestine, attaches calcium to bone money, and increases the release of calcium from bone tissue. In the small intestine, vitamin D helps increase the effectiveness of calcium absorption from the diet. The passive and proactive transportation process of phosphate has also been strengthened. In the kidneys, vitamin D inhibits calcium and phosphate excretion by increasing reabsorption in the renal tubules. The production of parathyroid hormones (PTH) in the parathyroid gland is directly inhibited by the biological activity of vitamin D3. In addition, the excretion of PTH is also inhibited by an increase in calcium absorption in the small intestine under the effect of Vitamin D activity.

Pharmacokinetics

absorption

Vitamin D is well absorbed in the stomach - intestines thanks to bile salt, so taking vitamin D in the main meals of the day helps increase vitamin D absorption.

Distribution and metabolism

Hydroxylation drugs in the liver to form 25 - hydroxy - cholecalciferol and then continue to be hydroxylation in the kidneys to form an active metabolic substance 1.25 - dihydroxololeciferol (Calcitriol).

Elimination

The metabolites circulate in the blood connect with a specific α - globin, vitamin D and its metabolites are excreted mainly through bile and feces.

Characteristics in special patient groups

Metabolic clearance in patients with renal failure is 57% lower than in healthy volunteers.

Reducing the absorption and reduction of vitamin D elimination occurs in people with absorption disorders. Obese people are less likely to maintain vitamin D levels when exposed to sunlight and may need a larger dosage of vitamin D to compensate for the shortage.

Before taking D-Cure 25000iu SMB solution and vitamin D deficiency treatment (1 blister x 4 tubes)

How to use

It is best to drink D - Cure 25000 IU at meals.

How to use for adults

all the amount of medicine in the tube should be poured directly into the mouth or poured into a spoon. You can also drink D - Cure 25000 IU by mixing with a small amount of cold or warm food and immediately used.

How to use for children

Can mix D - Cure 25000 IU with a small amount of food, yogurt, milk, cheese or other dairy products. The warning should not mix D - Cure 25000 IU in a bottle of milk or soft food box in case the child cannot use up and thus the child will not receive the enough dose. Parents need to make sure their children must be taken into the whole dose. For babies who are no longer breastfeeding, should be used with food.

Dosage

Children

Prevention of Vitamin D deficiency in children 0 - 1 year: 25,000 IU (1 tube) every 8 weeks.

Preventive deficiency of vitamin D in children 1 - 18 years old: 25,000 IU (1 tube) every 6 weeks.

Treatment of vitamin D deficiency in children 0 - 18 years old: 25,000 IU (1 tube) every 2 weeks for 6 weeks (then switch to maintain treatment 400 - 1,000 IU/day).

Adults

Prevention of Vitamin D deficiency: 25,000 IU/month (1 tube), can be used higher doses in certain cases.

Support in treating osteoporosis specific: 25,000 IU/month (1 tube).

Treatment of vitamin D deficiency ( People with high risk of vitamin D deficiency may have to take a higher dosage and need to monitor the concentration of 25 (OH) D serum:

Patients are hospitalized.

People with dark skin. glucocorticoid).

kidney failure

Do not use D - Cure 25000 IU with calcium for patients with severe renal failure.

Hepatic failure

No dose adjustments in patients with liver failure.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms of overdose

ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) have relatively low treatment index. Vitamin D poisoning threshold is 40,000 - 100,000 IU per day continuously for 1 to 2 months in adults with normal parathyroid function. Babies and young children may be sensitive to a much lower dose. Therefore, Vitamin D should not be used without the supervision of health workers.

Overdose leads to an increase in phosphorus concentration in serum and urine, as well as blood calcium hypercalca syndrome and leads to calcium deficit in tissues and especially calcium hypercactive in the kidneys (causing kidney stones, kidney calcium infection).

Stop using D - Cure 25000 IU when blood calcium concentration exceeds 10.6 mg/dL (2.65 mmol/l) or if the calcium concentration in the urine exceeds 300 mg/24 hours in adults or 4 - 6 mg/kg/day in children.

Chronic poisoning can lead to blood vessel calcification and organs due to blood calcium hypertension.

Symptoms of poisoning are often less characterized and show signs such as nausea, vomiting, at first diarrhea, after constipation, anorexia, fatigue, headache, muscle pain, muscle pain, muscle weakness, prolonged drowsiness, increased blood urea, thirst and multiple urinary, and finally dehydration. Biochemical results are usually hypercalcemia, hypercalcium and increase concentration 25 - hydroxycholeciferol in serum.

Overdose treatment

Symptomatic treatment of vitamin D chronic poisoning is forced to use diuretics and glucocorticoid or calcitonin.

It is necessary to take measures to treat hypercalcemia - often persistent and some life -threatening cases.

The first measure is to stop using vitamin D preparations; It usually takes a few weeks to increase blood calcium caused by vitamin D poisoning. Depending on the level of hypercalcemia, measures include a low -calcium or non -calcium diet, drink plenty of water, increase urine excretion with Furosemid, and use glucocorticoid and calcitonin.

If normal renal function, it is possible to reduce calcium levels significantly by transmitting the isothermal solution of sodium chloride (3 - 6 liters for 24 hours), supplementing Furosemid and in some cases, it may also supplement sodium edetate 15 mg/kg body weight/hour combined with continuous monitoring of calcium and electrocardiograms. In the case of anuria, dialysis measures (Calcium separation) are necessary.

No specific antidote.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using D - Cure 25000 IU, you may experience unwanted effects (ADR).

Side effects are listed according to the organs and frequency of appearance: less common (> 1/1000, 1/10000,

rarely

Metabolic and nutrient disorders: Hyperculia and hypercalcium.

rarely

Disorders on skin and subcutaneous tissue: itching, rash and urticaria.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

drug D - Cure 25000 IU Contraindicated in the following cases:

Hypersensitivity to any ingredients of the drug.

Hypercalcemia and/or hypercalcium.

Kidney stones and/or calcium deposition in the kidneys.

Severe kidney failure.

Excess vitamin D.

Impossoing the parathyroid gland.

Be cautious when used

should be careful when using vitamin D for patients with impaired renal function and monitoring effects on calcium and phosphate levels. Also should pay attention to the risk of soft tissue calcification.

Be cautious in patients who are treating cardiovascular disease.

Be cautious when prescribing D - Cure 25000 IU for patients with sarcoidosis, due to the risk of increased vitamin D metabolism into activity. In these patients, closely monitoring calcium levels in urine and serum.

Total amount of vitamin D in the case of patients being treated with drugs containing vitamin D, using food and milk rich in vitamin D and the level of exposure to the patient's sunlight.

There is no clear evidence of the causal relationship between vitamin D supplementation and kidney stones, but it is likely to occur, especially when supplementing simultaneously calcium. The need for additional calcium should be calculated for each patient and is indicated under strict medical supervision.

There has been a report on taking high doses of vitamin D (a single dose of 500,000 IU per year) increases the risk of fractures in the elderly group and the highest risk is within the first 3 months after medication.

The ability to drive and operate machinery

No impact.

Pregnancy

During pregnancy and lactation, it is recommended not to use high doses and can be used in low doses.

Data on the use of cholecalciferol in pregnant women is limited or not available. Animal studies have shown toxicity on fertility. The daily recommended dose for pregnant women is 400 IU, however, women with vitamin D deficiency may be used higher doses (up to 2,000 IU/day).

During pregnancy, mothers should adhere to the advice of a doctor because the need for vitamin D may vary depending on the severity of the disease and meet the treatment with vitamin D and metabolic substances are excreted into breast milk.

The period of breastfeeding

may be prescribed vitamin D during breastfeeding if necessary. This supplement cannot replace the use of vitamin D for babies.

Interactive drug

simultaneously used with anti -convulsions (such as phenytoin) or barbiturat group (and other drugs that cause liver enzyme induction) can reduce the effect of vitamin D3 due to inactivity.

Treatment of thiazid diuretics reduces the elimination of calcium through the kidneys, so it recommends monitoring serum levels.

Concentrated with glucocorticoid can reduce the effect of vitamin D.

In the case of treatment with digitalis and other cardiac glycosides, using vitamin D may increase the risk of Digitalis toxicity (causing arrhythmia). It is necessary to closely monitor, along with monitoring serum and electrocardiography if necessary.

Simultaneous treatment with ion exchange resin such as cholestyramin, colestipol hydrochlorid, orlistat or laxative such as paraffin oil can reduce vitamin D absorption in the digestive tract.

Actinomycin and imidazol antifungal toxic drugs hinder the activity of vitamin D by inhibiting the change of 25 - Hydroxy vitamin D to 1, 25 - Dihydroxy vitamin D by enzyme in the kidney 25 - hydroxy vitamin D - 1 - hydroxylase.

Storage

Store in a dry place, avoid light, the temperature does not exceed 30 ° C. To be out of reach of children.

Expiry date: 24 months from the date of manufacture. Do not use overdue drugs stated on the packaging.

Manufacturer: SMB Technology S.A.

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