Usage
This combination medication is primarily prescribed for conditions related to calcium deficiency, vitamin D deficiency, and bone health, such as osteoporosis (especially post-menopausal and corticosteroid-induced), and for preventing fractures in individuals with osteoporosis. It may also be used in patients with renal failure who have bone problems. It also supports general health and nerve function. Note that Omega-3 fatty acids are not typically included in this specific combination based on the provided sources.
Pharmacological Classification: This is a combination product with multiple classifications including:
- Vitamin supplement (Calcitriol, Vitamin K2-7, Methylcobalamin, L-Methyl Folate)
- Mineral supplement (Calcium Carbonate, Magnesium, Zinc Sulphate Monohydrate)
Mechanism of Action: This combination works synergistically to improve bone health and overall well-being:
- Calcitriol (Vitamin D3): Increases calcium absorption in the gut.
- Calcium Carbonate: Provides a source of calcium for bone mineralization.
- L-Methyl Folate: Plays a role in cell growth and division, supporting bone health.
- Magnesium: Essential for bone formation and calcium absorption.
- Methylcobalamin (Vitamin B12): Important for nerve function and red blood cell production.
- Vitamin K2-7: Directs calcium to the bones and prevents its deposition in soft tissues.
- Zinc Sulphate Monohydrate: Contributes to bone formation and maintenance.
Alternate Names
There is no single official alternate name for this combination medication. It is often referred to by the individual components it contains. Brand names include: Swascal K2-7 Plus, Betercal K2-7, and Z-CARE-K2.
How It Works
Pharmacodynamics: The components work synergistically to support bone health, nerve function, and general well-being. Calcitriol enhances calcium absorption while vitamin K2-7 ensures calcium is deposited in bone tissue. Magnesium, zinc, and L-methylfolate support bone formation and health. Methylcobalamin plays a critical role in nerve function.
Pharmacokinetics:
- Absorption: Calcium carbonate is absorbed in the small intestine, calcitriol is absorbed in the gut, Vitamin K2-7 absorption is improved with fats, methylcobalamin is absorbed in the terminal ileum, L-Methylfolate is absorbed from the small intestine and zinc sulphate monohydrate is absorbed in the jejunum.
- Metabolism: Calcitriol undergoes hepatic metabolism, methylcobalamin is stored in the liver, Vitamin K2-7 is metabolized in the liver and L-Methylfolate is metabolized in the liver.
- Elimination: Calcium is excreted renally and through feces. Calcitriol and Vitamin K metabolites are excreted in bile and urine. Methylcobalamin is excreted in bile and urine. L-Methylfolate is excreted renally and zinc is mainly excreted in faeces.
Mode of Action: Calcitriol binds to vitamin D receptors. Calcium carbonate acts as the main source of calcium. Methylcobalamin is a cofactor in numerous metabolic processes and L-Methylfolate is involved in DNA synthesis, amino acid metabolism. Vitamin K2-7 activates osteocalcin, a bone-specific protein. Zinc influences bone formation and mineralization.
Receptor Binding/Enzyme Inhibition/Neurotransmitter Modulation: Calcitriol acts on Vitamin D receptors. Methylcobalamin acts as a cofactor.
Elimination Pathways: Renal and hepatic excretion for various components.
Dosage
Dosage is dependent upon individual patient needs and should be determined by a physician.
Standard Dosage
Adults: Typically, one capsule per day, or as directed by the physician.
Children: Dosage should be determined by a pediatrician based on age, weight, and specific needs.
Special Cases: Dosage adjustments may be necessary for patients with renal impairment, hepatic dysfunction, or other comorbid conditions. This should be carefully assessed by a physician.
Clinical Use Cases
The combination is not typically indicated for acute clinical situations like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
Dose modifications are based on the patient’s specific condition, renal function, and hepatic function, as determined by the treating physician.
Side Effects
Common Side Effects:
- Constipation
- Nausea
- Hypercalcemia (elevated blood calcium)
Rare but Serious Side Effects:
- Kidney stones
- Cardiac arrhythmias
Long-Term Effects: Long-term excessive intake can lead to hypercalcemia and its associated complications.
Adverse Drug Reactions (ADR): Allergic reactions are possible.
Contraindications
- Hypercalcemia
- Vitamin D toxicity
- Hypersensitivity to any of the components
Drug Interactions
- Thiazide diuretics (may increase calcium levels)
- Some antibiotics (may affect calcium absorption)
- Levothyroxine (calcium can interfere with absorption)
Pregnancy and Breastfeeding
Consult with a physician before using this combination during pregnancy or breastfeeding. Dosage adjustments may be needed.
Drug Profile Summary
See information provided in prior sections.
Popular Combinations
Often prescribed as a stand-alone supplement or in conjunction with other bone health medications such as bisphosphonates if deemed necessary by a doctor.
Precautions
Monitor calcium levels regularly. Patients with pre-existing conditions should consult their physician before taking this combination. Caution advised for pregnant and breastfeeding women.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for this combination?
A: Dosage is patient-specific and determined by the treating physician. Typically, one capsule per day is recommended for adults.
Q2: Can this combination be used during pregnancy?
A: Consult a physician before use during pregnancy or breastfeeding.
Q3: What are the common side effects?
A: Common side effects include constipation, nausea, and possible hypercalcemia.
Q4: Are there any drug interactions I should be aware of?
A: Yes, interactions with thiazide diuretics, some antibiotics, and levothyroxine are possible. Consult a physician for a comprehensive list.
Q5: How does Vitamin K2-7 benefit bone health in this combination?
A: Vitamin K2-7 directs calcium to the bones and prevents its deposition in arteries and soft tissues.
Q6: Can this combination be used in patients with renal impairment?
A: Dosage adjustments may be needed in patients with renal impairment. Consult a nephrologist.
Q7: What should I monitor while a patient is on this combination?
A: Regularly monitor serum calcium levels.
Q8: What is the role of Methylcobalamin in this combination?
A: Methylcobalamin supports nerve health and red blood cell production.
Q9: What is the role of Magnesium in bone health?
A: Magnesium is essential for calcium absorption and bone formation.
