Usage
This combination of nutrients is primarily prescribed for the prevention and management of nutritional deficiencies, particularly those related to bone health, calcium and vitamin D metabolism, and red blood cell formation. It is commonly used to address conditions like osteoporosis, osteomalacia, rickets, and hypoparathyroidism. It may also be prescribed as an adjunct therapy for secondary hyperparathyroidism in patients undergoing renal dialysis. The combination supports bone health, enhances calcium absorption, and contributes to overall metabolic function. Since this is a combination of nutrients rather than a single drug entity, it does not fall under a single pharmacological classification.
Alternate Names
This combination medication does not have a universally recognized International Nonproprietary Name (INN). It is often referred to by the names of its constituent ingredients. Several brand names exist depending on the manufacturer, including Travocal K2 and C-More K2.
How It Works
Pharmacodynamics: This combination exerts its effects through the synergistic action of its components:
- Calcitriol: The active form of vitamin D, calcitriol increases intestinal absorption of calcium and phosphate. It stimulates osteoclasts (bone-resorbing cells) and promotes calcium reabsorption in the kidneys.
- Calcium Citrate Malate: A highly bioavailable form of calcium, crucial for bone mineralization and various physiological processes.
- Vitamin K2-7 (Menaquinone-7): Activates osteocalcin, a protein that facilitates calcium incorporation into bone matrix, and Matrix Gla protein (MGP), which inhibits vascular calcification.
- Folic Acid (Vitamin B9): Essential for cell division and growth, crucial in red blood cell production and DNA synthesis.
- Methylcobalamin (Vitamin B12): Plays a vital role in nerve function, DNA synthesis, and red blood cell formation.
- Omega-3 Fatty Acids: Exert anti-inflammatory effects and contribute to cardiovascular health.
- Boron: While its exact role in humans is still under investigation, boron is thought to influence calcium metabolism and bone health.
Pharmacokinetics: The individual components have different pharmacokinetic properties:
- Calcitriol: Absorbed in the small intestine, metabolized in the liver and kidneys, and excreted mainly in bile.
- Calcium Citrate Malate: Absorbed in the small intestine, influenced by vitamin D levels and dietary factors.
- Vitamin K2-7: Absorbed in the small intestine and stored in various tissues, including the liver.
- Folic Acid and Methylcobalamin: Absorbed in the small intestine and stored in the liver.
- Omega-3 Fatty Acids: Absorbed in the small intestine and incorporated into cell membranes.
- Boron: Absorbed in the gastrointestinal tract and excreted primarily in urine.
Dosage
Dosage recommendations should be individualized based on the patient’s specific needs and the clinical context. Since this is a combination of multiple nutrients, dosage is not standardized and needs to be determined by a physician based on individual patient needs and the clinical context.
Standard Dosage
No standardized dosage exists.
Clinical Use Cases
Dosage in clinical settings should be determined on a case-by-case basis by the attending physician.
Dosage Adjustments
Dose adjustments are crucial for patients with renal impairment, hepatic dysfunction, and other comorbid conditions. These adjustments must be made under strict medical supervision.
Side Effects
Common Side Effects
Gastrointestinal upset, nausea, constipation, headache, fatigue, dry mouth are possible.
Rare but Serious Side Effects
Hypercalcemia, hypercalciuria, allergic reactions.
Contraindications
Hypercalcemia, hypervitaminosis D, hypersensitivity to any component of the formulation, severe renal impairment.
Drug Interactions
Potential interactions may occur with certain medications, including some antibiotics, antacids, and anticonvulsants. Patients should disclose all medications and supplements they are taking to their doctor.
Pregnancy and Breastfeeding
This combination should be used during pregnancy and breastfeeding only if clearly needed and under strict medical supervision.
Drug Profile Summary
See information above.
Popular Combinations
This combination is itself a collection of frequently combined nutrients. Specific combinations and their rationale can vary based on the patient’s individual needs.
Precautions
Assess renal function and calcium levels before starting treatment. Monitor for signs of hypercalcemia. Caution is advised in patients with a history of kidney stones.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for this combination?
A: There is no universally recommended dosage. The appropriate dosage is determined by a healthcare professional considering the patient’s specific needs and clinical condition.
Q2: What are the common side effects?
A: Common side effects may include gastrointestinal issues like nausea, constipation, and stomach upset.
Q3: Can pregnant or breastfeeding women take this combination?
A: It should be used during pregnancy and breastfeeding only if clearly needed and under strict medical supervision.
Q4: Are there any contraindications?
A: Yes, contraindications include hypercalcemia, hypervitaminosis D, and hypersensitivity to any of the ingredients.
Q5: What are the signs of hypercalcemia to watch out for?
A: Signs of hypercalcemia can include nausea, vomiting, constipation, increased thirst, and frequent urination. Severe cases can involve confusion, lethargy, and cardiac arrhythmias.
Q6: How does Vitamin K2-7 contribute to bone health?
A: Vitamin K2-7 activates osteocalcin, which helps incorporate calcium into the bone matrix, strengthening bones.
Q7: What role does boron play in this combination?
A: Boron’s exact role is still being investigated, but it is thought to affect calcium metabolism and bone health.
Q8: Can this combination interact with other medications?
A: Yes, it can potentially interact with certain medications. It is crucial to inform your doctor about all other medications and supplements you are taking.
Q9: What should patients do if they experience side effects?
A: Patients should contact their healthcare provider immediately if they experience any adverse effects.
