Natecal D3 ItalFarmaco tablet for treatment and restoration of vitamin D (60 tablets)

Dosage form Box of 60 capsules
Specifications Calcium, cholecalciferol

Ingredient

Composition information	Content
Calcium	600mg
Cholecalciferol	400iu

Uses

indications

Natecal D3 drug is indicated in the following cases: Restoration of vitamin D deficiency combined with calcium in the elderly, vitamin D and calcium supplements such as support for specific treatment in osteoporosis patients with vitamin D deficiency in combination with calcium or high risk of vitamin D and calcium deficiency.

Pharmacokology

natecal d3 is a combination of calcium and vitamin D.

Vitamin D helps restore the body's vitamin D deficiency. It increases the absorption of calcium in the intestine. The best amount of vitamin D for the elderly is 500 - 1000 IU/day.

calcium helps to supplement calcium deficiency in a diet. Usually the demand for calcium in the elderly is 1500 mg/day.

Vitamin D treat secondary hyperthermia in the elderly.

pharmacokinetics

calcium carbonate

In the stomach, calcium carbonate release calcium depends on pH. Calcium oral in the form of calcium carbonate is absorbed from 20-30% and the absorption occurs mostly in the duodenum through the active transport mechanism depending on the saturated vitamin D. Calcium is excreted through urine, feces and sweat. Calcium excretion through urine depends on the filtration of the glomerular and reabsorption in the renal tubules of calcium.

cholecalciferol (vitamin D3)

Vitamin D is absorbed in the small intestine, then cohesion with specific a-globulin and transport to the liver, in the liver is converted into 25-hydroxy-cholecalciferol. This substance continues to be a second-time hydroxylation to 1.25-dihydroxy-Cholecalciferol in the kidney. This type of metabolism will increase the absorption of calcium, vitamin D in the form of non -metabolic stored in tissues such as adipose tissue and muscle. Vitamin D is excreted in feces and urine.

Before taking Natecal D3 ItalFarmaco tablet for treatment and restoration of vitamin D (60 tablets)

How to use and dose

Adults and the elderly

1 tablet/time x 2 times/day (morning, afternoon). Dosage should be reduced in cases where calcium concentration must be controlled in caution and drug interaction.

Should take the pill, should not swallow the whole pill.

It is best to take medicine after meals.

Pregnant women

1 tablet/day.

Patients with liver failure

No dose adjustments in patients with hepatic 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

Overdose can lead to increased blood vitamins and increase calcium in the blood and urine. Symptoms of hypercalcemia may include anorexia, thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disorders, thirst, urination, bone pain, kidney calcium infection, kidney stones and in severe cases may have arrhythmia. High blood calcium hypertension can lead to coma and death. Prolonged high calcium concentration can lead to permanent kidney damage and soft tissue calcification.

Handling

Must stop using calcium and vitamin D. must also stop treating with diuretics of thiazide, lithium, vitamin A, vitamin D and heart glycoside. Emptying the stomach in patients is no longer awake. Water compensation and depending on the severity of treatment can be treated separately or in combination with kidney diuretic, biphosphonate, calcitonin and corticosteroids. The serum electrolytes, kidney function and urination must be monitored. In severe cases, ECG and CVP should be done.

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. Note that it should not be used double the prescribed dose.

Side Effects

When using Natecal D3, you may experience unwanted effects (ADR).

The following side effects are classified by systemic or frequency agencies. The following frequency: Very common (1/10), common (> 1/100,

Not common

Nutrition and metabolic disorders: Increasing blood and urine calcium levels.

rarely

Gastrointestinal disorders: constipation, flatulence, nausea, stomach pain and diarrhea.

Rare

Disorders of the skin and skin: itching, rash, urticaria.

Unknown

The immune system disorder: Heavy allergic reactions such as angioed or laryngeal edema.

Notice the doctor the side effects encountered when taking the drug.

Warnings

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

contraindicated

Natecal d3 drugs contraindicated in the following cases:

History of allergies to calcium, vitamin D or any component of the drug (especially soybean oil).

Kidney stones (kidney stones, kidney calcium infection).

Severe renal failure and kidney failure.

hypercalcemia in the blood and urine, or in the case of a patient with the disease, the result may increase the levels of calcium in the blood or in the urine (the tumor, the primary hyperthyroid gland).

High blood vitamin D concentration.

Be cautious when using

natecal d3 must not be used for young children and teenagers.

With a long -term treatment process, it is advisable to closely monitor calcium levels in urine and serum and monitor kidney function through serum creatinine index. This control is especially important in elderly patients being treated simultaneously with heart glycoside and diuretics.

In case of hypercalcemia or showing signs of kidney failure, reducing dose or temporarily stopped treatment. Dosage should be reduced or temporarily stop treatment if the calcium concentration in the urine exceeds 7.5 mmol/24 hours (300 mg/24 hours).

Consider the dose of vitamin D (400 UI) when prescribing with other drugs containing vitamin D or functional foods containing vitamin D.

The supplementation of vitamin D or calcium must be used with the supervision of medical staff. In those cases, calcium concentration in urine and plasma should be controlled regularly. Increased risk of kidney stones when using calcium with a total amount of nearly 2000 mg/day. Therefore, the amount of calcium is taken into the body from other sources.

Clinical research results show that adherence in high patients is the decision for the effectiveness of additional treatment.

Be cautious when using drugs for patients with pain caused by sarcoid disease because there is a risk of increased vitamin D metabolism into an active metabolic form. Calcium concentration should be monitored in plasma and urine in these patients.

In patients with renal impairment, vitamin D. will occur in cholecalciferol treatment, the endothelial balance results of calcium and phosphate should be monitored. The risk of soft tissue calcification should also be concerned.

Be cautious when used in patients with paralysis with osteoporosis because it will increase the risk of hypercalcemia.

The drug contains aspartame, the root of phenylananine, so it can be harmful to people with phenylketone.

The drug contains hydrogenated soybean oil, so it must be contraindicated in patients with a history of allergies to peanuts and soybeans (see the "Contraindications" section).

The drug contains lactose. Therefore, drugs should not be used in patients with rare genetic galactose intolerance, lapp lactase or glucose/galactose absorption disorders.

The drug contains sucrose. Therefore, drugs should not be tolerated in rare genetic fructose, glucose-galactose absorption disorders or deficiency of sucrase-isomaltase enzymes. Can harm teeth.

The ability to drive and operate machinery

There has been no research on the effects of drugs on driving and operating machinery. Currently, no effect of the drug on the ability to drive and operate machines.

Pregnancy

should not use more than 1500 mg of calcium and 600 IU of vitamin D per day during pregnancy. Animal studies show that it can occur toxicity when taking high doses of vitamin D. It is not possible to overdose calcium and cholecalciferol in pregnant women because of the increase in calcium in the blood, causing adverse effects on fetal development. There is no sign that vitamin D is at a teratogenic treatment. Natecal D3 can be used during pregnancy, in case of calcium and vitamin D.

deficiency

breastfeeding period

Natecal D3 can be used for breastfeeding women. Calcium and vitamin D through breast milk. This should be considered when you need to supplement vitamin D for breastfeeding children.

Drug interaction

simultaneously used with phenytoin or sedatives can reduce the effects of vitamin D3 because of increased metabolism.

If used simultaneously with biphosphonate, sodium fluoride or fluoroquinolone, use these drugs 3 hours before using Natecal D3 because they can reduce the absorption in the digestive tract.

When treating with thiazide diuretics, it reduces the excretion of calcium through the kidneys. Therefore, regularly monitoring calcium levels in plasma.

Concentrated use with glucocorticoid can reduce the effect of vitamin D3.

Calcium carbonate can hinder the absorption of tetracyclin when used simultaneously. Therefore, Tetracycline should be used at least 2 hours before or 4 to 6 hours after taking calcium.

Hypercalcemia may increase the toxicity of digoxin and other heart glycosides when treated with calcium and vitamin D. Patients should be monitored with electrocardiography and serum calcium concentration.

Orlistat, combined with ion exchange resin such as cholestyramine or laxatives such as paraffin oil can reduce the absorption of vitamin D3 in the gastrointestinal tract.

Calcium salts can reduce the absorption of iron, zinc or stronti Ranelat. Therefore, iron, zinc or stronti ranelat should be used 2 hours before or after taking calcium.

Calcium salts can reduce estramustine absorption or thyroid hormone. So take Natecal D3 at least 2 hours away when taking these drugs.

oxalic acid (found in vegetables and royal plants) and phytic acid (found in all cereals) can inhibit calcium absorption through the formation of insoluble compounds with Ca2+ions. Patients should not use calcium within 2 hours before and after eating foods that contain oxalic acid and phytic acid.

Storage

Store at temperatures below 30 ° C, in closed packaging to avoid moisture.

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