Bones

Calcemin Sandoz. Calcium Sandoz Forte: instructions for use

Release form

Effervescent tablets.

1 effervescent tablet 1000 mg contains:
Active ingredients: calcium lactogluconate 2263.00 mg and calcium carbonate 1750.00 mg, which is equivalent to 1000 mg or 25 mmol ionized calcium.
Excipients: citric acid macrogol-6000, orange flavor (orange flavor contains sulfur dioxide (E220), butylated hydroxyanisole (E320), sorbitol), aspartame, sodium bicarbonate.

Package

10 tablets in a polypropylene case, sealed with a polypropylene lid containing silica gel and equipped with a first-opening control system. The pencil case along with instructions for use are placed in a cardboard box.

pharmachologic effect

Calcium Sandoz forte is a regulator of calcium-phosphorus metabolism.

Calcium is vital mineral element, necessary to maintain the balance of electrolytes in the body and the adequate functioning of numerous regulatory mechanisms. Replenishes Ca2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and antiallergic effects.

Calcium Sandoz Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into an active ionized form of calcium, which is easily absorbed. This dosage form provides an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic deficiency calcium in the body, as well as for treatment various types metabolic disorders in bone tissue.

Indications

Osteoporosis of various origins (postmenopausal, senile, caused by long-term therapy with glucocorticosteroids, immobilization, gastrectomy, etc.) in the composition combination therapy(eg with vitamin D3 and bisphosphonates).
- Conditions accompanied by an increased need for calcium, including pregnancy, lactation, periods of intensive growth in children.
- Prevention of osteoporosis.
- Osteomalacia (as an addition to the main therapy, including vitamin D3).
- Latent tetany, accompanied by hypocalcemia (for the treatment of acute tetany should be used injection solution calcium).
- Allergic reactions (maintenance therapy).

Contraindications

Hypersensitivity to the components of the drug, increased concentration of calcium in the blood and urine (hypercalcemia, hypercalciuria), chronic renal failure, nephrourolithiasis, nephrocalcinosis, phenylketonuria and sucrose/isomaltose deficiency, fructose intolerance, glucose-galactose malabsorption.

Use during pregnancy and breastfeeding

The drug can be prescribed during pregnancy and breastfeeding on the recommendation of a doctor. Calcium penetrates into breast milk. During pregnancy daily dose calcium should not exceed 1500 mg. Hypercalcemia during pregnancy can cause disturbances in fetal development.

Directions for use and doses

Inside, regardless of food intake. Before taking the tablet, dissolve it in a glass of water.

Children from 3 to 9 years: 500 mg per day.
Adults and children over 10 years of age: 1000 mg per day.

IN severe cases or when increased need in calcium (for example, during treatment with bisphosphonates), the dose may be increased to 2000 mg per day.

Side effects

Very rare (less than 1/10,000): reactions hypersensitivity, incl. rash, itching, urticaria, hypercalcemia. In isolated cases, systemic allergic reactions (anaphylactic reactions, facial swelling, angioedema). In some medical publications Hypercalciuria has been reported with calcium supplementation.

Rarely (more than 1/10,000, less than 1/1,000): flatulence, constipation, diarrhea, nausea, vomiting, epigastric pain. Upon admission to high doses(2000 mg/day when taken daily for several months) may be observed headache, increased fatigue, thirst, polyuria.

special instructions

In patients with mild hypercalciuria (exceeding 300 mg/24 hours or 7.5 mmol/day), mild or moderate pronounced violations renal function, as well as in the presence of anamnestic indications of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or discontinue it. Patients with a tendency to form stones in urinary tract It is recommended to increase fluid intake.

In patients with impaired renal function, calcium salts should be taken under medical supervision. Monitoring of serum calcium and phosphate levels is necessary.

When treating with calcium supplements, it is necessary to avoid taking large doses of vitamin D or its derivatives, unless necessary. special indications.

Patients on a low-salt diet should take into account the sodium content in 1 tablet of effervescent Calcium Sandoz Forte:
2.976 mmol (corresponding to 68.45 mg) sodium in one 500 mg tablet;
5.95 mmol (corresponds to 136.90 mg) sodium in one 1000 mg tablet.

Information for patients with diabetes:
One tablet of Calcium Sandoz forte contains 0.002 grain units, so the drug can be used in patients with diabetes.

Drug interactions

The combination of calcium carbonate + calcium lactogluconate may reduce the absorption of estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics and fluoride preparations. The interval between taking effervescent calcium carbonate + calcium lactogluconate tablets and the above drugs should be at least 3 hours. Simultaneous administration of vitamin D and its derivatives increases calcium absorption. When given in high doses along with vitamin D and its derivatives, calcium may reduce the effect of verapamil and possibly other blockers calcium channels.

With the simultaneous use of Calcium Sandoz forte effervescent tablets and tetracycline drugs, the absorption of the latter may be impaired. For this reason, tetracycline preparations should be taken at least 2 hours before or 4-6 hours after ingesting calcium preparations. Thiazide diuretics reduce urinary calcium excretion, therefore, when used concomitantly with Calcium Sandoz Forte effervescent tablets, regular monitoring of serum calcium concentrations should be carried out, as there is a risk of developing hypercalcemia.

Systemic corticosteroids reduce calcium absorption. If they are used simultaneously, it may be necessary to increase the dose of Sandoz Forte Calcium tablets.

When taking Calcium Sandoz Forte tablets orally in patients receiving cardiac glycosides, the toxicity of cardiac glycosides may increase due to the development of hypercalcemia. Such patients should regularly take an ECG and monitor the level of calcium in the blood serum.

At simultaneous administration oral bisphosphonate or sodium fluoride, these drugs should be taken at least 3 hours before taking Calcium Sandoz Forte tablets, since absorption from gastrointestinal tract(Gastrointestinal) bisphosphonate or sodium fluoride may decrease. Absorption of calcium from the gastrointestinal tract may be reduced by concomitant intake of certain foods containing oxalic acid (eg, spinach, rhubarb) or phytic acid(in all grains) due to the formation of insoluble complexes with calcium ions. Patients should not take Calcium Sandoz Forte tablets 2 hours before or after meals. rich in content oxalic or phytic acid.

Storage conditions

At a temperature not exceeding 30°C in a tightly closed container. Keep out of the reach of children.

Calcium Sandoz Forte - combined medicine, which is a regulator of calcium metabolism, used to treat and normalize the metabolism of this element.

What are the composition and release form of Calcium-Sandoz Forte?

The active ingredients of the drug are represented by the following compounds: calcium carbonate - 875 milligrams, calcium lactogluconate - 1132 mg. The content of ionized calcium is 500 mg.

Auxiliary components: butylated hydroxyanisole E320, sorbitol, citric acid, orange flavor E220, macrogol 6000, sodium bicarbonate, in addition.

The drug is available in flat effervescent tablets with a specific odor with beveled edges and a rough surface. The pharmaceutical industry produces Calcium Sandoz Forte dosage forms containing active calcium 500 and 1000 milligrams. The medicine is available without a prescription.

What is the effect of Calcium-Sandoz Forte?

Calcium Sandoz Forte is designed to eliminate calcium deficiency - vital important element, the role of which in the human body is difficult to overestimate. First of all, this element participates in the formation of bone tissue, normalizing its structure.

Secondly, calcium is actively involved in transmission processes nerve impulse and depolarization of membranes, indirectly affecting the functioning of most organs, determining the tone of smooth muscle fibers, regulating, and so on.

The use of the drug helps strengthen bone tissue, and therefore prevents the occurrence of spontaneous fractures of the limbs. Besides, in adolescence, the child’s body needs an increased amount of the element, directed to the processes of biological synthesis of components of the musculoskeletal system.

The drug ensures that calcium enters the body in an easily accessible form, in the form of a tasty, aromatic drink, replenishing the reserves of this valuable element. When taken orally, absorption processes active ingredients start in the small intestine. The bioavailability coefficient depends on many factors and varies from 25 to 50 percent.

Most of the absorbed mineral is deposited in structures such as: bone, tooth enamel and dentin. Only about 1 percent of calcium is present in the body in extracellular and intracellular fluid.

Removal of active components is carried out by 80 percent digestive system, composed of bile and pancreatic juice. The remaining part of the mineral is excreted from the body through the organs excretory system.

What are the indications for use of Calcium-Sandoz Forte?

The use of the drug as a means of preventing and treating calcium deficiency is indicated in the following cases:

Pregnancy and lactation;
;
Period of intensive growth;
Osteoporosis in the postmenopausal period

It would be a good idea to visit a doctor to have laboratory confirmation of calcium deficiency and determine an effective and safe dosage.

What are the contraindications for use of Calcium-Sandoz Forte?

The instructions for use prohibit the use of the drug Calcium-Sandoz Forte in the presence of any of the following conditions:

Increased calcium levels in the blood or urine;
Insufficient function of the excretory system;
Heavy;
Phenylketonuria;
Urolithiasis and cholelithiasis;
Nephrourolithiasis;
Glucose intolerance;
Hypersensitivity to the drug;
Age less than 3 years.

What are the uses and dosages of Calcium-Sandoz Forte?

The medicine should be taken orally, regardless of food. The effervescent tablet must first be dissolved in half a glass ordinary water. The dosage depends on the level of calcium in the blood and the age of the patient.

If you have severe calcium deficiency daily dosage for an adult patient it can be increased to 2 grams. The duration of treatment is determined by a specialist and varies from 4 to 6 weeks.

Overdose from Calcium-Sandoz Forte

Symptoms are as follows: thirst, vomiting, nausea. Treatment: stopping the drug, drinking plenty of fluids. For severe electrolyte disturbances, it is recommended to symptomatic treatment.

What are the side effects of Calcium-Sandoz Forte?

While taking the drug, the following may develop: side effects: allergic and anaphylactic reactions, increased fatigue, dyspeptic symptoms in the form of nausea, diarrhea, constipation, bloating, and so on.

special instructions

Patients suffering from diabetes mellitus, must adjust the amount of carbohydrates consumed, based on the calculation that one effervescent tablet of the drug contains 0.002 bread units.

The simultaneous use of several drugs intended to correct calcium metabolism is strictly unacceptable, as this can provoke severe side effects.

If you have a tendency to form calculi (stones) in the urinary tract, you should use increased amount liquids, unless there are other contraindications.

How to replace Calcium-Sandoz Forte, what analogues?

The therapeutic and prophylactic drug Calcium Sandoz Forte can be replaced with the following pharmaceuticals: Calcium Sandoz Forte, CalViv, as well as Calcium carbonate + Calcium lactogluconate.

Conclusion

In the treatment of calcium deficiency, a comprehensive approach is very important.

Calcium Sandoz Forte is a mineral supplement that replenishes calcium deficiency in the body.

Release form and composition

Calcium Sandoz Forte is available in the form effervescent tablets, 10 and 20 pcs. in polypropylene cases, one case in a cardboard box.

Active ingredients of the drug:

Calcium lactogluconate – 1132 mg or 2263 mg per tablet;
Calcium carbonate – 875 mg or 1750 mg per tablet.

* which corresponds to the content of 500 mg or 1000 mg Ca 2+ in one tablet, respectively.

Auxiliary components: citric acid, macrogol 6000, aspartame, sodium bicarbonate and orange flavor containing sorbitol, butylated hydroxyanisole (E320) and sulfur dioxide (E220).

Indications for use

Treatment and prevention of calcium deficiency, including in children during the period of intensive growth, in pregnant and breastfeeding women;
Osteomalacia (as an auxiliary drug);
Prevention and treatment of osteoporosis (in addition to specific therapy);
Allergic reactions (as maintenance therapy).

Contraindications

Hypercalciuria;
Hypercalcemia;
Nephrocalcinosis;
Nephrourolithiasis;
Chronic renal failure;
Glucose-galactose malabsorption, sucrase/isomaltase deficiency and fructose intolerance;
Phenylketonuria;
Children under 3 years of age;
Hypersensitivity to the components of the drug.

Directions for use and dosage

The tablets are taken orally, dissolved immediately before use in a glass of water, at any time. convenient time- regardless of food intake.

Children 3-9 years old are prescribed 500 mg per day, children over 10 years old and adults – 1000 mg per day. In severe cases and with an increased need for calcium (for example, during treatment with bisphosphonates), the daily dose can be increased to 2000 mg.

The duration of use of Calcium Sandoz Forte is determined individually in each case. When taken to compensate for calcium deficiency, the course of treatment is at least 4-6 weeks.

Side effects

In general, the drug is well tolerated. IN in rare cases noted:

Hypersensitivity reactions, incl. hypercalcemia, itching, rash, urticaria;
System allergic reactions– facial swelling, angioedema, anaphylactic reactions;
Nausea, vomiting, flatulence, epigastric pain, constipation or diarrhea.

With long-term use of Calcium Sandoz Forte in high doses (2000 mg per day), headache, polyuria, and increased fatigue are possible.

An overdose of calcium leads to the development of hypercalciuria and hypercalcemia, manifested by thirst, nausea, vomiting, polyuria, polydipsia, dehydration and constipation. Chronic overdose with hypercalcemia can lead to liming of organs and blood vessels. Intoxication threshold – long-term use(for several months) more than 2000 mg of calcium per day.

On initial stage chronic overdose, hydration of the body is carried out using a 0.9% sodium chloride solution. In some cases they are used loop diuretics– they help enhance calcium excretion and prevent the formation of edema in tissues. In case of intoxication, it is necessary to restore water-electrolyte balance.

For persistent hypercalcemia, it is prescribed additional examination to exclude other factors contributing to its development, including hypervitaminosis D and A, renal failure, primary hyperparathyroidism, stiffness of movement, malignant tumors.

In patients with renal failure hydration is ineffective, so they are given dialysis.

special instructions

When taking Calcium Sandoz Forte during pregnancy, in order to prevent the development of hypercalcemia, which can cause disturbances in the fetus, the dose should not exceed 1500 mg per day.

Patients with mild to moderate renal dysfunction, with slight hypercalciuria (exceeding 7.5 mmol/day), as well as in the presence urolithiasis history requires regular monitoring of urinary calcium excretion. If necessary, reduce the dose or discontinue the drug. In case of impaired renal function, the level of calcium and phosphate in the blood serum should also be monitored.

Patients with a tendency to form stones in urinary tract during treatment should be consumed a large number of liquids.

If not special indications, while taking Calcium Sandoz Forte, you should not take vitamin D and its derivatives in high doses.

People sticking dietary nutrition with limited salt intake, should take into account that 1 tablet of 500 mg contains 2.976 mmol of sodium, 1 tablet of 1000 mg contains 5.95 mmol (equivalent to 68.45 and 136.90 mg of sodium, respectively).

1 tablet of Calcium Sandoz Forte contains 0.002 XE, so the drug can be taken by patients with diabetes.

Negative impact on the ability to increased concentration The mineral supplement does not provide attention or visual acuity.

The absorption of calcium from the gastrointestinal tract is reduced by foods containing oxalic acid (for example, rhubarb and spinach) and phytic acid (cereals). For this reason, you should not take calcium 2 hours before or 2 hours after eating such a meal.

Drug interactions

Calcium Sandoz Forte may reduce the absorption of etidronate, estramustine and possibly other bisphosphonates, fluoride preparations, quinolones and phenytoin. Therefore, at least 3-hour intervals should be observed between taking these medications.

Calcium absorption is enhanced by vitamin D and its derivatives.

The combination of Calcium Sandoz Forte in high doses and vitamin D, when used simultaneously, reduces the effect of verapamil and, possibly, other calcium channel blockers.

When used in combination, the absorption of tetracycline antibiotics is impaired, so it is recommended to take them 2 hours before or 4-6 hours after taking a calcium supplement.

An increased dose of Calcium Sandoz Forte may be required when systemic corticosteroids are co-administered as they reduce calcium absorption.

Urinary calcium excretion is reduced when taking thiazide diuretics, which increases the risk of developing hypercalcemia. During treatment, it is necessary to regularly monitor the concentration of calcium in the blood serum.

Calcium Sandoz Forte may increase the toxicity of cardiac glycosides. Patients receiving these drugs require ECG monitoring and monitoring of blood calcium levels.